PSYCHOSOCIAL EFFECTS OF HALITOSIS AMONG MEDICAL AND DENTAL STUDENTS IN THE UNIVERSITY OF NAIROBI

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1 PSYCHOSOCIAL EFFECTS OF HALITOSIS AMONG MEDICAL AND DENTAL STUDENTS IN THE UNIVERSITY OF NAIROBI SILAS M. TOKA V28/2055/07 BOS III, 2010 NOVEMBER 2010 A Community Dentistry Research Project Report Submitted in partial fulfillment of the requirements for a Bachelors Degree in Dental Surgery of The University of Nairobi

2 s DEDICATION To Atieno, For always seeing the good in me... And to my good friend Dan Obara, For not abandoning me during my darkest hour... IV

3 ACKNOWLEDGEMENT I wish to acknowledge my supervisors for their guidance, tutoring and mentorship throughout admirable. the course of this busy year. The passion with which you do your work is My deepest regards to my classmates, Andrew Okiriamu, Alex Muoki Muidi and Jemimah Malinda, for their suggestions and technical support that helped see this research project to its successful completion. Lastly, I wish to fondly acknowledge nothing without you. my family members for their love and support. I am May the Almighty bestow His blessings on all of you. v

4 SUMMARY Background Bad breath affects just about everyone at one time or the other and raises no particular need for attention. However, halitosis, a condition presenting with persistent bad breath, brings about damaging feelings of lowered self-esteem and a heightened state of self- COnSCIOUSness. Main Objective This study was aimed at establishing the psychosocial effects of halitosis and pseudohalitosis among medical and dental students in the University of Nairobi. Study Design This was a descriptive cross-sectional study. Study Area The study was carried out in the University of Nairobi, School of Medicine and School of Dental Sciences. Study Participants A total of 309 students were recruited into the study using the stratified random sampling method. Data Collection and Analysis Data was collected using self-administered questionnaires. Data analysis was done using the SPSS (Statistical Package for Social Sciences) program, Version 17, and Microsoft Excel. Results A total of 294 respondents (95.2%) felt that halitosis has an effect on one's self confidence, 92 respondents (29.8%) reported of having avoided conversation at one point x

5 or the other because of halitosis, and 97.1% of respondents (300 individuals) felt that halitosis has an effect on one's social life. 232 of the respondents (75.1%) indicated that they believed halitosis has an effect on academic endeavors requiring interaction with the public, while 162 respondents (52.5%) indicated that they believed that halitosis can make one miss out on an employment opportunity. A total of 57.6% of the respondents (178 individuals) disagreed with the statement that halitosis can be the sole cause of ruin to one's life, and 277 individuals (89.7%) indicated that they felt that cure to halitosis can result in a marked change in the quality of one's life. Study Benefits The findings of this study could be used to formulate health education strategies aimed at reducing the psychosocial effects of halitosis and pseudohalitosis among medical and dental students in both the University of Nairobi, and in the general Kenyan population. Xl

6 CHAPTER! 1.0 INTRODUCTION AND LITERATURE REVIEW 1.1 INTRODUCTION Halitosis or fetor ex ore are terms used to describe noticeably unpleasant odors exhaled in breathing. [I] The smell may either be from an oral source due to bacteria, or from systemic conditions elsewhere in the body. Such conditions include: fetor hepaticus, lower respiratory tract infections (bronchial and lung infections), renal infections, renal failure, carcinoma, trimethylaminuria, diabetes mellitus, and metabolic dysfunction. [2] Sound epidemiologic data on halitosis is rare. Studies from Britain and Switzerland show the prevalence of halitosis among the respective populations of those countries as ranging between 17% and 50%. 3][4] There is little available data on the prevalence of halitosis in Kenya. Pseudohalitosis refers to a condition in which one has extreme fear, belief or conscious awareness, that he/she has bad breath. [5} Studies have shown that about 5% of people, who are reported as having halitosis, actually have pseudohalitosis. [6] Halitosis has a significant impact - personally and socially - on those who suffer from it or believe they do, and is estimated to be the third most frequent reason for seeking dental aid, following dental caries and periodontal disease. [7] Halitosis can lead to social embarrassment and even break relationships. It can be a devastating social disability. People have been denied employment, failed in business and relegated to low social status because of it. [8] Pseudohalitosis drives many people into quiet lives of low self-esteem, lost smiles and nearly non-existent expression of one self. [9][10] This research sought to establish how much halitosis affects medical and dental students in the University of Nairobi, and the psychosocial effects experienced by sufferers. 1