Musa Hamsah, Bratu Dana-Cristina, Pașca Ioana Georgiana, Popa Malina, Luca Magda Mihaela, Balean Octavia, Dumitrescu Ramona, Rosianu Ruxadra Sava, Galuscan Atena, Oancea Roxana
Doctoral School, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Department of Orthodontics II, Orthodontic Research Centre, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Revolutiei Boulevard 9, 300041 Timisoara, Romania.
J Clin Med. 2025 Jun 5;14(11):3995. doi: 10.3390/jcm14113995.
Halitosis poses a clinical and psychosocial burden, particularly in orthodontic contexts where plaque retention can exacerbate odor production. This cross-sectional study aimed to compare halitosis and oral health-related quality of life (OHRQoL) in three distinct groups: patients wearing removable clear aligners, patients with lingual orthodontic brackets, and non-orthodontic controls. We further explored dietary factors (frequent snacking vs. infrequent snacking) to identify their influence on halitosis severity and self-perceived well-being. A total of 162 participants (55 aligners, 58 lingual brackets, 49 controls) were recruited. Halitosis was assessed by the Halitosis Associated Life-Quality Test (HALT) questionnaire (range 0-100) and an organoleptic evaluation (range 0-5). OHRQoL was examined with the OHIP-14 instrument (range 0-56). Data on frequent vs. infrequent snacking were also recorded. One-way ANOVAs with Tukey's post hoc and chi-square tests were utilized for group comparisons. Spearman's correlation examined relationships between HALT scores, organoleptic measures, and OHIP-14. A significance threshold of < 0.05 was adopted. Aligner users demonstrated lower mean HALT scores (31.7 ± 5.8) compared to the lingual group (37.4 ± 6.2, = 0.001) and controls (34.6 ± 6.0, = 0.039). Lingual bracket wearers had the highest mean organoleptic score (2.4 ± 0.6, < 0.001). Frequent snackers exhibited worse HALT outcomes (36.9 ± 6.3) than infrequent snackers (32.6 ± 5.9, = 0.005). A correlation analysis showed a moderate positive correlation (r = +0.52, < 0.001) between HALT and organoleptic scores and a strong negative relationship (r = -0.63, < 0.001) between HALT and OHIP-14. Removable aligner use correlated with lower self-reported halitosis and better OHRQoL relative to lingual brackets. Frequent snacking appeared to aggravate halitosis across all groups. These findings emphasize the importance of tailored oral hygiene measures, dietary counseling, and orthodontic appliance selection to mitigate halitosis and enhance overall well-being.
口臭会带来临床和心理社会负担，尤其是在正畸情况下，牙菌斑的留存会加剧气味产生。这项横断面研究旨在比较三组不同人群的口臭情况以及与口腔健康相关的生活质量（OHRQoL）：佩戴可摘式透明矫治器的患者、使用舌侧正畸托槽的患者以及非正畸对照人群。我们进一步探究了饮食因素（频繁吃零食与不频繁吃零食），以确定它们对口臭严重程度和自我感知幸福感的影响。总共招募了162名参与者（55名佩戴矫治器者、58名佩戴舌侧托槽者、49名对照者）。通过口臭相关生活质量测试（HALT）问卷（范围0 - 100）和感官评估（范围0 - 5）对口臭进行评估。使用OHIP - 14工具（范围0 - 56）检查OHRQoL。还记录了频繁吃零食与不频繁吃零食的数据。采用单因素方差分析及Tukey事后检验和卡方检验进行组间比较。Spearman相关性分析检验了HALT评分、感官测量值与OHIP - 14之间的关系。采用的显著性阈值为<0.05。与舌侧组（37.4±6.2，P = 0.001）和对照组（34.6±6.0，P = 0.039）相比，佩戴矫治器者的平均HALT评分较低（31.7±5.8）。佩戴舌侧托槽者的平均感官评分最高（2.4±0.6，P<0.001）。频繁吃零食者的HALT结果（36.9±6.3）比不频繁吃零食者（32.6±5.9，P = 0.005）更差。相关性分析显示，HALT与感官评分之间存在中度正相关（r = +0.52，P<0.001），HALT与OHIP - 14之间存在强负相关（r = -0.63，P<0.001）。相对于舌侧托槽，使用可摘式矫治器与自我报告的口臭程度较低和更好的OHRQoL相关。在所有组中，频繁吃零食似乎都会加重口臭。这些发现强调了针对性口腔卫生措施、饮食咨询和正畸矫治器选择对于减轻口臭和提高整体幸福感的重要性。
