EVALUATION OF PATIENTS’ COMPIANCE TO A ‘STOPGAP TREATMENT PROTOCOL IN THE INITIAL MANAGEMENT OF PSYCHOLOGICAL HALITOSIS

Evaluation of compliance to stopgap protocol for psychological halitosis

Abstract

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.