Breath Malodor – A Review of the Fundamentals

Abstract

Recently, there has been an increased self-awareness of halitosis post the COVID-19 pandemic due to the continuous wearing of masks. Oral malodor, often known as foul/bad breath, is a foul odor that arises from the oral cavity. Numerous etiologic factors cause breath malodor, of which tongue coating is the most common intraoral cause. Extra-oral etiology, such as lung infections, diabetes, and kidney diseases, also plays a significant role. Halitosis is caused by anaerobic bacteria producing volatile sulfur compounds subsequent to protein degradation in the mouth. Intraoral etiology is the most common cause that can be efficiently treated with proper oral hygiene, mechanical, and chemical plaque control methods. Extra-oral etiology requires referral to a medical specialist. However, psychological causes such as halitophobia necessitate consultation with a clinical psychologist. Persistent oral malodor has a negative impact on social interactions and decreases the oral health-related quality of life. A literature search of review articles, systematic reviews, and studies on halitosis, using the mesh terms etiology, diagnosis, and management, was carried out using PubMed and Google Scholar search engines. This review addresses the basic concepts of oral malodor, its causes, pathophysiology, and management.