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Bad Breath: For Some a State of Mind

CHICAGO --How people rate their own breath odor is based on many factors, including psychological, according to an article in the May 2001 Journal of the American Dental Association (JADA).

Bad breath or halitosis is a common concern for millions of people, say researchers from Israel's Tel Aviv University. Yet, they explain that there is almost no reliable way for people to properly assess the odor of their breath.

"While many develop faulty perceptions about having bad breath that affect their entire lives, others who have halitosis are unaware of their condition," the researchers wrote.

In the JADA article, the authors discuss issues affecting self-perception of breath odor in patients who worry about bad breath, as well as in a more general population of those who do not worry about bad breath.

They said that self-perception of breath odor was multifactorial and related closely to one's body image and psychological profile.

During an investigation at Tel Aviv University, from 1992-1995, the researchers asked "worrier" subjects to smell and rate odors coming from their mouths, tongues and saliva. The results, they say, confirmed that there is built-in subjectivity when people attempt to assess their own breath odor. For example, the authors said, subjects who worried about bad breath rated their own bad-breath levels as being higher than did an impartial odor judge.

Later, the authors looked at a more general population of "non worriers" (60 subjects, 55 percent men and an average age of 35.5 years). They found that self-assessment of breath odor was more objective and positively associated with the odor judge's score and laboratory measurements.

"Subjects who had more positive feelings about their bodies generally tended to score themselves as having less bad breath," the authors concluded. "However, people who complain about having bad breath might harbor a self-perception that does not reflect objective findings."

Collectively, the data suggest that every person has a breath-odor self image. This self-image can range from little or no distortion to severe psychopathology. According to the authors, when a patient's self-image is relatively objective or only moderately distorted, the clinician has an excellent chance of treating not only the bad-breath complaint, but also the way the patient relates to the problem. In extreme cases, they say working with a mental health professional is necessary.

---American Dental Association

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