Oral factors associated with delusional halitosis: a report of 3 cases and review of the literature

Abstract

Objective: To emphasize the relevance of patient's associated oral predisposing factor(s) in the evaluation, counselling and treatment of delusional halitosis.
Method: Delusional halitosis was diagnosed using the standard halitosis questionnaire, clinical examination, halimeter assessment and mental health assessment were done.
Results: Three cases of delusional halitosis were diagnosed with associated carious teeth, bitter taste and seepage of saliva from around an upper single tooth denture as the oral predisposing factors for the condition. Two of the patients benefited from anti-anxiety medication, counselling and behavioural therapy.
Conclusion: The role of dentists in the management of delusional halitosis is emphasized. The oral factors linked as triggers for delusional halitosis in this study were useful for counselling the patients on the possible cause of their oral malo dour, which was followed up with behavioural therapy. Dental practitioners interested in assisting patients with psychosomatic tendencies need to be trained in cognitive behavioural therapy. Instead of a referral to mental health specialists, we recommend a joint clinic where the therapy sessions are in a dental setting.

KEY WORDS: counselling, delusion, dentist, halitosis, oral-factor