Halitophobia involves a pathologic fear of having bad breath without any evidence of having bad breath.
Features of a person with halitophobia:
(1) extreme fear of having bad or offensive breath
(2) obsessive oral care (frequent toothbrushing, chewing gum, use of breath mints, use of mouthwash)
(3) avoidance of social situations, with tendency to become reclusive
(4) always speaking from the side of the mouth or away from a person who is nearby
(5) often aware that the fear is irrational
(6) often secretive about the fear
(7) may feel driven to extreme oral hygiene (removal of all teeth, etc.)
The person may be afraid to check out his/her breath with someone else, or, if told that the breath is fine, may think the person is not telling the truth.
The person may have a masked anxiety/depressive disorder that underlies the phobia.
A person who has really bad breath from an underlying cause (cancer, metabolic disorder, hepatic or renal failure) may manifest some of these characteristics, but in this case they may have a good reason for the concern. If the cause can be controlled, then these patients will tend to revert to normal.
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