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Haltosis 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 or a manifestation of oral-nasal.


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. 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), or a metabolic derangement (renal or hepatic failure). In rare instances, the patient is the only one to note the condition, strongly suggesting a hallucination of psychiatric.


Evaluation of haltosis 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 an oral source from a nasal one can be done by pinching.


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.