Management of halitosis

Initial management of halitosis requires identifying and addressing the cause (see Common causes of halitosis).

Management of self-limiting causes of halitosis includes:

  • improving oral hygiene, including tongue cleaning
  • avoiding odour-causing foods, smoking and alcoholic beverages
  • addressing the cause of mouth breathing, if identified
  • considering a trial of other nonspecific measures, such as:
    • chewing sugar-free gum to stimulate saliva
    • ensuring adequate hydration
    • reducing caffeine intake.

Management of intraoral causes of halitosis depends on the origin of the malodour—see Common causes of halitosis. Promote oral hygiene for patients with an intraoral cause of halitosis. If improved oral hygiene and management of intraoral causes does not resolve halitosis, referral to a medical practitioner is appropriate to investigate for extraoral causes.

Note: Promote oral hygiene for patients with transient or intraoral causes of halitosis.

If an extraoral cause of halitosis is identified, manage as required; referral may be necessary.

Refer patients with persistent or recurrent halitosis to a specialist (eg oral medicine specialist, periodontist).

Patients with psychogenic halitosis present a diagnostic and treatment challenge, and, despite reassurance, may require psychological assessment.