How far does feedback on oral malodor assessment influence the decision to quit smoking?

DESIGN: A retrospective, uncontrolled, questionnaire-based, pre-post study involving adult male smoker volunteers who were invited to attend a one-day smoking cessation event at their workplace. OBJECTIVE: To assess the effect of feedback on motivation for smoking cessation using oral-malodor measurements. METHODS: At baseline, the participants attended a brief video presentation regarding various oral health-specific effects of smoking, joined a group introduction to smoking-cessation aids, and were given questionnaires that inquired information about smoking status including type, daily consumption, and duration. Subsequently, respiratory function and oral-malodor assessment were conducted using exhaled and oral cavity air, respectively. To measure oral-malodor, hydrogen sulfide, methyl mercaptan, and dimethyl sulfide concentrations were determined. Participants' intention for smoking cessation was evaluated through questionnaire before and after the event, classifying their intentions as aiming to quit within the next month, within the next 6 months, or having no intention to quit smoking. Immediate feedback on respiratory function and oral malodor measurements was provided by medical and dental blinded examiners, respectively. RESULTS: A total of 241 men, aged 20-54 years, were enrolled and included: 169 (70.1%) exclusive cigarette smokers, 39 (16.2%) exclusive heated-tobacco product users, and 33 (13.7%) users of both. Prior to the health event, 8.7%, 17.0%, and 74.3% of smokers expressed intentions to quit within the next month, the next 6 months, or had no intention to quit, respectively. After the event, the corresponding percentages shifted to 17.8%, 26.6%, and 55.6%. In multivariable logistic regression analysis, the association with intention to quit in the next month was significant only for methyl mercaptan concentration in oral cavity air, with an adjusted odds ratio (AOR) of 4.24 (95% CI: 1.52-11.84; p = 0.006). Sensitivity analysis revealed that this association was concentration-dependent. On the other hand, higher daily tobacco consumption (≥ 15 pieces) was significantly associated with less likely intention to quit in the next 6 months (AOR = 0.37; 95% CI: 0.15-0.92, p = 0.032). CONCLUSION: Feedback on oral malodor measurement may support the motivation of men to quit smoking within the next month, rather than waiting for the next 6 months.

Translation and validation of the Hindi version of the Geriatric Oral Health Assessment Index.

PURPOSE: To translate the original English version of the Geriatric Oral Health Assessment Index (GOHAI) into Hindi and assess its validity and reliability for use among people in India. MATERIALS AND METHOD: After translation into Hindi, a total of 385 participants aged 55+ demonstrated acceptable validity and reliability when used for people in India. Individual GOHAI items were recorded and summed as originally recommended. The questionnaire sought information about socio-demographic characteristics and self-reported perception of general and oral health. Clinical examination included assessment of periodontal status and number of decayed teeth, missing teeth, filled teeth and crowned teeth. RESULT: Mean GOHAI score was 40.9 (SD, 10.6; range, 12-60). Cronbach's alpha for the GOHAI score was 0.88, indicating a high degree of internal consistency and homogeneity between the GOHAI items. The test-retest correlation coefficient for add-GOHAI scores was 0.72, indicating good stability. Add-GOHAI scores increased with poorer perceived general and oral health. Convergent validity, construct validity and discriminant validity of the GOHAI were demonstrated. CONCLUSION: It could therefore be used as a valuable instrument for measuring oral health-related quality of life for people in this region.

Patients' self-assessment of oral malodour and its relationship with organoleptic scores and oral conditions.

OBJECTIVES: The aim of this study was to compare patients' self-rating of oral malodour with organoleptic evaluation and to relate them to oral conditions. METHODS: One hundred and eighty systemically healthy patients with a primary complaint of oral malodour participated in this cross-sectional study. They were asked to complete a questionnaire regarding family and social discomfort and type of halitosis complaint, and to score the degree of their own oral malodour. The quality of the mouth air was assessed organoleptically by a calibrated odour judge. Odour-judge scores and self-assessments of bad breath were compared with one another as well as with clinical parameters (plaque index, bleeding index, probing depth and tongue coating score). RESULTS: The organoleptic test revealed that 93.9% of the subjects were found actually to have halitosis. The self-rating of oral malodour varied widely among patients. In 37.8% of patients, there was a correspondence between subjective and organoleptic measurements. The better correspondence was evident at 2-3 scores. The organoleptic ratings were significantly related to clinical parameters, whereas patients' self-measurements did not. The bleeding index had the highest correlation coefficient among the periodontal parameters examined (r = 0.665, P < 0.001). CONCLUSIONS: Self-estimation of bad breath correlated well with the presence of oral malodour as determined by organoleptic examination. Patients with slight or moderate oral halitosis presented the highest correlation rate between self- and odour-judge assessment.

