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BACKGROUND: Delusional halitosis is a psychiatric disorder characterized by persistent beliefs about malodour from the mouth. It is often associated with avoidance, humiliation, embarrassment and significant psychological distress.
OBJECTIVE: This report aimed at highlighting the relationship between delusional halitosis and psychopathology as well as reporting on the current collaborative management approach of such conditions.
CASE REPORT: A 40-year-old single, male patient presented with persistent bad breath of six months duration. He claimed that he brushed his teeth more than ten times daily and rinsed his mouth with various types of mouthwashes without any improvement. No bad breath was perceived using the organoleptic measurement and a diagnosis of delusional halitosis was made. He was referred to Consultant Psychiatrist who made a diagnosis of moderate depressive episode with psychotic features using a self-rating depression scale. The patient was treated with 25mg amitriptyline daily for 4weeks, then increased gradually to 75mg over 3months and weekly cognitive behavioural therapy for 12 weeks. There was remission after 3months and patient was placed on maintenance doze of 25mg amitriptyline daily for 12 months.
CONCLUSION: This report demonstrates that delusional halitosis can be associated with patients suffering from depression with psychotic features, which should be referred to the mental health expert for psychiatric or psychological interventions. Also, it supports collaboration between the dental practitioners and mental health experts in institutions where both departments exist.