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Halitosis - Management
Basis for recommendation
These recommendations are extrapolated from published narrative reviews on halitosis or oral malodour [Rosenberg, 1996; Coventry et al, 2000; Messadi and Younai, 2003; Scully and Felix, 2005a; Porter and Scully, 2006; Lee et al, 2007; Hughes and McNab, 2008; Scully and Greenman, 2008].
Examination of oral cavity and assessment of oral hygiene
- The recommendations to examine the oral cavity for oral and dental disease and to review dental hygiene are in line with published expert opinion and reflect the fact that in 80–90% of people with persistent halitosis there is a problem in the mouth.
- In a study involving 2000 consecutive people visiting a Dutch multidisciplinary breath odour clinic, an oral cause was found in 76% of people — with the main causes being tongue coating (43%), gingivitis/periodontitis (11%), or a combination of the two (18%) [Quirynen et al, 2009]. Xerostomia was responsible for 2.5% of cases. Only around 2% had an extra-oral cause, no cause was found in 0.8%, and 16% were classified as pseudo-halitosis/halitophobia.
- The recommendation on how to assess tongue coating is based on expert opinion [Rosenberg, 1996; Messadi and Younai, 2003].
Assessment of non-oral causes of halitosis
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