Translation, cultural adaptation and validation of the "Halitosis Associated Life-quality Test" for use in Brazilian adolescents

O Halitosis Associated Life-quality Test (HALT) e um instrumento especifico, autoaplicado, composto de 20 itens sobre o impacto da halitose na qualidade de vida. Este estudo objetivou traduzir para o Portugues Brasileiro, realizar a adaptacao transcultural e validar o HALT para uso em adolescentes. Foram selecionados escolares da rede publica de Piracicaba/SP, de 12 a 15 anos, ambos os sexos, com denticao permanente higida. O HALT passou pelas seguintes etapas: traducao, traducao reversa, revisao por comite especializado e pre-teste. Na 1a etapa (n=13), os itens 2, 12 e 15 apresentaram nivel de incompreensao superior a 15%, foram reformulados e reaplicados em 13 adolescentes. A versao socioculturalmente adaptada foi autoaplicada por 56 adolescentes (¿=64%; 13,4}1,0anos), dos quais 25 participaram do teste-reste. Foram avaliadas a presenca de biofilme visivel, sangramento gengival, calculo e saburra lingual. A autopercepcao de halitose apos exalar/respirar o ar da boca foi aferida por questao unica. O escore do HALT variou de 0 a 62 pontos (media=10,1}13,4) e o efeito piso foi de 5,4%. A consistencia interna foi excelente (Alfa de Cronbach=0,92) e a reprodutibilidade moderada (Coeficiente de Correlacao Intraclasse=0,59). Sujeitos com gexcessoh de saburra lingual na regiao posterior apresentaram maior escore do HALT do que aqueles com quantidade pequena e/ou moderada (p<0,001). Na analise de regressao, somente o sexo masculino esteve relacionado com maior escore do HALT (p<0,05). A versao em Portugues Brasileiro do HALT mostrou ser de facil compreensao pelos adolescentes; a halitose esteve associada a higiene oral deficitaria nesta populacao, principalmente no sexo masculinoThe Halitosis Associated Life-quality Test (HALT) is a specific, self-applied instrument composed of 20 items about the impact of halitosis on quality of life. This study aimed to translate into Brazilian Portuguese language, to perform cross-cultural adaptation and to validate the HALT for use in adolescents. Twelve to fifteen-yr-old students were selected from public schools of Piracicaba/SP, both sexes, with healthy permanent dentition. HALT was submitted to the following steps: translation, back translation, committee review and pre-test. In the first stage (n=13), items 2, 12 and 15 items 2, 12 and 15 were misunderstood by more than 15% of the sample, were reformulated and reapplied in 13 adolescents. The socioculturally adapted version was self-applied by 56 adolescents (¿=64%, 13.4}1.0 yrs), of whom 25 participated in the test-retest. The presence of visible biofilm, gingival bleeding, calculus and lingual saburra were evaluated. The self-perception of halitosis after exhalation/breathing of the mouth air was assessed by a single question. The HALT score ranged from 0 to 62 (mean=10.1}13.4) and the floor effect was 5.4%. Internal consistency was excellent (Cronbach\u27s alpha=0.92) and reproducibility was moderate (Intraclass Correlation Coefficient=0.59). Subjects with gsevere discolorationh in the posterior part of the dorsum of the tongue had a higher HALT score than those with no and/or light discoloration (p<0.001). In the regression analysis, only male sex was associated with a higher HALT score (p