Influence of Alcohol Consumption, Tobacco Use, and Liquid Intake on Halitosis in the Elderly: A Cross-Sectional Study

Background: Halitosis affects people all around the world, but its prevalence is higher in the elderly due to some factors such as poor oral hygiene, changes in eating habits, use of dentures, reduced salivary flow, presence of systemic diseases and use of multiple medications.

Aims: The aim of this study was to evaluate the association of external factors on the breath of elderly Brazilians aged 65 to 74 years.

Study Design: Analytical cross-sectional study.

Place and Duration of Study: 50 elderly people, living in Juiz de Fora and registered in the Family Health Strategies (FHS), from January to May 2019.

Methodology: Individuals of both sexes, aged between 65 and 74 years, were included. The following information was collected: halitosis measurement, questionnaires on socioeconomic data and daily habits/practices, smoking and alcohol consumption. Halitosis was measured using a portable halimeter, and for addictions to alcoholism and smoking, the AUDIT and QSU-B questionnaires were used, respectively. Pearson's chi-square test was performed, the odds ratio was calculated, and the univariate and multivariate logistic regression model was constructed, using pseudo-R2 measurements.

Results: The mean age of the 220 individuals was 69.9 (± 2.9) years, and 59% were female. Of these, 111 (50.5%) had excellent to good breath. Older adults aged 70 to 74 years were more likely to have halitosis (OR: 3.01; CI 1.71-5.31; p<0.001) in relation to the elderly aged 65 to 69 years. Individuals who cleaned their mouths once or twice/day were 9.11 times more likely to have halitosis than those who cleaned their mouths three or more times/day. In the multivariate analysis, it was observed that age, sex, fluid intake and alcoholism addiction explained on average 16% of the occurrences of breath changes in the studied population, with a statistically significant association with lower amounts of daily fluid intake (OR: 2.10; CI: 1.55 – 2.84; p<0.001) and greater dependence on alcoholism (OR: 2.12: CI: 1.27 – 3.53; p= 0.004). Each additional year of life increases the chance of halitosis by 7% and the individual being male reduces the chance of having halitosis by 38%, although p values were not significant for these variables.

Conclusion: This study demonstrated the correlation between lifestyle habits, such as fluid consumption, frequency of hygiene, alcohol dependence, use of tobacco and halitosis in the elderly.