From the Guidelines
Halitosis can be effectively treated through a combination of good oral hygiene practices and targeted interventions, with a focus on reducing bacteria that cause bad breath and addressing underlying conditions that may contribute to it. The most important treatment is thorough daily oral hygiene including brushing teeth twice daily with fluoride toothpaste, flossing once daily, and cleaning the tongue with a tongue scraper or toothbrush. Antimicrobial mouthwashes containing chlorhexidine (0.12%) or cetylpyridinium chloride can help reduce bacteria that cause bad breath; use as directed, typically twice daily for 30 seconds 1. Staying hydrated is crucial as dry mouth contributes to halitosis, so drink plenty of water throughout the day. For persistent dry mouth, artificial saliva products like Biotène or xylitol-containing lozenges can help stimulate saliva production. Avoid tobacco products, alcohol, coffee, and foods with strong odors like garlic and onions that can worsen breath odor.
Some natural products have also been shown to have anti-halitosis effects, such as herbal-based mouthwashes and toothpastes, which can be used as an adjunct to traditional treatments 1. However, it is essential to note that the evidence for these products is still emerging, and more research is needed to fully understand their effectiveness. If halitosis persists despite these measures, consult a dentist to rule out dental issues like gum disease, cavities, or infections that may require professional treatment. Bad breath often stems from volatile sulfur compounds produced by bacteria breaking down food particles and cells in the mouth, which is why targeting these bacteria through proper oral hygiene is the foundation of effective treatment.
In terms of specific treatments, tonsillectomy may be considered in cases where halitosis is severe and persistent, and other treatments have failed, although the benefits of tonsillectomy for halitosis must be weighed against the risks of surgery 1. However, this should only be considered after a thorough evaluation by a healthcare professional to rule out other underlying conditions that may be contributing to the halitosis. Overall, a comprehensive approach that includes good oral hygiene, targeted interventions, and addressing underlying conditions is the most effective way to treat halitosis and improve quality of life.
From the Research
Halitosis Treatment Options
- Tongue brushing and mouth rinsing are considered basic treatment measures for halitosis, categorized as treatment needs (TN)-1 2
- Tongue cleaning is more effective than mouth rinsing, as the origin of physiological halitosis is mainly the dorso-posterior region of the tongue 2
- Chlorhexidine mouthwash is effective in reducing oral malodour, but should not be used routinely; instead, zinc-containing mouthwashes are recommended 2
- Chewing gum can be used to reduce oral malodour, but sugarless chewing gum may increase methyl mercaptan, a principal component of oral malodour 2
Causes of Halitosis
- Halitosis is caused primarily by bacterial putrefaction and the generation of volatile sulfur compounds 3
- Ninety percent of patients suffering from halitosis have oral causes, such as poor oral hygiene, periodontal disease, and tongue coat 3
- Systemic causes of halitosis include renal or hepatic failure, carcinomas, diabetes, and trimethylaminuria 3
Diagnosis and Management
- Dental professionals play a key role in diagnosing and treating halitosis, and should be able to identify the various etiologies of the condition 4
- Treatment options for halitosis include maintaining proper oral hygiene, periodontal treatment, and tongue brushing 3, 4
- An individualized treatment plan should be developed for each patient, and referral to other healthcare professionals may be necessary in some cases 4, 5