• Carmela Mento, Clara Lombardo, Mariacristina Milazzo, Nicholas Ian Whithorn, Montserrat Boronat-Catalá, Pedro J Almiñana-Pastor, Cristina Sala Fernàndez, Antonio Bruno, MuscatelloMaria Rosaria AnnaMRA0000-0001-7271-6989Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Psychiatric Unit Policlinico "G. Martino" Hospital, 98124 Messina, Italy., and Rocco Antonio Zoccali.
• Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Psychiatric Unit Policlinico "G. Martino" Hospital, 98124 Messina, Italy.
• Medicina (Kaunas). 2021 Jun 12; 57 (6).

Abstract(1) Background: Halitosis is a frequent condition that affects a large part of the population. It is considered a "social stigma", as it can determine a number of psychological and relationship consequences that affect people's lives. The purpose of this review is to examine the role of psychological factors in the condition of self-perceived halitosis in adolescent subjects and adulthood. (2) Type of studies reviewed: We conducted, by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines, systematic research of the literature on PubMed and Scholar. The key terms used were halitosis, halitosis self-perception, psychological factors, breath odor and two terms related to socio-relational consequences ("Halitosis and Social Relationship" OR "Social Issue of Halitosis"). Initial research identified 3008 articles. As a result of the inclusion and exclusion criteria, the number of publications was reduced to 38. (3) Results: According to the literature examined, halitosis is a condition that is rarely self-perceived. In general, women have a greater ability to recognize it than men. Several factors can affect the perception of the dental condition, such as socioeconomic status, emotional state and body image. (4) Conclusion and practical implication: Self-perceived halitosis could have a significant impact on the patient's quality of life. Among the most frequent consequences are found anxiety, reduced levels of self-esteem, misinterpretation of other people's attitudes and embarrassment and relational discomfort that often result in social isolation.

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