Oral and Extraoral Factors Associated with Delusional Halitosis

Objectives: A number of patients with delusional halitosis claim that their bad breath was due to oral and or extraoral condition(s), or previous dental treatment. This study evaluates the role of oral and extraoral associated factors, as well as previous dental treatment, as possible predisposing (triggering) factors in delusional halitosis at the Dental clinic, University of Benin Teaching Hospital, Benin City, Nigeria. Methods: Forty-six (46) patients with diagnosis of delusional halitosis, over a consecutive period of 2 years (2003-2004) were selected for this study. Diagnosis was based on clinical assessment to exclude oral malodour, absence of reliable third party, and screening with sulphur monitor (RH-17 Series Halimeter), which was within normal range (80-140ppb). Data collected were patient's age, gender, associated oral and extraoral conditions, and previous dental treatments. The frequency percentages of each age group were calculated and the sex incidence ratio of males to females was determined. The types of oral and extraoral associated factors and previous dental treatments were outlined and their frequency percentages were calculated. Results: 24 cases (52.2%) had associated possible predisposing factors, while 22 cases (47.8%) could not specify the cause of their presumed oral malodour. The most common associated factors were bitter taste 6 cases (13.1%), dental deposits 5 cases (10.9%), hole in the tooth 4 cases (8.7%) and tooth extraction 4 cases (8.7%). There were 12 categories of Oral factors, 6 categories of extraoral factors and 4 types of dental treatments Conclusion: Oral and/or extraoral factors(s) or previous dental treatment may be the triggering event, which may have facilitated the development of delusional halitosis in patients with underlying psychosomatic tendencies.