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Halatosis

Halitosis is defined as a foul breath odor arising from a person's oral cavity or nasal passages. It differs from disorders of taste and smell in that the condition is typically not noticeable to the patient. The condition may be physiologic.

Pathophysiology

The most common physiologic cause is so-called morning breath. The universal condition derives from the cessation of regular salivary flow with sleep. Its marked reduction and resulting buccal cavity stasis allow mouth flora an opportunity to feed on remaining food particles, sloughed epithelial cells, and stagnant saliva in halatosis. The byproducts of bacterial metabolism cause the foul odor. Pathologic halitosis may derive from impairment of normal salivary flow (eg, parotid disease, Sjogren's syndrome), increased presentation of bacterial substrate (periodontitis, sinusitis).

Workup

is similar to that described above for disorders of taste and smell, with more attention paid to possible oral cavity pathology. It helps to begin the assessment by directly confirming the reported odor. Differentiating halatosis caused by an oral source from a nasal one can be done.

Treatment

Treatment should be etiologic. Trying to mask the odor is far less effective than addressing its etiology. Mouthwashes are a poor substitute for good oral hygiene.

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