Relationship between Psychological Status and Self-Perception of Halitosis among Young Adults with Moderation by Oral Health Status in Bengaluru City

Abstract

Background: Halitosis is a term defining a common concern of individuals with a bad odor originating from their mouth. Halitosis is a symptom related to both somatic and emotional status. There is a need to investigate the relationship between psychological status and halitosis with the moderation by oral health. Aim: To assess the relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status (OHS). Methodology: A cross-sectional study was conducted among 160 self-perceived halitosis (SPH) and 160 halitosis suggestive (HS) young adults in Bengaluru city. Questionnaire for self-perception of halitosis and Symptom Checklist-90-Revised (SCL-90-R) questionnaire for psychological status were used. Halitosis was measured using organoleptic test. OHS was assessed using the World Health Organization Oral Health Assessment form for Adults, 2013. Independent t-test, Chi-square test, and multivariate linear regression were performed. A moderation analysis was carried out to examine the effect of OHS. The P < 0.05 was considered significant. Results: The mean age was 21.56 ± 1.84 years and 23.8 ± 1.93 years in the self-perceived halitosis and HS groups, respectively. Questionnaire for self-perception of halitosis majority of them experienced bad breath for the past 3 months; were hesitant to talk to others; felt uneasy; avoided social interaction, and the workplace was affected. The mean SCL-90-R score of SPH (291.46 ± 13.17) was significantly greater than HS (137.06 ± 25.09) (P < 0.001). Most of the participants in SPH had malodor and 50% had no odor in HS group. The mean Decayed, Missing, and Filled Teeth were 2.37 ± 3.92 and 1.87 ± 2.86 in SPH and HS groups, respectively (P = 0.19). The mean of teeth with gingival bleeding was significantly higher in SPH (3.46 ± 3.87) when compared to HS groups (1.61 ± 2.44) (P < 0.001). On multivariate linear regression, there was a significant relationship noted between the self-perceived halitosis group and SCL-90-R (R 2 = 0.07; P < 0.001). In the moderation analysis, the effect of oral health and self-perception of halitosis was significant with psychological status. Conclusions: There is a relationship between the psychological status and self-perception of halitosis with moderation by OHS.

Emotional and Social Impact of Halitosis on Adolescents and Young Adults: A Systematic Review

“…After screening the abstracts, eight articles were assessed in full-text, where two articles were excluded for not meeting the age criteria and the symptoms criteria, resulting in 6 articles [ 22 , 23 , 24 , 25 , 26 , 27 ] being included in the systematic review, as seen in Figure 1 . Included studies took place in Brazil [ 22 , 26 ], India [ 25 , 27 ], Rwanda [ 23 ], and Nigeria [ 24 ]. The cohort sample size was relatively large, ranging from 200 participants [ 25 ] to 736 participants [ 22 ].…”

“…The cohort sample size was relatively large, ranging from 200 participants [ 25 ] to 736 participants [ 22 ]. Age categories were distributed equally, with half of the studies focusing on adolescents [ 22 , 24 , 26 ] and the other half on young adults [ 23 , 25 , 27 ], along with gender, since both female and male patients were distributed almost equally in each study, apart from one that did not report gender proportions in the study groups [ 24 ].…”

“…The majority of the studies used self-reported questionnaires or specific questions to assess the presence of halitosis [ 22 , 23 , 24 , 26 ] and only two of them used organoleptic measures [ 25 , 27 ]. Questionnaires used to evaluate the presence of halitosis comprised items such as “Do you have bad breath?” [ 22 ], while the ones that used organoleptic tests implied medical devices that evaluate the presence of bad breath [ 25 , 27 ].…”

“…The majority of the studies used self-reported questionnaires or specific questions to assess the presence of halitosis [ 22 , 23 , 24 , 26 ] and only two of them used organoleptic measures [ 25 , 27 ]. Questionnaires used to evaluate the presence of halitosis comprised items such as “Do you have bad breath?” [ 22 ], while the ones that used organoleptic tests implied medical devices that evaluate the presence of bad breath [ 25 , 27 ]. One study used FitScan Breath Checker, which is a palm-sized monitor that measures compounds responsible for breath odors [ 25 ], and another one used Breath Alert, a device that measures the breath odor of the person who blows into it [ 27 ].…”

“…In terms of social and emotional impact, three of the studies evaluated the overall quality of life [ 22 , 24 , 26 ], two of them evaluated the social and psychological consequences of bad breath [ 23 , 25 ], and one of them evaluated the psychological impact from a mental health disorder perspective [ 27 ]. Additionally, two studies did not use a psychometric scale and relied only on the specific question that regards psychosocial aspects of halitosis [ 23 , 25 ].…”