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Self-reported Halitosis and Gastro-esophageal Reflux Disease in the General Population

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Abstract

Background

Patients with halitosis contact primary care practitioners, dentists, and gastroenterologists alike.

Objectives

It is unclear whether gastroesophageal reflux disease (GERD) is a risk factor for halitosis.

Design and Patients/Participants

We studied this possible relationship in the general population using the cross-sectional Study of Health in Pomerania (SHIP). Employing structured interviews, self-reported halitosis was assessed among 417 edentulous (toothless) subjects aged 40 to 81 years and among 2,588 dentate subjects aged 20 to 59 years. The presence of heartburn or acid regurgitation (GERD-related symptoms) at 4 levels (absent, mild, moderate, severe) was taken as exposure and used for logistic regression. Analyses were adjusted for relevant confounders, such as age, sex, depressive symptoms, history of chronic gastritis, history of gastric or duodenal ulcer, smoking, school education, and dental status.

Measurements and Main Results

We found a strong positive association between GERD-related symptoms and halitosis (odds ratio 12.94, 95% confidence interval (CI) 2.66–63.09, P = 0.002 for severe compared to no GERD-related symptoms) in denture-wearing subjects and a moderate, positive association between GERD-related symptoms and halitosis (odds ratio 2.24, 95% CI 1.27–3.92, P = 0.005) in dentate subjects with a clear dose–effect relationship.

Conclusions

The present study provides clear evidence for an association between GERD and halitosis. As there are effective treatments for GERD, these results suggest treatment options, such as proton pump inhibitors, for halitosis. These should be studied in randomized controlled trials.

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Abbreviations

DMF-S:

number of decayed, missing and filled surfaces

GERD:

gastroesophageal reflux disease

SHIP:

Study of Health in Pomerania

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ACKNOWLEDGMENTS

This work is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant no. ZZ9603), the Ministry of Cultural Affairs, and the Social Ministry of the Federal State of Mecklenburg-West Pomerania.

Conflicts of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Unit of Periodontology, University of Greifswald, Greifswald, Germany

    Franziska Struch, Christian Schwahn PhD & Thomas Kocher DDS, PhD

  2. Department of Medicine A/Gastroenterology, Endocrinology and Nutrition, University of Greifswald, Greifswald, Germany

    Henri Wallaschofski MD, PhD & Markus M. Lerch MD, PhD

  3. Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany

    Hans J. Grabe MD, PhD

  4. Department of Epidemiology and Social Medicine, University of Greifswald, Greifswald, Germany

    Henry Völzke MD, PhD

  5. Department of Pharmacology, University of Greifswald, Greifswald, Germany

    Peter Meisel PhD

  6. School of Dentistry, University of Greifswald, Greifswald, Germany

    Christian Schwahn PhD

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  1. Franziska Struch
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  2. Christian Schwahn PhD
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  3. Henri Wallaschofski MD, PhD
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  4. Hans J. Grabe MD, PhD
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  5. Henry Völzke MD, PhD
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  6. Markus M. Lerch MD, PhD
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  7. Peter Meisel PhD
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  8. Thomas Kocher DDS, PhD
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Corresponding author

Correspondence to Christian Schwahn PhD.

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Struch, F., Schwahn, C., Wallaschofski, H. et al. Self-reported Halitosis and Gastro-esophageal Reflux Disease in the General Population. J GEN INTERN MED 23, 260–266 (2008). https://doi.org/10.1007/s11606-007-0486-8

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  • DOI: https://doi.org/10.1007/s11606-007-0486-8

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