Dr. Mel Rosenberg

19.03.08, 09:34

About 25% of the patients seeking professional advice on bad breath suffer from a highly exaggerated concern of having bad breath. For some of them, this concern cannot be verified by odor judges (in organoleptic tests) or laboratorial methods. This concern is known as Delusional halitosis, halitophobia, or as a manifestation of Olfactory Reference Syndrome, and may severely affect the lives of some 0.5-1.0% of the adult population.

Lochner and Stein (2003) describe the Olfactory Reference Syndrome as “preoccupation about body odour accompanied by shame, embarrassment, significant distress, avoidance behaviour and social isolation”.

These patients are certain that they have noticeable bad breath, although many have not asked anyone for an objective opinion. Some of the people suffering from delusion halitosis tend to suspect normal activity around them as signs to their condition. Actions such as opening a window, scratching the nose or offering chewing gum – are interpreted as clues for the condition they believe they have.

A research done by Seemann et al. (2006) at the Charité-University Medical School of Berlin, Germany, describes the data collected from a multidisciplinary breath consultation in Germany. According to this research, 28% of the patients complaining on bad breath did not show detectable signs of bad breath – meaning that their concern of halitosis was exaggerated. Within this group, 76% received prior treatments for bad breath, 36% received gastroscopies and 14% underwent an ENT operation – all that without having any detectable signs of bad breath. Only 9% of those patients went through an actual organoleptic evaluation of their breath before they underwent these medical procedures.

It is suspected that some of the people suffering from delusion halitosis might have gotten remarks on having bad breath, sometimes at a young age, and tend to believe they have it for years afterwards. Some of them might have had a parent or other relative suffering from bad breath and believe they have it too, and others might be overly concerned about their body image and about the way others see them.

Only few psychologists and health professionals have tried to come to terms with this debilitating and difficult-to-treat emotional problem, probably because most halitohobic patients do not refer to their condition as a psychological problem, and are certain they have an incurable condition.

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                                                                                                                              • Halitophobia (delusional halitosis)
                                                                                                                                • Halitophobia (delusional halitosis)
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                                                                                                                                    • Halitophobia (delusional halitosis)
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