Job Stress Can Lead to Intestinal Inflammation and Subsequent Gut‐Originated Extraoral Halitosis

ABSTRACT Objectives Reports on stress‐associated halitosis are scarce and have only focused on intraoral halitosis. This work aimed to study stress‐associated extraoral halitosis (EOH) and further investigate its potential association with stress‐induced intestinal inflammation. Methods This retrospective study included 664 white‐collar employees with self‐reported stress‐associated halitosis. They underwent the organoleptic score (OLS) to assess halitosis, modified Brief Job Stress Questionnaire (BJSQ) score to assess job stress, OralChroma breath test to measure volatile sulfur compounds (VSCs) in breath, and hydrogen/methane breath test (HMBT) and nitric oxide breath test (NOBT) to detect intestinal inflammation. They were classified into high‐stress and low‐stress groups based on their modified BJSQ score. Results Totally, 106 eligible patients were identified as having stress‐associated EOH, and 61 of them had high stress. Additionally, 70 (66.04%) and 73 (68.87%) of them tested positive for HMB and NOBT, respectively. Dimethyl sulfide (DMS) was found to be the predominant VSC in breath. High‐stress patients had significantly higher positivity rates for HMBT and NOBT, OLS, and exhaled DMS levels compared to low‐stress patients. HMBT‐positive patients and NOBT‐positive patients had significantly higher OLS and exhaled DMS levels compared to their respective negative counterparts. Conclusions Job stress can lead to intestinal inflammation and subsequent gut‐originated EOH.