title: Prevalence of halitosis in young male adults: a study in swiss army recruits comparing self-reported and clinical data.
abstract: BACKGROUND
  Sound epidemiologic data on halitosis are rare. We evaluated the prevalence of halitosis in a young male adult population in Switzerland using a standardized questionnaire and clinical examination.
  
  
  METHODS
  Six hundred twenty-six Swiss Army recruits aged 18 to 25 years (mean: 20.3 years) were selected as study subjects. First, a standardized questionnaire focusing on dental hygiene, self-reported halitosis, smoking, and alcohol consumption was filled out by all participants. In the clinical examination, objective values for the presence of halitosis were gathered through an organoleptic assessment of the breath odor and the measurement of volatile sulfur compounds (VSCs). Additionally, tongue coating, plaque index, and probing depths were evaluated for each recruit.
  
  
  RESULTS
  The questionnaire revealed that only 17% of all included recruits had never experienced halitosis. The organoleptic evaluation (grades 0 to 3) identified eight persons with grade 3, 148 persons with grade 2, and 424 persons with grade 1 or 0. The calculation of the Pearson correlation coefficient to evaluate the relationship among the three methods of assessing halitosis revealed little to no correlation. The organoleptic score showed high reproducibility (kappa = 0.79). Tongue coating was the only influencing factor found to contribute to higher organoleptic scores and higher VSC values.
  
  
  CONCLUSIONS
  Oral malodor seemed to pose an oral health problem for about one-fifth of 20-year-old Swiss males questioned. No correlation between self-reported halitosis and organoleptic or VSC measurements could be detected. Although the organoleptic method described here offers a high reproducibility, the lack of correlation between VSC values and organoleptic scores has to be critically addressed. For further studies assessing new organoleptic scores, a validated index should always be included as a direct control.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Stocker
authors.forename: Rainer
authors.initials: R
authors.lastname: Seemann
authors.forename: Walter B
authors.initials: WB
authors.lastname: Bürgin
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D001294:Attitude to Health; D015331:Cohort Studies; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data; D003774:Dental Plaque Index; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006209:Halitosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D009910:Oral Hygiene / Q000706:statistics & numerical data; D010514:Periodontal Pocket / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012466:Salivary Gland Diseases / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D013457:Sulfur Compounds / Q000032:analysis; D013557:Switzerland / Q000453:epidemiology; D014060:Tongue Diseases / Q000453:epidemiology; D014099:Toothbrushing / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D013457:Sulfur Compounds