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Halitosis - Management
How should I manage someone complaining of halitosis?

  • Refer all people with dental disease or suspected oral cancer.
  • Manage any underlying causes of halitosis.
  • If no pathological cause is identified:
    • Offer self-care advice about oral hygiene and advise the person to visit their dentist if oral or denture hygiene is poor.
      • Consider referring all people with halitosis (including those without a pathological cause) to a dentist for a full oral examination as some oral diseases may be difficult to diagnose by visual examination alone.
    • Give advice on reducing risk factors for halitosis.
      • Avoid foods and drinks known to cause transient halitosis — such as garlic, onion, and alcohol.
      • Advise smoking cessation and to avoid chewing tobacco (for further information, see the CKS topic on Smoking cessation).
      • Treat dry mouth by increasing fluid intake, sucking sugar-free sweets or chewing sugar-free gum. Consider the use of an artificial salivary substitute if these measures are insufficient.
      • Advise that dentures should be left out at night, and that the person consults their dentist if they have problems with their dentures.
    • Advise regular dental checks to ensure maintenance of oral hygiene.
    • Empirical treatment with antibiotics and Helicobacter pylori eradication therapy are not recommended.
  • For people without detectable halitosis:
    • Offer reassurance.
    • Suspect the possibility of pseudo-halitosis or halitophobia — particularly if they have good oral and dental health.
    • Discuss referral for psychological therapy if halitophobia is severe.

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