The role of dentists as a stop-gap in the initial management of patients with delusional halitosis.

Abstract

OBJECTIVE:

This article proposes a 'stop-gap protocol'for the initial management of delusional halitosis, which dental practitioners can apply where a multidisciplinary team of dentists and mental health experts (psychiatrist and psychologist) cannot be assembled.

METHODS:

A 4-year prospective study of delusional halitosis patients managed with a 3-step 'Stop-gap protocol' is presented in this paper, to demonstrate our experience in applying the 'Stop-gap protocol'.

RESULTS:

Twenty three (23) patients diagnosed with delusional halitosis were managed with the 'Stop-gap protocol' within the study period. There were 13 (56.5%) males and 10 (43.5%) females, giving a male to female ratio of 1.3:1.Most of the patients were in the 3rd decade of life (n=10, 43.5%), the mean duration of the bad breath complaint was 5 years, with unknown trigger factor (n=19, 82.6%) in most of the patients and a mean psychological score of 7 ± 1.8. No clinical oral malodour was observed in all of these patients. A normal oral flora was observed in 13 (56.5%) of the cases and a low level of volatile sulphur compound (VSC) was found in 12 (52.2%) of the patients, with a mean VSC level of 22.3 ± 2 ppb. Twenty (87.0%) of the patients presented for follow up /counselling and the mean duration of follow up was 13 weeks. Three (13.0%) patients responded to referral to the joint clinic with mental health experts.

CONCLUSION:

Although we do not claim that the 'Stop-gap protocol' is comprehensive, it is hoped that this paper will serve as a useful guide for dentists practising in health facilities without mental health specialists and also to encourage the formation of multi-disciplinary teams in centres where they are present.

• Authors: O Akpata, O F Omoregie, L O Ibhawoh
• Journal: West African journal of medicine (West Afr J Med) 2013 Oct-Dec Vol. 32 Issue 4 Pg. 291-6 ISSN: 0189-160X [Print] Nigeria
• PMID: 24488286 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Child
• Clinical Protocols
• Dentists
• Female
• Halitosis (diagnosis, psychology, therapy)
• Humans
• Male
• Middle Aged
• Nigeria
• Professional Role
• Prospective Studies
• Referral and Consultation
• Schizophrenia, Paranoid (diagnosis, therapy)
• Young Adult