Int J Stomatol ›› 2024, Vol. 51 ›› Issue (3): 368-373.doi: 10.7518/gjkq.2024042

• Original Articles • Previous Articles     Next Articles

Research progress on psychological factors in the pathogenesis of halitosis

Congcong Li1(),Man Zhao1,Chuanxia Liu2()   

  1. 1.Dept. of General Dentistry, Stomatology Hospital, Zhejiang University School of Medicine & Zhejiang University School of Stomatology & Zhejiang Provincial Clinical Research Center for Oral Diseases & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University & Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
    2.Dept. of Oral Medicine, Stomatology Hospital, Zhejiang University School of Medicine & Zhejiang University School of Stomatology & Zhejiang Provincial Clinical Research Center for Oral Diseases & Key Laboratory of Oral Biomedical Research of Zhejiang Province & Cancer Center of Zhejiang University & Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
  • Received:2023-06-26 Revised:2023-12-26 Online:2024-05-01 Published:2024-05-06
  • Contact: Chuanxia Liu E-mail:china_lcc@zju.edu.cn;0014806@zju.edu.cn

Abstract:

Halitosis has always been prevalent in humans, affecting nearly half of the world's population. With the improvement of people’s health awareness, it has recently become a health concern among the public. Studies have shown that psychological factors were closely related to the occurrence and development of halitosis. Negative emotions such as anxiety and depression might directly lead to delusional halitosis while indirectly promoting the generation of volatile sulfur compounds in the oral cavity through affecting oral microbiota, periodontitis, saliva, immune function, and systemic diseases. This article provides a summary of research on direct and indirect correlations on the psychological factors in the pathogenesis of halitosis in recent years to improve the understanding of clinical doctors and provide some inspiration for the clinical diagnosis and treatment of patients with halitosis in the future.

Key words: halitosis, psychological factors, negative emotion, oral microenvironment, sulfide

CLC Number: 

