Research links periodontitis and halitosis

Franziska Beier, Dental Tribune International

Tue. 30. March 2021

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SEOUL, South Korea: As periodontitis and halitosis share a microbiological pathogenesis, researchers from the Seoul National University School of Dentistry have investigated whether there is a correlation between the two. They found that halitosis may be an indicator of periodontitis and thus of the development of other systemic diseases.

To date, there has been little data on the possible association between periodontitis and halitosis after adjusting for relevant covariates. Driven by this research gap, the research team aimed to explore this correlation in South Korean adults. A total of 302 participants, aged between 47 to 86 years and recruited from a South Korean health cohort from 2015, were considered for analysis.

The study results showed a 1.8 times higher risk of halitosis among individuals with periodontitis compared with those without the disease. Periodontitis was associated with halitosis independent of known confounders, including age, sex, education level, smoking, dietary preferences, oral hygiene habits and other oral conditions.

The researchers suggested that, as advanced periodontitis leads to deepened periodontal pockets in which periodonto-pathogenic microorganisms thrive, this may accelerate the production of malodorous gases. They also put forth inflammation-associated hyperaemia of the gingival tissue as another explanation for halitosis in periodontal patients.

While acknowledging some limitations of the study, the researchers emphasised that their study has “some strength”, as the findings highlight the possibility of periodontal health as a clinical indicator of halitosis. In addition, halitosis may indicate a risk of patients developing system disease, including cardiovascular disease and diabetes.

Further studies are needed to clarify the causality and mechanism of the association between periodontitis and halitosis. Nevertheless, the research team emphasised that the data confirms that bad breath is not solely “a social handicap but a potentially associated factor with periodontal disease status”.

The researchers concluded: “Dentists should take periodontal conditions into account for preventing or controlling dental patients’ oral malodour. Likewise, physicians are advised to provide care for oral malodour patients with the possibility of periodontitis as a source of the malodour.”

The study, titled “Association of periodontitis with oral malodor in Korean adults”, was published online on 4 March 2021 in PLOS ONE.

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