Factors Associated with Self-Perceived Halitosis in Kuwaiti Adults

Objectives: Oral malodor is a common complaint of dental patients. The majority of oral malodor has been reported to originate from the oral cavity, while systemic causes account for a minority of cases. The aim of this study was to examine the association of self-perceived oral malodor with demographic, medical, and dental history variables in a sample of Kuwaiti adults. Methods: A 19-point structured questionnaire assessing socio-demographic variables, medical and dental histories, oral hygiene habits, and self perception of halitosis was completed by 1551 adult subjects (response rate=86.2%). Logistic regression analysis was utilized to examine significant associations. Results: The mean age of subjects was 28.6 ± 11.5 years, and 23.3% had self-perceived halitosis. Use of the toothbrush less than once daily was the factor most strongly associated with self-perceived halitosis (OR= 2.68; 95% C.I.= 1.83-3.92; p< 0.001), followed by current or past smoking (OR= 2.51; 95% C.I.= 1.79-3.53; p< 0.001). Other factors significantly associated with self-perceived halitosis included female gender (OR= 1.54; 95% C.I.= 1.11-2.13; p= 0.009), being 30 years of age or older (OR= 1.35; 95% C.I.= 1.01-1.80; p= 0.044), having high school education or less (OR= 1.41; 95% C.I.= 1.07-1.84; p= 0.014), history of chronic sinusitis (OR= 1.58; 95% C.I.= 1.13-2.21; p= 0.008) or gastrointestinal disorders (OR= 1.73; 95% C.I.= 1.19-2.52; p= 0.004), never using miswak (OR= 1.56; 95% C.I.= 1.19-2.03; p= 0.001), and never using dental floss (OR= 1.33; 95% C.I.= 1.02-1.73; p= 0.039). Conclusion: Inadequate oral hygiene practices are the factors most strongly associated with self-perceived oral malodor in this sample of Kuwaiti subjects.