Variation in subjective oral health indicators of 65-year-olds in Norway and Sweden.

OBJECTIVE: Guided by the conceptual framework of Gilbert and co-workers, this study assesses satisfaction with oral health as reported by 65-year-olds in Sweden and Norway, the relationship of socio-demographic factors, clinical and subjective oral health indicators with satisfaction of oral health, and the consistency of those relationships across countries. MATERIAL AND METHODS: In 2007, standardized questionnaires were mailed to all the residents in two counties in Sweden and three in Norway who were born in 1942. Response rates were 73.1% (n=6078) in Sweden and 56.0% (n=4062) in Norway. RESULTS: Totals of 76.8% of the Swedish and 76.5% of the Norwegian participants reported satisfaction with oral health. Corresponding figures for toothache were 48.1% (Sweden) versus 51.5% (Norway), and for temporomandibular joint symptoms, 10.9% (Sweden) versus 15.1% (Norway). Multiple logistic regression analysis revealed that subjects who perceived they had bad health, smoked daily, had missing teeth, experienced toothache, had problems with chewing, bad breath, and oral impacts were less likely than their counterparts in the opposite groups to be satisfied with their oral health status. The corresponding odds ratios (ORs) ranged from 0.08 (problems chewing) to 0.2 (oral impact). No statistically significant two-way interactions occurred and the model explained 46% of the variance in satisfaction with oral health across the two countries (45% in Sweden and 47% in Norway). CONCLUSIONS: The oral condition of 65-year-olds in Norway and Sweden produced impacts in oral symptoms, functional limitations, and problems with daily activities that varied to some extent. Satisfaction with oral health varied by socio-demographic factors and subjective oral health indicators. A full understanding of the oral health and treatment needs of 65-year-olds cannot be captured by clinical measures alone.

Halitosis among racially diverse populations: an update.

The aim of this paper is to highlight the cultural perceptions of halitosis to dental professionals. Halitosis (oral malodour or bad breath) is caused mainly by tongue coating and periodontal disease. Bacterial metabolism of amino acids leads to metabolites including many compounds, such as indole, skatole and volatile sulphur compounds (VSC), hydrogen sulphide, methyl mercaptan and dimethyl sulphide. They are claimed to be the main aetiological agents for halitosis. Gastrointestinal diseases are also generally believed to cause halitosis. In general, physicians and dentists are poorly informed about the causes and treatments for halitosis. The paper reviews the prevalence and distribution of halitosis, oral malodour, its aetiology, concepts of general and oral health and diseases and their perception among racially diverse population. Eating, smoking and drinking habits and understanding of halitosis as a social norm among different people has been highlighted. The treatment options have also been presented very briefly. A brief discussion about general importance within existing healthcare services has been highlighted. Oral malodour may rank only behind dental caries and periodontal disease as the cause of patient's visits to the dentist. It is a public social health problem. The perception of halitosis is different in culturally diverse populations. So the dental professionals should be aware of the cultural perceptions of halitosis among racially and culturally diverse populations. There is a need to integrate the cultural awareness and knowledge about halitosis among the dental professional for better understanding of halitosis to treat patients with the social dilemma of halitosis to improve the quality of life and well-being of individuals with the problem. It is concluded that dental professionals (especially dental hygienists) should be prepared to practice in a culturally diverse environment in a sensitive and appropriate manner, to deliver optimal oral health and hygiene care.

Historical and social aspects of halitosis / Los aspectos históricos y sociales de halitosis / Aspectos históricos e sociais da halitose

Buccal odors have always been a factor of concern for society. This study aims to investigate the historical and social base of halitosis, through systematized research in the database BVS (biblioteca virtual em saúde - virtual library in health) and also in books. Lack of knowledge on how to prevent halitosis allows for its occurrence, limiting quality of life. As social relationships are one of the pillars of the quality of life concept, halitosis needs to be considered a factor of negative interference. Education in health should be accomplished with a view to a dynamic balance, involving human beings' physical and psychological aspects, as well as their social interactions, so that individuals do not become jigsaw puzzles of sick parts.

