Oral Malodour and its Management: A Periodontal Perspective

ABSTRACT Halitosis is a very common condition which may affect up to 30% of the population. In most cases the aetiology of the condition is from local oral causes (oral malodour). Oral malodour is the result of the action of anaerobic bacteria in producing a range of malodorous molecular species including volatile sulphur compounds. Patients with halitosis may seek treatment from dental clinicians for their perceived oral malodour. Physiologic halitosis, oral pathologic halitosis and pseudo-halitosis would be in the treatment realm of dental practitioners. Management of oral malodour is directed at managing and reducing the bacterial load both in periodontitis and in tongue coatings by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiseptic agents. Treatments have also been proposed to neutralise malodorous compounds by chemical agents to mask the presence of the condition. Further evidence is required to demonstrate the long-term efficacy of therapies for this troublesome condition. The purpose of this article is to review the etiology, diagnosis and treatment of oral malodor from a periodontal perspective. The review will be limited to bad breath odors originating within the mouth.