Halitophobia (synonym: fear of bad breath; ICD-10-GM F40.9: Phobic disorder, unspecified) describes the belief or fear of suffering from bad breath.
Halitosis (bad breath) is a problem that is often kept quiet about. Hardly anyone openly addresses the person they are talking to about their unpleasant smell, because bad breath is still a taboo subject for many. But there are people who are confronted daily with the question of whether they themselves suffer from bad breath. About 12 to 27 percent of halitosis patients are halitophobics.
Symptoms – complaints
Patients with halitophobia firmly believe they have bad breath. They perceive this. Patients with true halitosis, on the other hand, usually do not notice their often strong bad breath themselves at all. Here lies a big difference between the two clinical pictures. A halitophobic patient cannot be convinced in any way that their bad breath does not exist. The patients feel ashamed because of the supposed smell, depressive moods are possible. Because patients believe they actually suffer from halitosis, they are unlikely to see a psychiatrist or psychologist; instead, if they manage to overcome their shame, they are most likely to see a dentist.
Pathogenesis (development of disease) – etiology (causes)
The causes of halitophobia are psychological. What exactly led to the appearance of the disease must be determined individually by a psychologist or psychiatrist in collaboration with the patient.
Consequential diseases
If increasing delusions regarding one’s own bad breath occur, this is referred to as olfactory reference syndrome.
Diagnosis
The dentist recognizes halitophobia by several characteristics. The patient often tells about his problem under shame, which, however, is not subjectively perceived by the practitioner. The dentist asks whether the patient has ever been approached by people from the social environment about his bad breath, which is usually denied. Nevertheless, the patient withdraws socially so as not to offend anyone with his bad breath. The patient is also not convinced by olfactory measurements that speak against the presence of halitosis.
Therapy
The therapy of halitophobia cannot be done by a dentist, because it is a psychological disorder. Therefore, the dentist should gently and with great empathy refer the patient to an experienced colleague in psychology or psychotherapy. Only in this way is it possible to find out the causes of the halitophobia and to work out possible solutions.In advance, it can be helpful not to confront the patient with his halitophobia right away, but to first explain common oral hygiene procedures for halitosis and to build up a basis of trust before referring the patient to a psychologist. In this way, an attempt should be made to avoid the patient feeling that he or she is not being taken seriously and, if necessary, discontinuing treatment because of this.
