Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • malodorous breath
  • halitosis not noticed by either clinician or patient's partner/relatives
  • history of obsessive behaviour, depression, phobic anxiety, paranoid ideation, and reduced social interaction
  • patient reports that people react to his/her bad breath by covering their nose and opening windows
  • consumption of onions, garlic, or spiced food
  • evidence of dental and/or periodontal disease
  • evidence of disease of the oral mucosa
  • evidence of nasopharyngeal disease

Other diagnostic factors

  • evidence of upper respiratory tract or GI disease
  • evidence of upper respiratory tract and GI malignancy
  • evidence of endocrine, metabolic, hepatic, or renal disease

Risk factors

  • oral disease
  • respiratory disease
  • GI disease
  • hepatic disease
  • renal disease
  • endocrine disease
  • metabolic disease

Diagnostic investigations

Investigations to consider

  • sulfide monitor
  • gas chromatography
  • benzol-arginine-naphthylamide (BANA) test
  • dark-field microscopy
  • PCR of oral bacteria
  • selected ion flow tube mass spectroscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Stephen R. Porter

Director and Professor of Oral Medicine

UCL Eastman Dental Institute

London

UK

Disclosures

SRP declares that he has no competing interests.

Stefano Fedele

Senior Clinical Lecturer in Oral Medicine

UCL Eastman Dental Institute

London

UK

Disclosures

SF has received research funding and advisory/consultancy fees from Amgen for work unrelated to this article. SF has also received fess from professional conferences for lecturing on topics unrelated to this article.

Peer reviewers VIEW ALL

Professor of Oral Medicine

Department of Oral Sciences

University of Palermo

Palermo

Italy

Disclosures

GC declares that she has no competing interests.

Professor

Howard University College of Dentistry

Washington

DC

Disclosures

RSB declares that he has no competing interests.

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