Occurrence of halitosis, breath malodour or 'bad breath' may indicate certain medical problems (e.g. periodontitis) and may cause social problems. In only 10% of all cases halitosis is caused by an internal (e.g. diabetes mellitus, oesophagitis) or ear-nose-throat problem. For the remaining 85-90% quite a wide range of different oral causes (e.g. gingivitis, periodontitis, necrotising ulcerative gingivitis and periodontitis, caries lesions with food impaction, fissurated tongue) exists. Halitosis may be assessed clinically (organoleptic) or by using instrumental devices. Together with patient history, careful examination provides information about the most likely case of malodour. With a dental cause, an effective individual oral hygiene programme should be rendered. Therapy will be targeted at reduction of oral micro-organisms, reduction of bacterial nutrients, transformation of volatile sulphur compounds into non-volatile molecules and, if required, rinsing solutions to mask halitosis. Harbouring approximately 60% of all oral bacteria, the tongue should be cleaned by the patient on a daily basis. If halitosis is caused by periodontitis, a systematic anti-infective periodontal programme eventually followed by periodontal surgery should solve the problem.
Keywords: breath malodour, organoleptic assessment,volatile sulphur compounds