The Impact of COVID-19 on Halitosis among the General Population in Saudi Arabia: A Potential Symptom
Background: This study assessed the impact of COVID-19 on levels of self-perceived halitosis among adults in Saudi Arabia. Methods: A total of 1,143 participants completed the study questionnaire, which was distributed online via different social media platforms. The Halitosis Associated Life-quality Test (HALT) and other questions were used to assess halitosis and various behaviors related to halitosis during the COVID-19 pandemic. Results: Participants’ mean HALT score was 14.21 (out of 100), with a standard deviation of 17.52. Regarding self-perceived halitosis, 6.2% reported having halitosis, and 51% sometimes did. All participants used at least one natural remedy to protect themselves from or to treat COVID-19 during the lockdown; the most common item related to good breath was honey (38.40%), and for bad breath, it was garlic (15.5%). Participants who had COVID-19 and did not lose their sense of smell had significantly higher HALT scores than those not infected with COVID-19 (p=0.01). A total of 24% thought the COVID-19 pandemic improved their hygiene; 32.20% noticed a bad smell after wearing masks, and 30.7% thought that wearing the mask prevented others from noticing their halitosis. Conclusion: This study indicated a low level of self-perceived halitosis among the population in Saudi Arabia during the COVID-19 pandemic. The lockdown changed Saudi Arabia residents’ behaviours in ways that affected perception of and treatment for halitosis. It is suggested that halitosis might be a secondary symptom of COVID-19 infection; however, more studies are needed for validation.