Abstract: Objective To investigate the factors associated with halitosis in Shanghai white-collar employees. Methods Subjects in three randomly selected office buildings in Shanghai, China, were enrolled in this cross-sectional study using cluster random sampling. Oral malodor was assessed by measuring volatile sulfur compounds (VSCs) with a portable sulfide monitor. Subjects oral health, including dental caries, periodontal status, and tongue coating, was evaluated clinically. A questionnaire was used to obtain information about participants demographic characteristics, oral hygiene habits, and health behaviors. Results Of 805 subjects invited to participate in this study, 720 were enrolled (89.4% response rate) and data from these subjects were used for statistical analyses. The mean VSC was (117.47±102.56) mg/L, and the prevalence of halitosis was 33.2% (VSC ≥ 110 mg/L). In the final regression model, halitosis was significantly related to tongue coating thickness, periodontal pocket depth, food consumption within 2 h prior to oral examination, and intake frequency of sweet foods. Conclusion In this Shanghai white-collar population, tongue coating and periodontal disease were associated with halitosis. Oral hygiene education should be provided at the population level to encourage the maintenance of oral health and fresh breath. Sweet food may reduce VSC production, but this finding requires further investigation.

Key words: halitosis, tongue coating, periodontal disease, sweet food