Association Between Social Anxiety with Oral Hygiene Status and Tongue Coating among Patients with Subjective Halitosis.

Halitosis is a universal affliction suffered by many individuals irrespective of age, sex and social status. Concern about oral malodor can significantly impede an individual's personal, professional and public life which can lead to the development of social anxiety. The present study was undertaken to assess the association between social anxiety with oral hygiene status and tongue coating among patients with subjective halitosis. A total of 321(n=321) subjects were self-recruited to participate in this IRB approved study. A 24- item Liebowitz Social Anxiety Scale, Self-Report version (LSAS-SR) was distributed and completed by the participants; followed by oral examination using Simpified Oral Hygiene Index and Tongue Coating Record (TCR). ANOVA, t-test and Mann Whitney U test was used for comparison among variables. Correlation was performed using Karl Pearson's correlation coefficient method. The level of significance was set as p<0.05. The total LSAS for the study population of 321 was 61.41±24.09; with females having significantly higher scores (64.64±24.95; p=0.01*). Comparison of clinical oral parameters between the genders revealed that poor oral hygiene (2.45±1.06) with a higher tongue coating score (71.38±18.24) was observed among male participants. However, these scores were statistically insignificant. A significant correlation between total LSAS, majority of its subscales and the oral parameters among females and subjects with high school education was also reported. This study revealed that social anxiety, poor oral hygiene and tongue coating were associated with subjective halitosis. Hence, maintenance of good oral health along with the use of appropriate tongue cleaning methods is of critical importance in reducing oral malodor. In some cases, comprehensive treatment of halitosis may require a multidisciplinary approach including dental, psychology and counselling professionals.