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Relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status in Bengaluru City: A cross-sectional study

Background: Halitosis is a term defining a common concern of individuals with a bad odor originating from their mouth. Halitosis is a symptom related to both somatic and emotional status. There is a need to investigate the relationship between psychological status and halitosis with the moderation by oral health. Aim: To assess the relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status (OHS). Methodology: A cross-sectional study was conducted among 160 self-perceived halitosis (SPH) and 160 halitosis suggestive (HS) young adults in Bengaluru city. Questionnaire for self-perception of halitosis and Symptom Checklist-90-Revised (SCL-90-R) questionnaire for psychological status were used. Halitosis was measured using organoleptic test. OHS was assessed using the World Health Organization Oral Health Assessment form for Adults, 2013. Independent t-test, Chi-square test, and multivariate linear regression were performed. A moderation analysis was carried out to examine the effect of OHS. The P < 0.05 was considered significant. Results: The mean age was 21.56 ± 1.84 years and 23.8 ± 1.93 years in the self-perceived halitosis and HS groups, respectively. Questionnaire for self-perception of halitosis majority of them experienced bad breath for the past 3 months; were hesitant to talk to others; felt uneasy; avoided social interaction, and the workplace was affected. The mean SCL-90-R score of SPH (291.46 ± 13.17) was significantly greater than HS (137.06 ± 25.09) (P < 0.001). Most of the participants in SPH had malodor and 50% had no odor in HS group. The mean Decayed, Missing, and Filled Teeth were 2.37 ± 3.92 and 1.87 ± 2.86 in SPH and HS groups, respectively (P = 0.19). The mean of teeth with gingival bleeding was significantly higher in SPH (3.46 ± 3.87) when compared to HS groups (1.61 ± 2.44) (P < 0.001). On multivariate linear regression, there was a significant relationship noted between the self-perceived halitosis group and SCL-90-R (R2 = 0.07; P < 0.001). In the moderation analysis, the effect of oral health and self-perception of halitosis was significant with psychological status. Conclusions: There is a relationship between the psychological status and self-perception of halitosis with moderation by OHS.