Prevalence of Self-Reported Halitosis in Individuals With Type 1 and Type 2 Diabetes Mellitus: A Cross-Sectional Study

Background: Diabetes mellitus (DM) is a well-known metabolic disorder that leads to multiple oral complications, including increased caries incidence, periodontal breakdown, periapical abscesses, and delayed wound healing. Oral malodor is influenced by local (intraoral) and systemic (extraoral) factors. DM is believed to have a direct influence on both intra and extra oral halitosis. The aim of the study was to evaluate the prevalence of self-reported halitosis among diabetic individuals and compare it between type 1 and type 2 diabetes. Methods: A cross-sectional online survey consisting of 34 questions was used. The survey collected demographic, medical and lifestyle data, as well as halitosis-related parameters. The survey was validated by two experts and piloted with 30 participants to ensure clarity and reliability. The targeted sample consisted of individuals with type 1 DM (group I), type 2 DM (group II), and a control group of healthy subjects (group III). Results: A total of 632 surveys were analyzed, with 12 subjects excluded due to reported loss of smelling ability. Halitosis was self-reported by 50.7%, 48.0% and 28.0% of groups I, II and III, respectively. Subjects with DM reported a higher intensity of halitosis (P value = 0.005), with more than 65% of respondents reported smelling ability score more than 8 out of 10, and the subjects with diabetes reported significantly less smelling ability score. Only 1.7% of subjects with DM were informed about their halitosis by a healthcare provider. Conclusions: DM demonstrates a significant correlation with halitosis prevalence and intensity, with similar outcomes observed in individuals with type 1 and type 2 DM. The reported reduced smelling ability in patients with DM may lead to an underestimation of self-reported halitosis. Moreover, insufficient communication from healthcare providers further exacerbates this issue.