These recommendations are based on published narrative reviews on halitosis or oral malodour [Rosenberg, 1996; Coventry et al, 2000; Yaegaki and Coil, 2000; Morita and Wang, 2001; Messadi and Younai, 2003; Scully and Felix, 2005a; Porter and Scully, 2006; Lee et al, 2007; Hughes and McNab, 2008; Scully and Greenman, 2008].

• Smelling the person's breath is recommended to confirm halitosis and to exclude suspected pseudo-halitosis or halitophobia.
• It is generally recognized that individual assessment is a poor measure of halitosis [Hughes and McNab, 2008; Scully and Greenman, 2008].
• Because of the difficulty inherent in smelling one's own breath, some people may have exaggerated concerns about their own breath [Rosenberg, 1996; Eli et al, 2001].
• In a study involving 2000 consecutive people visiting a Dutch multidisciplinary breath odour clinic, 15.7% had no objective signs of malodour and were grouped as pseudo-halitosis/halitophobia [Quirynen et al, 2009].
• Subjective (organoleptic) assessment is regarded as the most simple, reliable, and practical method for evaluating the severity of halitosis [Yaegaki and Coil, 2000; Porter and Scully, 2006; Scully and Greenman, 2008; Vandekerckhove et al, 2009].
• Methods such as gas chromatography or measurement of volatile sulphur compounds are more objective and are commonly used in research. However, these methods are impractical, expensive, and unavailable in primary care. The limitations of volatile sulphur compound measurement is discussed in Supporting evidence.