Self-reported halitosis and emotional state: impact on oral conditions and treatments

Health Qual Life Outcomes. 2010 Mar 26:8:34. doi: 10.1186/1477-7525-8-34.


Background: Halitosis represents a common dental condition, although sufferers are often not conscious of it. The aim of this study was to examine behavior in a sample of Italian subjects with reference to self-reported halitosis and emotional state, and specifically the presence of dental anxiety.

Methods: The study was performed on Italian subjects (N = 1052; range 15-65 years). A self-report questionnaire was used to detect self-reported halitosis and other variables possibly linked to it (sociodemographic data, medical and dental history, oral hygiene, and others), and a dental anxiety scale (DAS) divided into two subscales that explore a patient's dental anxiety and dental anxiety concerning dentist-patient relations. Associations between self-reported halitosis and the above mentioned variables were examined using multiple logistic regression analysis. Correlations between the two groups, with self-perceived halitosis and without, were also investigated with dental anxiety and with the importance attributed to one's own mouth and that of others.

Results: The rate of self-reported halitosis was 19.39%. The factors linked with halitosis were: anxiety regarding dentist patient relations (relational dental anxiety) (OR = 1.04, CI = 1.01-1.07), alcohol consumption (OR = 0.47, CI = 0.34-0.66), gum diseases (OR = 0.39, CI = 0.27-0.55), age > 30 years (OR = 1.01, CI = 1.00-1.02), female gender (OR = 0.71, CI = 0.51-0.98), poor oral hygiene (OR = 0.65, CI = 0.43-0.98), general anxiety (OR = 0.66, CI = 0.49-0.90), and urinary system pathologies (OR = 0.46, CI = 0.30-0.70). Other findings emerged concerning average differences between subjects with or without self-perceived halitosis, dental anxiety and the importance attributed to one's own mouth and that of others.

Conclusions: Halitosis requires professional care not only by dentists, but also psychological support as it is a problem that leads to avoidance behaviors and thereby limits relationships. It is also linked to poor self care. In the study population, poor oral health related to self-reported halitosis was associated with dental anxiety factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcohol Drinking / psychology
  • Dental Anxiety / psychology*
  • Dental Care
  • Dentist-Patient Relations
  • Diagnostic Self Evaluation*
  • Female
  • Halitosis / diagnosis
  • Halitosis / psychology*
  • Halitosis / therapy
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Oral Health
  • Regression Analysis
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult