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OBJECTIVE: This study evaluates patients’ compliance to a ‘stopgap treatment protocol’ for initial management of psychological halitosis and compares the findings with the treatment outcome in a Tertiary Hospital in Nigeria.
METHOD: A 4-year prospective study of patients’ compliance to a 3-step ‘stopgap treatment protocol’ for initial management of psychological halitosis was performed.
RESULTS: Sixty five (65) patients were diagnosed of psychological halitosis within the study period. Most of the patients filled the halitosis questionnaire (n=43, 66.2%). The mean duration of bad breath complaint was 5 (+ 0.7 S.E.) years. The mean psychological score was 4 (+ 0.4 S.E.). No clinical oral malodour was observed in all the patients. Microscopy, culture and sensitivity were performed for 45 (69.2%) patients and most of the patients had a normal oral flora 36 (55.4%). Screening for volatile sulphur compound (VSC) was performed for 23 (35.9%) patients and the mean VSC level was 8.3 (+ 1.9 S.E.) ppb. Fifty-two (80.0%) patients came for follow up and counseling visit, and the mean duration of follow up was 21 (+ 6.4 S.E.) weeks. Fifty two (80.0%) patients complied with warm saline mouth rinse instructions, while scaling and polishing procedure was performed for 49 (75.4%) of the patients. There were 42 (64.6%) diagnosed pseudohalitosis cases and 30 (46.2%) cases had improved oral malodour, significantly associated with normal oral flora (p=0.008) and compliance to scaling and polishing procedure (p=0.000). The 23 (35.4%) patients diagnosed of delusional halitosis had persistent oral malodour.
CONCLUSION: The study showed overall high patients’ compliance to the ‘stopgap treatment protocol’ and improved oral malodour was observed in patients with pseudohalitosis.