Classifying a person’s type of bad breath.

When a patient seeks treatment for halitosis, the dentist must first assess the specific type of breath condition they have. This is an important step because the needed solution for different categories of bad breath varies significantly.

The three major classifications of halitosis are:

• Genuine halitosis
• Pseudo-halitosis
• Halitophobia

The category Genuine halitosis is further subdivided into the following three subtypes:  Oral Pathologic,  Extraoral Pathologic,  and Physiologic halitosis.

A) Genuine Halitosis

Identification.

This category refers to cases where the person’s bad breath can be readily detected by:

• Organoleptic testing, which refers to the evaluation of the person’s breath by smelling it (although under controlled/objective conditions).

  Related page: Self-testing- How to smell your own breath accurately. 6 methods.

• Or via the use of some type of testing apparatus that can detect the types of smelly compounds  volatile sulfur compounds typically associated with bad breath.

  Related page: 6 devices used to test for halitosis: Breath checkers, detectors, sensors, testing strips. How well do they work?

Symptoms.

The patient has an obvious malodor, it has an intensity that lies beyond what’s generally considered socially acceptable, and as such, it tends to affect their personal relationships.

The category of Genuine halitosis is further broken down into the subcategories: Pathologic and Physiologic halitosis.

B) Pseudo-halitosis

This classification refers to the situation where the patient does not have an actual breath odor problem (nothing can be detected by smell or scientific testing) but they are still certain that they do have bad breath. Since no real breath problem exists, treatment consists of counseling the patient about their misconception.

Pseudo-halitosis represents about 15% of cases.

▲ Section references – Quirynen

C) Halitophobia

This category refers to the situation where a patient’s perception of a breath problem continues to exist despite the successful treatment of their genuine halitosis condition, or in the case of pseudo-halitosis, after receiving counseling.

At this point, treatment for the patient’s condition needs to be referred to a medical professional who can provide appropriate psychological counseling.

The subcategories of Genuine Halitosis.

Medical professionals subdivide the genuine halitosis category (the situation where an actual breath odor problem can be detected by testing) into two further classifications, “physiologic” and “pathologic” halitosis.

1) Pathologic Halitosis

This condition refers to the situation where the person’s breath odor is a result of disease or other pathologic condition, or aggravated by it.

As detailed below, the category of Pathologic halitosis is further broken down into the subcategories: Oral and Extraoral halitosis.

2) Physiologic Halitosis

This category refers to the situation where the person’s malodor is due to putrefaction (the decay or rotting of organic matter) taking place in their oral cavity, frequently within the white-colored coating found on the posterior (rearmost) portion of their tongue (see picture below).

This is the most common form of bad breath and involves 90% of cases. (Bartold)

Related page: What’s the actual source of most people’s breath odors? It’s not much of a mystery.

The most common cause of Genuine halitosis is debris on the posterior portion of the tongue.

Treatment.

This classification of bad breath is considered to be transient, in the sense that its presence comes and goes, as determined by temporary localized conditions in the mouth.

A patient is usually able to resolve their physiologic halitosis simply by improving their oral home care, especially if tongue cleaning is included.

▲ Section references – Bartold

Related pages:

• The approach that’s able to cure just about everyone’s bad breath. It’s three simple goals.
• Why tongue cleaning (scraper, brush or even just a spoon) is the only bad breath cure that most people need. Our how-to guide.

The subcategories of Pathologic Halitosis.

The subdivisions of the pathologic halitosis category are based on the location of the disease process that’s associated with the patient’s breath problem.

1) Oral Pathologic Halitosis

This category includes situations where the person’s odor problems are caused or aggravated by a disease or other pathologic conditions associated with tissues inside the mouth.

As a primary example, a person’s malodor may be due to, or aggravated by, the presence of advanced gum disease. The role it plays. Additionally, co-factors (like dry mouth and smoking) See full list. can play a role in pathologic halitosis too.

2) Extraoral Pathologic Halitosis

With these cases, the person’s breath malodor originates from a disease or a pathologic condition involving body tissues other than in the mouth. The odor may originate from:

Sinus discharge can be the cause of breath odors.

• The nasal, paranasal or laryngeal areas (upper respiratory tract).

  Possible associated conditions: postnasal drip, chronic sinusitis, acute viral or bacterial infection, tonsillitis, tonsilloliths, deep tonsillar crypts.

• The lower respiratory tract (lungs) or upper digestive tract.

  Possible associated conditions: chronic bronchitis, bronchiectasis, hiatus hernia, Helicobacter pylori infection, malabsorption conditions.

• Disorders anywhere else in the body. In these cases, compounds produced by the disease process are bloodborne and a state of breath malodor is created when they are exhaled from the lungs.

  Possible associated conditions: diabetes, liver cirrhosis, uremia, kidney insufficiency, menstrual cycle, internal bleeding.

Our next page explains what the odors you smell are and where they come from. Once you know that, you’ll know how to cure your problems.