Los olores bucales siempre han sido un factor de preocupación para la sociedad, y ellos todavía son ahora. El objetivo de este estudio es hacer una base histórica y social en la halitosis. Fue efectuada una investigación sistematizada en la base de datos BVS (biblioteca virtual em saúde - la biblioteca virtual en salud) y también en los libros. La ignorancia en cómo prevenir la halitosis permite su ocurrencia, que limita la calidad de vida. Siendo las relaciones sociales uno de los pilares del concepto de calidad de vida, es necesario considerar la halitosis un factor de interferencia negativa. La educación en salud se debe llevar a cabo buscando un equilibrio dinámico, involucrando los aspectos físicos y psicológicos del ser humano, así como sus interacciones sociales, para que los individuos no se vuelvan rompecabezas de partes enfermas.

O problema referente aos odores bucais sempre foi fator de preocupação para a sociedade e ainda hoje se mostra presente. O objetivo do presente estudo foi realizar um embasamento histórico e social sobre a halitose. Para tanto, foi feita busca sistematizada, selecionando artigos por meio da base de dados BVS (Biblioteca Virtual em Saúde) e também pesquisa em livros. O desconhecimento sobre como prevenir halitose permite a sua ocorrência, limitando a qualidade de vida. Sendo os relacionamentos sociais um dos pilares do constructo qualidade de vida, é preciso considerar a halitose como fator de interferência negativa. A educação em saúde deve ser realizada visando o equilíbrio dinâmico, envolvendo aspectos físicos e psicológicos do ser humano, assim como suas interações sociais, para que os indivíduos não se tornem quebra-cabeças de partes doentes.

A cross-cultural comparison of dental health attitudes and behaviour among freshman dental students in Japan, Hong Kong and West China.

OBJECTIVE: To clarify the differences in dental health attitudes/behaviour among freshman dental students. DESIGN: Cross-cultural differences. SETTING: Japan, Hong Kong and West China. PARTICIPANTS AND METHODS: The original version of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) was written in Japanese. After testing the validity of both English and Chinese versions, the original version of the HU-DBI was administered to 58 freshman Japanese dental students, the English version to 43 Hong Kong Chinese peers and the Chinese version to 39 West Chinese peers. RESULTS: Significant cultural differences were found for 16 items out of 20. The most striking result was that the Japanese students were more likely to have used a dye to see how clean their teeth were, compared to their Chinese peers (P<0.001). The Chinese students were less likely to have a belief that they could clean their teeth well without using toothpaste (P<0.001), whereas higher percentages of the Chinese students worried about having bad breath (P<0.001). A higher percentage of the Hong Kong students reported that they regularly checked their teeth in a mirror than did their West Chinese or Japanese peers (P<0.05). CONCLUSIONS: There were considerable differences in dental health attitudes/behaviour among freshman dental students in the three cultural groups.

Self-assessment of oral malodor 1 year following initial consultation.

OBJECTIVE: In an initial study, subjects complaining of bad breath were generally unable to score the level of their own oral malodor in an objective fashion. Subjects were taught several techniques for self-measurement of bad breath. One year following the initial consultation, subjects were recalled to determine whether their ability to assess their own oral malodor had improved. METHOD AND MATERIALS: In the study, subjects were blinded to their own scores 1 year earlier, to the odor-judge scores, and to the results of the clinical laboratory tests. Thirty-two of 43 subjects in the original study who presented with a complaint of oral malodor agreed to participate in the follow-up study. Odor-judge scores and self-assessments of oral malodor (whole-mouth odor, tongue odor, and saliva odor) were compared with one another as well as with clinical parameters. RESULTS: Objective improvements were noted in both oral health parameters and malodor levels of subjects. Despite this, self-assessments generally remained unrelated to objective parameters (odor-judge scores, clinical indices, and laboratory tests). Self-assessments were all significantly correlated with one another, and also were significantly associated with corresponding self-estimates made 1 year earlier. CONCLUSION: Subjects with a complaint of oral malodor remain largely unable to score their own bad breath in an objective fashion. In addition, they are not capable of sensing reductions in oral malodor 1 year following the original assessment, even though, from a clinical standpoint, improvements have taken place.