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Detecting and treating oral and nonoral malodors.

This article suggests methods on how to detect and treat the various oral and nonoral malodor conditions with which patients present. These conditions are separated into those emanating from the nasal passage, sinuses and upper respiratory sources; the mouth; the tongue; the oropharynx; the lower respiratory tract; and the lungs. Foul odors also develop as a result of systemic and gastrointestinal disorders and diseases, as well as the normal breakdown of odiferous ingested foods. The available detection methods are described and future methods are suggested. The overall conclusions made from this review are that currently available management methods will be able to treat most cases. A careful, knowledgeable clinician can usually determine the patient's problem by the use of a thorough history and examination. Occasionally medical consults will be needed; and, in these cases, the approach that must be taken is a combined treatment approach. For example, effective therapy might require a combination of periodontal disease treatment, correction of dental restoration-based food traps and a rigorous daily mechanical debridement of the tongue. The above treatments will often have to be supplemented by the most appropriate mouthwash for the patient's specific condition. Finally, this article hopes to encourage manufacturers of "halitosis products" to support and conduct well-designed clinical trials on their products so that the field is advanced and treatments become more predictable.