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Review
. 2022 Sep 8;19(18):11303.
doi: 10.3390/ijerph191811303.

Revisiting Standard and Novel Therapeutic Approaches in Halitosis: A Review

Catarina Izidoro  1   2 , João Botelho  1   2 , Vanessa Machado  1   2 , Ana Mafalda Reis  3   4 , Luís Proença  5 , Ricardo Castro Alves  1   2 , José João Mendes  2
Affiliations
Review

Revisiting Standard and Novel Therapeutic Approaches in Halitosis: A Review

Catarina Izidoro et al. Int J Environ Res Public Health. .

Abstract

Halitosis, or bad breath, is an oral health problem characterized by an unpleasant malodor emanating from the oral cavity. This condition can have different origins and causes a negative burden in social interactions, communication and quality of life, and can in uncommon cases be indicative of underlying non-oral non-communicable diseases. Most cases of halitosis are due to inadequate oral hygiene, periodontitis and tongue coating, yet the remaining proportion of cases are due to ear-nose-throat-associated (10%) or gastrointestinal/endocrine (5%) disorders. For this reason, the diagnosis, treatment and clinical management of halitosis often require a multidisciplinary team approach. This comprehensive review revisits the etiology of halitosis as well as standard and novel treatment that may contribute to higher clinical success.

Keywords: halitosis; mouthwashes; periodontal disease; periodontitis; probiotics; tongue coating.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pathophysiology of halitosis. Bacteria present in the gingival pockets and the dorsum of the tongue metabolize amino acids through enzymes into volatile sulfur compounds that are exhaled.
Figure 2
Figure 2
Current classification of halitosis.
Figure 3
Figure 3
Treatment approach based on halitosis types and etiology.
See this image and copyright information in PMC

References

    1. Rayman S., Almas K. Halitosis among racially diverse populations: An update. Int. J. Dent. Hyg. 2008;6:2–7. doi: 10.1111/j.1601-5037.2007.00274.x. - DOI - PubMed
    1. Nadanovsky P., Carvalho L.B.M., de Leon A.P. Oral malodour and its association with age and sex in a general population in Brazil. Oral Dis. 2007;13:105–109. doi: 10.1111/j.1601-0825.2006.01257.x. - DOI - PubMed
    1. Lopes R.G., De Godoy C.H.L., Deana A.M., De Santi M.E.S.O., Prates R.A., França C.M., Fernandes K.P.S., Mesquita-Ferrari R.A., Bussadori S.K. Photodynamic therapy as a novel treatment for halitosis in adolescents: Study protocol for a randomized controlled trial. Trials. 2014;15:443. doi: 10.1186/1745-6215-15-443. - DOI - PMC - PubMed
    1. Loesche W.J., Kazor C. Microbiology and treatment of halitosis. Periodontol. 2000. 2002;28:256–279. doi: 10.1034/j.1600-0757.2002.280111.x. - DOI - PubMed
    1. Donaldson A.C., McKenzie D., Riggio M.P., Hodge P.J., Rolph H., Flanagan A., Bagg J. Microbiological culture analysis of the tongue anaerobic microflora in subjects with and without halitosis. Oral Dis. 2005;11((Suppl. S1)):61–63. doi: 10.1111/j.1601-0825.2005.01094.x. - DOI - PubMed

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