- Mel Rosenberg, PhD
Mel Rosenberg, PhD
- Professor Emeritus, Department of Human Microbiology
- Sackler Faculty of Medicine
- Tel Aviv University, Israel
Bad breath (sometimes referred to as halitosis, oral malodor, fetor oris, or fetor ex ore) is defined as any detectable offensive smell carried on the breath. Gases that might appear in the breath in abnormal concentrations, yet are not detected by the nose, would not fall under this definition.
This topic will cover the etiology, pathogenesis, diagnosis, and treatment of bad breath. Other related topics such as gingivitis, periodontitis, and odontogenic infections are discussed elsewhere. (See "Gingivitis and periodontitis in adults: Classification and dental treatment" and "Epidemiology, pathogenesis, and clinical manifestations of odontogenic infections" and "Complications, diagnosis, and treatment of odontogenic infections".)
Bad breath has been with us for thousands of years. The problem is discussed at length in the Jewish Talmud, as well as by Greek and Roman writers. Islam also stresses fresh breath in the context of good oral hygiene.
Ancient folk remedies abound that are still in use. The book of Genesis (Chapter 37) mentions ladanum (mastic), which may be the mastic gum derived from the Pistacia lentiscus tree, which has been used in Mediterranean countries for breath freshening for thousands of years. Other folk cures include mint, anise, parsley (Italy), cloves (Iraq), guava peels (Thailand), and eggshells (China).
Modern literature on bad breath dates back to a monograph published by Howe in the 19th century. Experimental research on the subject dates back over 70 years.
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- Sterer N, Rosenberg M. Effect of deglycosylation of salivary glycoproteins on oral malodour production. Int Dent J 2002; 52 Suppl 3:229.
- Sterer N, Rosenberg M. Streptococcus salivarius promotes mucin putrefaction and malodor production by Porphyromonas gingivalis. J Dent Res 2006; 85:910.
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- Kozlovsky A, Gordon D, Gelernter I, et al. Correlation between the BANA test and oral malodor parameters. J Dent Res 1994; 73:1036.
- Bosy A, Kulkarni GV, Rosenberg M, McCulloch CA. Relationship of oral malodor to periodontitis: evidence of independence in discrete subpopulations. J Periodontol 1994; 65:37.
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- Leo Sreebny, personal communication.
- Suarez F, Springfield J, Furne J, Levitt M. Differentiation of mouth versus gut as site of origin of odoriferous breath gases after garlic ingestion. Am J Physiol 1999; 276:G425.
- Eli I, Baht R, Kozlovsky A, Rosenberg M. The complaint of oral malodor: possible psychopathological aspects. Psychosom Med 1996; 58:156.
- Murata T, Rahardjo A, Fujiyama Y, et al. Development of a compact and simple gas chromatography for oral malodor measurement. J Periodontol 2006; 77:1142.
- Rosenberg M, McCulloch CA. Measurement of oral malodor: current methods and future prospects. J Periodontol 1992; 63:776.
- Outhouse TL, Al-Alawi R, Fedorowicz Z, Keenan JV. Tongue scraping for treating halitosis. Cochrane Database Syst Rev 2006; :CD005519.
- McCullough MJ, Farah CS. The role of alcohol in oral carcinogenesis with particular reference to alcohol-containing mouthwashes. Aust Dent J 2008; 53:302.
- Rosenberg M. The science of bad breath. Sci Am 2002; 286:72.