Self Reported Halitosis in Relation to Glycated Hemoglobin Level in Diabetic Patients

Mohammad S Al-Zahrani1, Khalid H Zawawi2, *, Obadah N Austah3, Hamed S Al-Ghamdi4
1 Department of Oral Basic and Clinical Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
2 Department of Preventive Dental Science, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
3 Dental Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
4 Dental Department, King Fahad Military Hospital, Jeddah, Saudi Arabia

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© Al-Zahrani et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Preventive Dental Science, Faculty of Dentistry, King Abdulaziz University,P.O. Box 80209, Jeddah 21589, Saudi Arabia; Tel: +(966-2) 640-3443; Ext: 21265; Fax: +(966-2) 640-3316; E-mail:; Website:



This study was conducted to examine the relationship between the glycated hemoglobin level (HbA1c) and halitosis status among diabetic patients affected with periodontitis and to examine if there is a relationship between halitosis and different periodontal parameters.

Methods and Materials:

Consecutive type 2 diabetic patients were recruited from patients presented for treatment at a University hospital. Age, gender and smoking were recorded. A structured questionnaire on patients’ perception of their oral health, halitosis and diabetes severity and control was completed. Peripheral blood samples were obtained and analyzed for HbA1c levels. In addition, periodontal clinical parameters including probing depth, clinical attachment level, bleeding on probing and plaque scores were recorded.


A total of 38 type 2 diabetic patients were selected. The mean age was 52.1 (±8.8) years. Sixteen subjects (42.1%) reported halitosis. Of these, 62.5% were females, and only one subject was a current smoker. The mean levels of HbA1c were significantly different between those with and without halitosis, mean 9.6 (±2) and 8.2 (±1.6), respectively (p=0.03). No significant differences were found in the mean periodontal parameters between those with and without halitosis.


The results of this study suggest an association between halitosis and increased levels of HbA1c. Further studies are needed to explain the nature of this association.

Keywords: Halitosis, Bad Breath, Glycated Hemoglobin, HbA1c. Diabetes, Periodontitis.