Clinical characteristics of halitosis: differences in two patient groups with primary and secondary complaints of halitosis.

Halitosis, defined as an unpleasant oral odor, has become a health concern among the general public. The objective of this study was to evaluate the diversity of clinical characteristics of halitosis of the patients who visited dental clinics. Sixty-eight patients with primary complaints of halitosis and 19 patients with primary complaints of periodontal diseases but secondary complaints of halitosis were studied by organoleptic examination. The patients with primary complaints were diagnosed as having halitosis in fewer cases than the patients with secondary complaints-25% and 53%, respectively. Patient complaints for halitosis were further categorized, by questionnaire, into three types: Type 1, self-conscious; Type 2, conscious by the indication of others; and Type 3, conscious by presumptions from the attitude of others. Although 80% of the patients of both groups were of Type 1, only 24.1% of the Type 1 patients with primary complaint, in comparison with 50% of the Type 1 patients with secondary complaint, were actually found to have halitosis. The results suggest that the majority of patients with primary complaints of halitosis at the dental clinic did not actually have halitosis, but suffered from an imaginary halitosis due to presumptions based upon others' attitudes. After treatment, these patients were more likely to be dissatisfied than patients who had visited the clinic with halitosis as their secondary complaint.