Clinical dilemmas posed by patients with psychosomatic halitosis

Patients affected by psychosomatic halitosis never wish to visit a psychologic specialist, because they cannot recognize their own psychosomatic condition. They also never doubt that they have offensive oral malodor. Other people's behavior, such as covering the nose or averting the face, is interpreted by these patients as an indication that their breath is offensive, and these behaviors or attitudes reinforce their belief that they have a strong oral malodor. To clarify whether the patient's perception of another individual's attitude is affected by his or her delusion, this article is focused on the relationship between the behavior toward oral malodor and the psychologic profiles of patients with psychosomatic halitosis. If a patient expects simple avoidance behavior from other individuals, the development of psychosomatic halitosis may be accelerated, as it becomes a self-fulfilling prophecy. Individuals who are concerned with their own oral malodor but exhibit no oral malodor may have latent psychosomatic tendencies and may be mentally immature. A protocol for referring a patient to a psychologic specialist is presented.