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

Salvatore Settineri,Ambra Saitta,Simona C Gugliotta,Antonella Terranova,Domenico Mallamace,Giuseppe Trimarchi,Carmela Mento

doi:10.1186/1477-7525-8-34

Salvatore Settineri, Ambra Saitta + Show 5 more

Open Access

https://doi.org/10.1186/1477-7525-8-34

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Abstract

BackgroundHalitosis 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.MethodsThe 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 abovementioned 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.ResultsThe 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.ConclusionsHalitosis 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.

Highlights

Halitosis represents a common dental condition, sufferers are often not conscious of it
Many studies on self-reported halitosis have stressed that the problem of halitosis is often not self-perceived [6,7,12]., Few studies in the literature have highlighted the links between halitosis and emotions, e.g. anxiety [13]
The aim of this study is to examine the links between self-reported halitosis and factors related to emotional state, dental anxiety

Summary

Introduction

Halitosis represents a common dental condition, 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 the presence of dental anxiety. Halitosis is a term used to describe oral malodor and is a common reason for seeking professional dental care. According to the American Dental Association, 50% of the adult population have suffered from an occasional oral malodor disorder, while 25% appear to have a chronic problem. The relations between anxiety and halitosis have been analyzed with clinical observations suggesting that anxious situations may increase VSC concentration causing halitosis [14]. One specific anxious situation is dental anxiety, defined as the response to stressful dental stimuli and to dentist-patient relations [15,16]. The impact of dental anxiety on appropriate dental care would appear to be considerable [17,18]

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