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VOLUME 3 , ISSUE 1 ( January-April, 2009 ) > List of Articles


Oral Malodour and its Management: A Periodontal Perspective

Kalwa Pavankumar

Citation Information : Pavankumar K. Oral Malodour and its Management: A Periodontal Perspective. J Oral Health Comm Dent 2009; 3 (1):6-13.

DOI: 10.5005/johcd-3-1-6

License: CC BY-NC 3.0

Published Online: 00-01-2009

Copyright Statement:  Copyright © 2009; Jaypee Brothers Medical Publishers (P) Ltd.


Halitosis is a very common condition which may affect up to 30% of the population. In most cases the aetiology of the condition is from local oral causes (oral malodour). Oral malodour is the result of the action of anaerobic bacteria in producing a range of malodorous molecular species including volatile sulphur compounds. Patients with halitosis may seek treatment from dental clinicians for their perceived oral malodour. Physiologic halitosis, oral pathologic halitosis and pseudo-halitosis would be in the treatment realm of dental practitioners. Management of oral malodour is directed at managing and reducing the bacterial load both in periodontitis and in tongue coatings by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiseptic agents. Treatments have also been proposed to neutralise malodorous compounds by chemical agents to mask the presence of the condition. Further evidence is required to demonstrate the long-term efficacy of therapies for this troublesome condition. The purpose of this article is to review the etiology, diagnosis and treatment of oral malodor from a periodontal perspective. The review will be limited to bad breath odors originating within the mouth.

