Oral medicine: 5. halitosis

Specialist referral may be indicated if the Practitioner feels:

Oral malodour, or halitosis, is a common complaint in adults, though few mention it, and can have a range of causes (Table 1). With oral malodour from any cause, the patient may also complain of a bad taste.

Oral malodour is common on awakening (morning breath) and then often has no special significance, being usually a consequence of low salivary flow, lack of oral cleansing during sleep as well as mouthbreathing.

This rarely has any special significance, and can be readily rectified by rinsing the mouth with fresh water, eating and tongue brushing. Hydrogen peroxide rinses will also help abolish this odour.

Oral malodour at other times is often the consequence of eating various foods such as garlic, onion or spices, foods such as cabbage, brussel sprouts, cauliflower and radish, or of habits such as smoking, or drinking alcohol. Durian is a tropical fruit which is particularly malodorous.