Correlation between Self-Perception and Objective Assessments of Halitosis

Objectives: Self-perceived halitosis is often associated with significant psychological and social effects. Objective assessment by qualified dental care providers should aid in the correct diagnosis and treatment of this condition. Methods for the objective assessment of oral malodor include organoleptic scoring and the use of the Halimeter sulfide monitor, and clinical assessments of periodontal health. The aim of this study was to investigate the correlation between self-perceived and objectively assessed oral malodor. Methods: A questionnaire assessing self-perception of halitosis was administered to 39 subjects (mean age=33.9±12.9 years), followed by a thorough clinical examination. Clinical assessments included organoleptic scoring of expelled mouth air, Halimeter scores, BANA bacterial tests, tongue coating, and pocket depth (PD) and bleeding on probing (BOP) measurements on Ramfjord's index teeth. Statistical tests included univariate analyses and Pearson correlation coefficients. Results: Seventeen (43.6%) patients reported self perception of halitosis, while 20 (51.3%) patients had clinically objectionable breath as assessed by an organoleptic score of 2 or more. Mean Halimeter scores were not significantly different between patients with or without self-perceived halitosis (161.5 vs. 123.1 p.p.b.; p=0.33). No correlation was found between organoleptic scores or Halimeter readings and self-perceived halitosis. However, organoleptic scores were significantly correlated with both mean PD (r=0.605; p<0.001) and BOP (r=0.342; p<0.05) measurements. Conclusions: No significant correlations were found between self-perceived and objectively assessed oral malodor in this sample of patients. However, clinical assessments of periodontal health were significantly correlated with organoleptic scores.