The Prevalence of Oral Malodor and Associated Factors Among Dental Students from Twin Cities, Pakistan

Objective: To assess the prevalence of halitosis and the factors associated with it among dental students in Rawalpindi and Islamabad, Pakistan. Methodology: A cross-sectional study conducted, and a sample of dental students was collected from four dental colleges in twin cities of Pakistan. The survey was conducted between December 2023 and April 2024, using a non-probability convenience sampling technique. A total of 450 participants were approached through shared link of the Google form. A self-reported questionnaire was administered and informed consent was obtained. The associations between oral malodor and different variables of the study were evaluated using Chi-square test and logistic regression analysis. Statistical significance was determined using a 95% confidence interval (CI). Results: Three hundred and one participants (aged 18–24 years) completed the survey with a response rate of 66.8%. The study found that 75.4% of participants suffered from bad breath, or halitosis, with a notable difference in how bothered they were by it - 78.7% were concerned, while 25.9% considered it normal. The majority (63.1%) experienced bad breath in the morning. Despite the 75.4% prevalence, only 14.7% had a dental check-up for oral malodor, and 31.2% attempted self-medication. Tongue deposits/coating were more common among participants with severe halitosis (25.6%) than those with mild halitosis (9.5%). However, there was no significant difference in oral hygiene practices between those with minimal and profound halitosis, suggesting that factors beyond oral hygiene contribute to the severity of bad breath. Conclusions: The study identified high prevalence of halitosis among dental students. They should be appropriately diagnosed and managed by a dentist. The regular toothbrushing, use of dental floss, mouthwash and removal of tongue coating can significantly reduce halitosis and improve the quality of life.