  • R781.9

TrendMD: 
1 Oshiro A, Zaitsu T, Inoue Y, et al. Concerning perceived and clinically-measured levels of halitosis[J]. J Breath Res, 2022, 17(1). doi: 10.1088/1752-7163/ac9db3 .
doi: 10.1088/1752-7163/ac9db3
2 冯希平, 杜民权, 林焕彩. 口腔预防医学[M]. 7版. 北京: 人民卫生出版社, 2020: 107-108.
Feng XP, Du MQ, Lin HC. Preventive dentistry[M].7th ed. Beijing: People’s Medical Publishing House, 2020: 107-108.
3 孟焕新. 牙周病学[M]. 5版. 北京: 人民卫生出版社, 2020: 176-177.
Meng HX. Periodontics[M].5th ed. Beijing: People’s Medical Publishing House, 2020: 176-177.
4 Izidoro C, Botelho J, Machado V, et al. Revisiting standard and novel therapeutic approaches in halitosis: a review[J]. Int J Environ Res Public Health, 2022, 19(18): 11303.
5 Memon MA, Memon HA, Muhammad FE, et al. Aetiology and associations of halitosis: a systematic review[J]. Oral Dis, 2023, 29(4): 1432-1438.
6 曹阳, 季若桐, 吴琳. 口腔心身疾病的研究进展[J]. 心理月刊, 2021, 16(2): 215-218.
Cao Y, Ji RT, Wu L. Research progress of oral psychosomatic disorders[J]. Psychol Magazine, 2021, 16(2): 215-218.
7 Mento C, Lombardo C, Milazzo M, et al. Adolescence, adulthood and self-perceived halitosis: a role of psychological factors[J]. Medicina (Kaunas), 2021, 57(6): 614.
8 姚敏, 束余声. 健康焦虑的研究进展[J].中西医结合护理, 2022, 8(5): 139-143.
Yao M, Shu YS. Research progress of health anxiety[J]. Chin J Integr Nurs, 2022, 8(5): 139-143.
9 Scarella TM, Boland RJ, Barsky AJ. Illness anxiety disorder: psychopathology, epidemiology, clinical cha-racteristics, and treatment[J]. Psychosom Med, 2019, 81(5): 398-407.
10 Arnáez S, García-Soriano G, López-Santiago J, et al. Illness-related intrusive thoughts and illness an-xiety disorder[J]. Psychol Psychother, 2021, 94(1): 63-80.
11 Akpata O, Omoregie OF, Ibhawoh LO. The role of dentists as a stop-gap in the initial management of patients with delusional halitosis[J]. West Afr J Med, 2013, 32(4): 291-296.
12 Seizer L, Schubert C. On the role of psychoneuroimmunology in oral medicine[J]. Int Dent J, 2022, 72(6): 765-772.
13 Wu DD, Ngowi EE, Zhai YK, et al. Role of hydrogen sulfide in oral disease[J]. Oxid Med Cell Longev, 2022, 2022: 1886277.
14 Foo LH, Balan P, Pang LM, et al. Role of the oral microbiome, metabolic pathways, and novel diagnostic tools in intra-oral halitosis: a comprehensive update[J]. Crit Rev Microbiol, 2021, 47(3): 359-375.
15 Hampelska K, Jaworska MM, Babalska ZŁ, et al. The role of oral microbiota in intra-oral halitosis[J]. J Clin Med, 2020, 9(8): 2484.
16 Ye W, Zhang Y, He M, et al. Relationship of tongue coating microbiome on volatile sulfur compounds in healthy and halitosis adults[J]. J Breath Res, 2019, 14(1): 016005.
17 Izidoro C, Botelho J, Machado V, et al. Periodontitis, halitosis and oral-health-related quality of life-a cross-sectional study[J]. J Clin Med, 2021, 10(19): 4415.
18 Paudel D, Kuramitsu Y, Uehara O, et al. Proteomic and microbiota analyses of the oral cavity during psychological stress[J]. PLoS One, 2022, 17(5): e0268155.
19 de Lima PO, Nani BD, Almeida B, et al. Stress-related salivary proteins affect the production of volatile sulfur compounds by oral bacteria[J]. Oral Dis, 2018, 24(7): 1358-1366.
20 Nani BD, Lima PO, Marcondes FK, et al. Changes in salivary microbiota increase volatile sulfur compounds production in healthy male subjects with aca-demic-related chronic stress[J]. PLoS One, 2017, 12(3): e0173686.
21 Silva MF, Nascimento GG, Leite FRM, et al. Perio-dontitis and self-reported halitosis among young adults from the 1982 Pelotas Birth Cohort[J]. Oral Dis, 2020, 26(4): 843-846.
22 D’Ambrosio F, Caggiano M, Schiavo L, et al. Chro-nic stress and depression in periodontitis and peri-implantitis: a narrative review on neurobiological, neurobehavioral and immune-microbiome interplays and clinical management implications[J]. Dent J (Basel), 2022, 10(3): 49.
23 Bertolini Botelho MC, Cintra LTA, da Silva CC, et al. Early life stress exacerbates bone resorption and inhibits anxiety-like behaviour induced by apical periodontitis in rats[J]. Int Endod J, 2023, 56(2): 203-212.
24 Lee YH, Suk C, Shin SI, et al. Salivary cortisol, dehydroepiandrosterone, and chromogranin A levels in patients with gingivitis and periodontitis and a novel biomarker for psychological stress[J]. Front Endocrinol (Lausanne), 2023, 14: 1147739.
25 Silva MF, Cademartori MG, Leite FRM, et al. Is periodontitis associated with halitosis? A systematic review and meta-regression analysis[J]. J Clin Perio-dontol, 2017, 44(10): 1003-1009.
