Aim: To investigate whether halitosis is associated with impaired oral-health-related quality of life (OHRQoL).Materials and Methods: This is a systematic review of the literature. Electronic searches were performed in PubMed via Medline, Web of Science, Scopus, and EMBASE up to and including June 2021. Observational studies that assessed halitosis in association with OHRQoL were included. The pooled standardized mean difference (SMD) was estimated by meta-analysis.Results: Thirteen studies were included in the review; however, the meta-analysis included only 10 studies, all cross-sectional, comprising 2692 individuals. The overall meta-analysis showed an association between halitosis and impaired OHRQoL (SMD 0.51; 95% confidence interval 0.27-0.75). Subgroup analyses, however, indicated that this association remained only among adults. Neither the OHRQoL instrument nor the halitosis assessment method, or the cultural background, influenced the pooled estimates. Meta-regression analyses revealed that the OHRQoL instrument, the halitosis assessment method, and the sample composition did not explain the between-study heterogeneity. Methodological quality appeared to explain 20% of the overall heterogeneity, as studies with high risk of bias overestimated the magnitude of the association. Conclusion:Our findings suggest that halitosis is associated with impaired OHRQoL.
Aim To investigate and compare the effects of clinical and self‐perceived oral conditions on oral health‐related quality of life (OHRQoL) among young adults. Materials and methods Adults enrolled in the 1982 Pelotas birth cohort were included in this study. OHRQoL was assessed by the Oral Health Impact Profile‐14 (OHIP‐14) instrument. Clinical parameters such as dental caries, periodontitis, aesthetics, and occlusal characteristics, and tongue coating were collected through clinical evaluation, while dental anxiety and halitosis were self‐reported. Direct and indirect effects of clinical and self‐perceived oral conditions on OHRQoL were assessed using structural equation modelling. Results Five‐hundred and thirty‐nine individuals participated in this study. Dental caries (β = 0.12) and periodontitis (β = 0.11) were directly and indirectly (via halitosis, β = 0.05 for periodontitis only) associated with greater OHIP‐14 scores, while the other clinical conditions did not influence the OHIP‐14 scores. Dental anxiety and halitosis were also associated with higher OHIP‐14 scores (β = 0.31 and β = 0.27, respectively). Conclusions This study found a positive association between clinically diagnosed and self‐reported oral conditions and OHRQoL; however, the self‐reported conditions had a higher impact on OHRQoL.
The association between periodontitis and lifestyle factors has been widely investigated. However, an association between periodontitis and dietary patterns has not been explored. Therefore, this study investigated the association between periodontitis and food consumption among a Southern Brazil population. Data from the 1982 Pelotas Birth Cohort were used (n = 537). The exposure, periodontitis, was clinically measured and classified using the AAP/CDC system, then two latent variables were defined: ‘initial’ and ‘moderate/severe’ periodontitis. The consumption of in natura, processed, and ultra-processed foods (NOVA classification) was the outcome and measured in calories using the food frequency questionnaire (FFQ). Confounders were sex, maternal education, smoking status, xerostomia, and halitosis. Data were analyzed by structural equation modeling. ‘Initial’ periodontitis was associated with a higher consumption of in natura food (standardized coefficient (SC) 0.102; p-value = 0.040), versus processed (SC 0.078; p-value = 0.129) and ultra-processed (SC 0.043; p-value = 0.400) foods. ‘Moderate/severe’ periodontitis was associated with higher consumption of ultra-processed foods (SC 0.108; p-value = 0.024), versus processed (SC 0.093; p-value = 0.053) and in natura (SC 0.014; p-value = 0.762) foods. ‘Moderate/severe’ periodontitis appears to be associated with the consumption of processed and ultra-processed foods.
The suggested decision-making aims to facilitate clinicians' selection of the most appropriate restorative technique for reproducing color and appearance of anterior teeth after ultra-conservative preparation and according to different clinical scenarios CLINICAL SIGNIFICANCE: The selection of the appropriate ceramic material for each case is of major importance, since the entire treatment plan will be determined based on the type of ceramic material that will be used for the final restoration. Each restorative material has a specific tooth preparation requirement, indications, and limitations that shall be respected for maximum esthetical outcomes. (J Esthet Restor Dent 28:267-276, 2016).
The multidisciplinary nature and long duration of birth cohort studies allow investigation of the relationship between general and oral health and indicate the most appropriate stages in life to intervene. To date, the worldwide distribution of oral health-related birth cohort studies (OHRBCSs) has not been mapped, and a synthesis of information on methodological characteristics and outcomes is not available. We mapped published literature on OHRBCSs, describing their oral health-related data and methodological aspects. A 3-step search strategy was adopted to identify published studies using PubMed, Embase, Web of Science, and OVID databases. Studies with baseline data collection during pregnancy or within the first year of life or linked future oral health data to exposures during either of these 2 life stages were included. Studies examining only mothers' oral health and specific populations were excluded. In total, 1,721 articles were suitable for initial screening of titles and abstracts, and 528 articles were included in the review, identifying 120 unique OHRBCSs from 34 countries in all continents. The review comprised literature from the mid-1940s to the 21st century. Fifty-four percent of the OHRBCSs started from 2000 onward, and 75% of the cohorts were from high-income and only 2 from low-income countries. The participation rate between the baseline and the last oral health follow-up varied between 7% and 93%. Ten cohorts that included interventions were mostly from 2000 and with fewer than 1,000 participants. Seven data-linkage cohorts focused mostly on upstream characteristics and biological aspects. The most frequent clinical assessment was dental caries, widely presented as decayed, missing, and filled teeth (DMFT/dmft). Periodontal conditions were primarily applied as isolated outcomes or as part of a classification system. Socioeconomic classification, ethnicity, and country- or language-specific assessment tools varied across countries. Harmonizing definitions will allow combining data from different studies, adding considerable strength to data analyses; this will be facilitated by forming a global consortium.
ObjectivesTo investigate the association between self‐reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities.Materials and MethodsData were collected through a digital survey. A total of 1239 individuals from Aarhus University – Denmark, the University of Iowa, and the University of Florida – USA were included. Self‐reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self‐perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID‐19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach.ResultsThe total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self‐reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]).ConclusionOur findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.
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