Evaluation of oral and extra-oral factors predisposing to delusional halitosis

Abstract

SUMMARYObjective: This study evaluated the role of patients' associated oral and extra-oral factors, as well as previous dental treatment, as possible predisposing (triggering) factors in the development delusional halitosis. Method: Forty-six patients diagnosed of delusional halitosis, over a consecutive period of 2 years (2003)(2004) were selected for this study. Diagnosis was based on: use of standard halitosis questionnaire (to confirm the presence of psychological component) modified to obtain data on oral and extra-oral factors, as well as previous dental treatment linked by patients as cause of oral malodour; clinical assessment without objective evidence of oral malodour; absence of reliable third party to confirm patients' claim of oral malodour; and screening with sulphur monitor (RH-17 Series Halimeter, Interscan, Chatsworth, CA) that was within normal range (80-140ppb). Results: All the 46 patients studied had normal halimeter measurement and no reliable third party to confirm the patients' claim of oral malodour. Twenty-four (52.2%) patients had associated possible predisposing factors. The most common associated factors were bitter taste (25.0%), oral deposits (20.8%), carious tooth (16.7%) and previous tooth extraction (16.7%). Associated factors were divided into oral, extra-oral and dental treatment. Patients' associated oral factors were significantly correlated as predisposing factors for delusional halitosis (p<0.01) Conclusion: This study shows significant correlation of patients' associated oral factors as the triggering event, which could predispose those individuals who may have underlying psychosomatic tendencies to developing delusional halitosis.

Halitosis: Current concepts on etiology, diagnosis and management

“…[ 10 ] Patients, who relate their emotional state to be a possible cause of their oral malodor, would benefit more from early referral to clinical psychologist for mental assessment and appropriate treatment. [ 66 ] To treat delusional halitosis a multidisciplinary approach of health care practitioner, psychologists and psychiatrist are required.…”

“…[ 67 ] Diagnosis and treatment need to be a multidisciplinary approach involving the primary healthcare clinician, dentist, an ENT specialist, nutritionist, gastroenterologist and clinical psychologist. [ 66 ] Future research is needed to test accessible methods of drawing a person's attention to his/her halitosis, being the first step of seeking treatment. [ 68 ]…”

Bad-breath: Perceptions and misconceptions of Nigerian adults

“…Many cases of bad-breath can be treated by simple oral hygiene measures except for pseudohalitosis, delusional halitosis and halitophobia. [8][9][10] Poor knowledge of the real causes of bad-breath mystifies and stigmatizes bad-breath with the resultant reluctance to seek medical help. Those who should have sought help depend on self-perception.…”

Association of Fusobacterium Isolation From Periodontal Pockets With Halitosis and the Related Risk Factors in Shiraz, Iran

“…Halitophobia is a psychological problem used to describe apparently healthy individuals with a delusional fear of halitosis, even though it is not actually present (22). In our study, the majority (68%) of individuals with an organoleptic score of >2 before examination by a physician complained of bad breath.…”