Correlation among Halitosis, Xerostomia and Stress in Adults

일부 성인의 구취와 구강건조감 및 스트레스의 관련성

  • Received : 2016.09.05
  • Accepted : 2016.09.21
  • Published : 2016.10.31


This study is conducted to provide a basis for effective management of bad breath with a poll in 155-scaling patients visiting the dental hygiene department of a university located in Gyeong-gi province after grasping the relevance among halitosis, xerostomia, and stress from them. Analysis was performed using PASW Statistics 18.0. The results of the halitosis measurements based on the general properties showed a significant difference in the hydrogen sulfide ($H_2S$) level depending on the patient's age; the highest level of 355.61 was observed in patients in their twenties followed by 227.85 in the fifties (p<0.001). The level was higher in cases with sinusitis or rhinitis (p=0.034). The $H_2S$ and $(CH_3)_2S$ levels showed are levant (r=0.492, p<0.01) correlation with the components of halitosis. Further, among other factors affecting breath odor, $(CH_3)_2S$ was shown to increase with increased stress. These results indicate that emotional factors, such as stress, should be considered when diagnosing patients with halitosis, and systematic and standardized diagnostic tools should be developed.




  1. Kleinberg I, Westbay G: Salivary and metabolic factors involved in oral malodor formation. J Periodontol 63: 768-775, 1992.
  2. Miyazaki H, Sakao S, Katoh Y, Takehara T: Correlation between volatile sulphur compounds and certain oral health measurements in the general population. J Periodontol 66: 679-684, 1995.
  3. Waler SM: On the transformation of sulfur-containing amino acids and peptides to volatile sulfur compounds (VSC) in the human mouth. Eur J Oral Sci 105: 534-537, 1997.
  4. Tonzetich J: Direct gas chromatographic analysis of sulphur compounds in mouth air. Arch Oral Biol 16: 587-597, 1971.
  5. Han KS: A study on the factors affecting feeling of oral malodor. J Korean Acad Med 27: 255-269, 2002.
  6. Spielman AI, Bivona P, Rifkin BR: Halitosis. A common oral problem. N Y State Dent J 62: 36-42, 1996.
  7. Tonzetich J: Production and origin of oral malodor. A review of mechanisms and methods of analysis. J Periodontol 48: 13-20, 1977.
  8. Tangerman A, Winkel EG: Intra- and extra-oral halitosis: finding of a new form of extra-oral blood-borne halitosis caused by dimethyl sulfide. J Clin Periodontol 34: 748-755, 2007.
  9. Kleinberg I, Wolff MS, Codipilly DM: Role of saliva in oral dryness, oral feel and oral malodour. Int Dent J 52: 236-240, 2002.
  10. Shon WY, Chun YH, Lee JY, Cho HG, Hong JP: A study of relationship between halitosis and salivary gland function. J Korean Acad Med 23: 353-359, 1998.
  11. Guggenheimer J, Moore PA: Xerostomia: etiology, recognition and treatment. J Am Dent Assoc 134: 61-69, 2003.
  12. Al-Hashimi I: Xerostomia secondary to Sjogren's syndrome in the elderly: recognition and management. Drugs Aging 22: 887-899, 2005.
  13. So JS, Chung SC, Kho HS, Kim YK, Chung JW: Dry mouth among the elderly in Korea: a survey of prevalence, severity, and associated factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110: 475-483, 2010.
  14. Spielman A, Ben-Aryeh H, Gutman D, Szargel R, Deutsch E: Xerostomia diagnosis and treatment. Oral Surg Oral Med Oral Pathol 51: 144-147, 1981.
  15. Bergdahl M, Bergdahl J: Low unstimulated salivary flow and subjective oral dryness: association with medication, anxiety, depression and stress. J Dent Res 79: 1652-1658, 2000.
  16. Heo HY, Shin SC, Cho JW, Park KS: A study about the relationship between worker's mouth-odor survey and factor analysis. J Korean Acad Dent Health 29: 368-384, 2005.
  17. Pai S, Ghezzi EM, Ship JA: Development of a visual analogue scale questionnaire for subjective assessment of salivary dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91: 311-316, 2001.
  18. Koh KB, Park JK, Kim CH: Development of the stress response inventory. J Korean Neuropsychiatr Assoc 39: 707-719, 2000.
  19. Yaegaki K, Sanada K: Biochemical and clinical factors influencing oral malodor in periodontal patients. J Periodontol 63: 783-789, 1992.
  20. Kazor CE, Loesche WJ: Longitudinal oral malodor treatment evaluation. Curr Infect Dis Rep 5: 110-134, 2003.
  21. Miyazaki H, Sakuo S, Katoh Y, Takehara T: Correlation between volatile sulfur compounds and certain oral health measurements in the general population. J Periodontol 66: 679-684, 1995.
  22. Lee YO, Hong JP, Lee TY: Halitosis and related factors among rural residents. J Korean Acad Med 32: 157-175, 2007.
  23. Park MS, Ryu SA: Degree of dry mouth and factors influencing oral health-related quality of life for community-dwelling elders. J Korean Acad Nurs 40: 747-755, 2010.
  24. Hong MH: Correlation between stress, dry mouth and halitosis in adults. J Korean Soc Dent Hyg 15: 389-397, 2015.
  25. Oh JK, Kim YJ, Kho HS: A study on the clinical characteristics of patients with dry mouth. J Korean Acad Med 26: 331-343, 2001.
  26. Ji MG: A study on relationship between halitosis causing factors and components. J Korea Inst Electron Commun Sci 8: 1971-1978, 2013.
  27. Choi JM: A study on the bad breath of some dental students and other students. J Korean Soc Dent Hyg 6: 494-503, 2006.
  28. Chung JS, Park HS, Na DW, Noh EK, Choi CH, Park J: Halitosis and related factors among adolescents in Korea. J Korean Acad Dent Health 34: 534-542, 2010.
  29. Jee YJ, Kim JS, Lee JH, Jeon ES: A study on the relationship between halitosis developments and oral environmental. J Dent Hyg Sci 10: 101-107, 2010.