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  1. A Brief Review CDHA Journal 1999; 14(2):13–15.
  2. Dent Econ 1995;6.
  3. What to do about halitosis? Brit Med J 1994;308:217–18.
  4. Non oral etiologies of oral malodor and altered chemosensation. J Periodontol 1992;63(9): 790–96.
  5. Field EA. Halitosis: A review. Dental Update 1993;20:57–61.
  6. Clinical assessment of bad breath: current concepts. J Am Dent Assoc 1996;127(4):475–82.
  7. Oral Malodor-a review. J Can Dent Assoc 1993;(7): 607–10.
  8. Gastatory and olfactory considerations. Examination and treatment in general practice. J Am Dent Assoc 1993;31:53–73.
  9. Halitosis and Helicobacter pylori. J Clin Gastroenterl 1993;15:236–37.
  10. Salivary metabolic factors and involved in oral malodor formation. J periodont 1992;63(9):768–75.
  11. The Role of periodontitis in Oral Malodor: Clinical Perspectives Bad breath: A multidisciplinary approach. van Daniel Steenberghe and Mel Rosenberg Editors.
  12. Bad Breath: research perspectives. Ramot Pub Tel Aviv 1995.
  13. Bad Breath: etiology and treatment. Periodontics Oral Health 1991;19–24.
  14. Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol 1977;28:13–20.
  15. Biochemical and clinical factors influencing oral malodor in periodontal patients. J Periodontol 1992;63:783–89.
  16. Cadaverine as a putative component of oral malodor. J Dent Res 1994;73(6):1168–72.
  17. On the transformation of sulfur-containing amino acids and peptides to volatile sulfur compounds (VSC) in the human mouth. Eur J Oral Sci 1997;105(5 pt 2):534–37.
  18. Volatile sulfur compounds in mouth air from clinically healthy subjects and patients with periodontal disease. J Periodont Res 1992;27:223–38.
  19. The tongue microflora and tongue surface characteristics contribute to oral malodor In: van Steenberge D. Rosenberg M (eds), Bad Breath: A Multidisciplinary Approach. Leuven Belgium: Leuven University Press, 1996:111–121.
  20. Correlation between BANA test and oral malodor parameters. J Dent Res 1994;73(5):1036–42.
  21. Assessing the contribution of anaerobic microflora of the tongue to oral malodor. JADA 1995;126:1384–93.
  22. The biological basis of oral malodor formation In Rosenberg M. (Ed) Bad Breath: research Perspective. Tel Aviv, Israel Ramot Publishing. Tel Aviv University 1995:13–39.
  23. The role of microorganisms in the production of oral malodor. Oral Surg 1972;34:41
  24. Cadaverine as a putative component of oral malodor. J Dent Res 1994;73(6):1168–72.
  25. Measurements of oral malodor: current methods and future prospects. J Periodontol 1992;63:776–82.
  26. Study on the organleptic intensity scale for measuring oral malodor. J Dent Res 2004;83:81–5.
  27. Effects of training on odor judges scoring intensity. Oral Dis 2005;11:40–4.
  28. Halitosis measurement by an industrial sulfide monitor. J Periodon 1991;62:487–89.
  29. Reproducibility and sensitivity of oral malodor measurements with a portable sulfide monitor. J Dent Res 1991;11:1436–40.
  30. Communication of gender from human breath odors: Relationship to perceived intensity and pleasantness. Norm Behav 1982;16:13–22.
  31. Evaluation of volatile odiferous components of saliva. Arch Oral Biol 1964;9:39–45.
  32. Where gastroenterology and periodontology meet: determination of oral volatile organic compounds using closed-loop trapping and high resolution gas chromatography ion trap detection. In: van Steenberghe D, Rosenberg M, Bad Breath: A multidisciplinary approach. Leuven University Press. Leuven, Belgium 1998:pg17–30.
  33. Detection and simultaneous identification of microorganisms from headspace samples using an electronic nose. Sensors and Actuators 1970;B44:413–22.
  34. Association between oral malodour and adult periodontitis: a review. J Clin Periodontol 2001;28:813–19.
  35. Clinical assessment of bad breath: current concepts. JAm Dent Assoc 1996;127:475–82.
  36. Tongue scraping for treating halitosis. Cochrane Database Syst Rev 2006;(2):CD005519.
  37. Mechanical effects and volatile sulphur compound-reducing effects of chewing gums: comparison between test and base gums and a control group. Quintessence Int 1999;30:319–23.
  38. Halitosis.
  39. The effect of a 1-stage full-mouth disinfection on oral malodour and microbial colonization of the tongue in periodontitis: a pilot study. J Periodontol 1998;69:374–82.
  40. Effects of a two-phase oil-water mouthwash on halitosis. Clin Prev Dent 1992;14:5–9.
  41. Efficacy of a 2-phase oil-water mouthrinse in controlling oral malodour, gingivitis and plaque. J Periodontol 1996;67:577–82.
  42. Odor reduction potential of a chlorine dioxide mouthrinse. J Clin Dent 1998;9:39–42.
  43. Oral malodour: an indicator of health status and oral cleanliness. Int Dent J 1978;28:309–19.
  44. Clinical effectiveness of a triclosan/copolymer/sodium fluoride dentifrice in controlling oral malodour: a 3 week clinical trial. Oral Dis 2005;11:51–3.
  45. The clinical comparison of a triclosan/copolymer/sodium fluoride dentifrice vs a breath-freshening dentifrice in reducing breath odor overnight: a crossover study. Oral Dis 2005;11:54–56.
  46. Effect of visible light on malodour production by mixed oral microflora. J Med Microbiol 2005;54:1225–29.
  47. Self assessment of oral malodour 1 year following initial consultation. Halitophobia 1999;30:324–27.
  48. Physiology of taste receptors. Physiology of olfactory receptors. In: Basic Oral Physiology. Bradley, R.M. ed. Chicago and London, Year Book Medical Publishers. Ch 3,21-24; Ch 4,43-57, 1981.
  49. Sensations arising in the mouth. In: Physiology and Biochemistry of the Mouth GN. Jenkins, ed. Oxford and London. Blackwell Scientific Publications (67 References to Basic Physiology) 1978:pp.542–570.
  50. Bad breath, etiology, diagnosis and treatment. Oral Health 1991;81:19–24.
  51. Delusional halitosis. Review of the literature and analysis of 32 cases. Br Dent J 1990;168:294–96.
  52. Sources measurement and implication of oral malodor. J Dent Res 1991;70:337, 572.
  53. The correlation between organoleptic mouth-odor ratings and levels of volatile sulfur compounds. Oral Surg 1978;45:560–67.
  54. Quantitative differences in volatiles from healthy mouths and mouths with periodontitis. Clin Chem 1981;27:842–45.
  55. Fractionation of the salivary cellular elements by Percoll density gradient centrifugation and the distribution of oral malodor precursors. Shigaku 1989;77:269–75.
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