We have discussed the theme of referral to psychiatry concerning a 17-yr old female patient complaining of halitosis. The clinical features of the case fulfilled the diagnostic criteria of Yamashita's typical fear of interpersonal relationships and was considered to be within the neurotic level.
However as therapy relationships became closer, several factors led to the conclusion that this case deviated from the neurotic level and thus was referred to psychiatry.
Some problems arise when treating halitosis patients in the department of oral surgery, the first is when the clinical features of the patient are not enough as to decide personality level, thus at times resulting in delayed referral to psychiatry.
Another problem arises when the patient is strongly attached to a physical etiology of the symptom, therefore resisting referral to psychiatry.
At present, a liasion-consultation system with psychiatry seems to be absolutely needed.