26 Botelho J, Machado V, Mascarenhas P, et al. Stress, salivary cortisol and periodontitis: a systematic review and meta-analysis of observational studies[J]. Arch Oral Biol, 2018, 96: 58-65.
27 Calil CM, Oliveira GM, Cogo K, et al. Effects of stress hormones on the production of volatile sulfur compounds by periodontopathogenic bacteria[J]. Braz Oral Res, 2014, 28: S1806-S83242014000100228.
28 Proctor GB, Shaalan AM. Disease-induced changes in salivary gland function and the composition of saliva[J]. J Dent Res, 2021, 100(11): 1201-1209.
29 Wu J, Cannon RD, Ji P, et al. Halitosis: prevalence, risk factors, sources, measurement and treatment-a review of the literature[J]. Aust Dent J, 2020, 65(1): 4-11.
30 Gholami N, Hosseini Sabzvari B, Razzaghi A, et al. Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia[J]. J Dent Res Dent Clin Dent Prospects, 2017, 11(4): 247-252.
31 Hugo FN, Hilgert JB, Corso S, et al. Association of chronic stress, depression symptoms and cortisol with low saliva flow in a sample of south-Brazilians aged 50 years and older[J]. Gerodontology, 2008, 25(1): 18-25.
32 Engeland CG, Bosch JA, Rohleder N. Salivary biomarkers in psychoneuroimmunology[J]. Curr Opin Behav Sci, 2019, 28: 58-65.
33 Dich N, Rozing MP, Kivimäki M, et al. Life events, emotions, and immune function: evidence from Whitehall Ⅱ cohort study[J]. Behav Med, 2020, 46(2): 153-160.
34 Sherer ML, Voegtline KM, Park HS, et al. The immune phenotype of perinatal anxiety[J]. Brain Behav Immun, 2022, 106: 280-288.
35 Liu JQ, Dan RC, Zhou XM, et al. Immune senescence and periodontitis: from mechanism to therapy[J]. J Leukoc Biol, 2022, 112(5): 1025-1040.
36 Gonçalves MLL, Kalil Bussadori S, Dadalti Fragoso Y, et al. Effect of photodynamic therapy in the reduction of halitosis in patients with multiple sclerosis: clinical trial[J]. J Breath Res, 2017, 11(4): 046006.
37 Elahi M, Telkabadi M, Samadi V, et al. Association of oral manifestations with ulcerative colitis[J]. Gastroenterol Hepatol Bed Bench, 2012, 5(3): 155-160.
38 Enver A, Ozmeric N, Isler SC, et al. Evaluation of periodontal status and cytokine levels in saliva and gingival crevicular fluid of patients with inflammatory bowel diseases[J]. J Periodontol, 2022, 93(11): 1649-1660.
39 Schmidt J, Weigert M, Leuschner C, et al. Active matrix metalloproteinase-8 and periodontal bacteria-interlink between periodontitis and inflammatory bowel disease[J]. J Periodontol, 2018, 89(6): 699-707.
40 Kruk J, Aboul-Enein BH, Bernstein J, et al. Psychological stress and cellular aging in cancer: a meta-analysis[J]. Oxid Med Cell Longev, 2019, 2019: 1270397.
41 Kulzer B, Albus C, Herpertz S, et al. Psychosocial factors and diabetes[J]. Exp Clin Endocrinol Diabetes, 2023, 131(1/2): 94-109.
42 Graves DT, Corrêa JD, Silva TA. The oral microbiota is modified by systemic diseases[J]. J Dent Res, 2019, 98(2): 148-156.
43 Person H, Keefer L. Psychological comorbidity in gastrointestinal diseases: update on the brain-gut-microbiome axis[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2021, 107: 110209.
44 Frolkis AD, Vallerand IA, Shaheen AA, et al. Depression increases the risk of inflammatory bowel disease, which may be mitigated by the use of antidepressants in the treatment of depression[J]. Gut, 2019, 68(9): 1606-1612.
45 Chen T, Wang R, Duan ZL, et al. Akkermansia muciniphila protects against psychological disorder-induced gut microbiota-mediated colonic mucosal barrier damage and aggravation of colitis[J]. Front Cell Infect Microbiol, 2021, 11: 723856.
[1] Huang Peiqing,Peng Xian,Xu Xin. Volatile sulfur compounds and its role in the management of intra-oral halitosis [J]. Int J Stomatol, 2021, 48(5): 592-599.
[2] Zhang Yu, Chen Xi, Feng Xiping. Relationship between gastrointestinal diseases and halitosis [J]. Inter J Stomatol, 2014, 41(6): 703-706.
[3] Wang Yanzhi, Li Shu.. Nitric oxide and other gas signaling molecules and periodontal disease [J]. Inter J Stomatol, 2014, 41(2): 204-208.
[4] Tang Chun, Ye Wei.. Etiology of pathologic extra -oral halitosis [J]. Inter J Stomatol, 2012, 39(5): 689-692.
[5] . Preliminary study of screening oral bacteria producing hydrogen sulfide by cotton balls with lead acetate [J]. Inter J Stomatol, 2010, 37(5): 507-510.
[6] WEN Yan-li, WAN Hu-chun. Resear ch progr esses in administer Streptococcus salivarius to halitosis [J]. Inter J Stomatol, 2008, 35(5): 523-523~525.
[7] SHANG Hai-yan, CHEN Yong-jin.. Role of psychological factors in temporomandibular disorders [J]. Inter J Stomatol, 2007, 34(04): 275-277.
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