If you think you have halitosis, you're probably not crazy

Having bad breath is something that virtually all human beings have in common, and while this bond may be a little unpleasant, it's a decided fact. More than 20 percent of adults suffer from halitosis at any one moment, which is more than can be said of the rare - and, as yet, clinically unrecognized - olfactory reference syndrome (ORS).

Occasionally, a magazine article or blog post will address ORS, often to explore the idea that your bad breath could be all in your head. While the idea can be amusing, most psychiatric authorities make two points about ORS.

The first is that if you think you have it, you almost certainly don't. The second is that while oral odor is widespread, ORS is very uncommon.

ORS is the unshakable notion that your body or breath is constantly emitting a foul odor. Few estimates exist as to how common the condition is. Many healthcare experts say that ORS is not its own mental disorder but the symptom of another one, like obsessive-compulsive disorder (OCD) or body dysmorphic disorder.

The OCD Center of Los Angeles states that people with true ORS are obsessed at all times with the idea that they smell terrible, even after repeated or excessive amounts of washing or brushing. Anyone who has used a specialty breath freshening rinse should be aware that this is unlikely, since such products can effectively eliminate bad breath.

Because of its tenuous status as a mental condition, ORS has not yet been added to the Diagnostic and Statistical Manual of Mental Disorders, although scientists are currently debating its inclusion in the fifth edition of the book, due out in 2013.

Psychoses aside, some people may be convinced that they have a neurosis about bad breath. A 2008 study, which was published in the journal Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, estimated that 13 percent of adults occasionally have pseudohalitosis, or the mistaken but not obsessive belief that they have oral odor.

The report suggested that more than 40 percent of these adults were neurotic, and that many more suffered from anxiety. However, it still concluded that nearly all participants who thought they had bad breath really did have some level of halitosis.

Overall, if you think you have bad breath, the odds are that you do.