Prevention and therapy of halitosis

  • Treatment is mainly directed towards patient education regarding the cause and prevention of halitosis and aimed at reducing the bacterial load. Teeth and tongue cleaning and the use of mouthrinses are considered effective treatments. Antibacterial substances have been shown to reduce the growth of VSC-producing bacteria (de Boever & Loesche 1995, Pratten et al. 2003, Outhouse et al. 2006).
  •  The scientific evidence for the effectiveness of mechanical tongue cleaning alone in halitosis control is still under discussion (Danser et al. 2003, Haas et al. 2007, Outhouse et al. 2006, Pedrazzi et al. 2004, Quirynen et al. 2004, Seemann et al. 2001). But it is common sense that the mechanical removal of the tongue coating has to be part of the halitosis treatment as the tongue is the largest niche for odour-causing bacteria in the oral cavity. Therefore, Filippi (2009) proposes to use a tongue cleaner in combination with a special paste for the tongue.

Treatment and prevention of halitosis

 

  • Mechanical biofilm control e.g. tongue cleaning, interdental cleaning, toothbrushing
  • Chemical plaque control with antibacterial substances, including regular use of antimicrobial toothpastes and mouthrinses  e.g. chlorhexidine digluconate, amine fluoride/stannous fluoride, triclosan, hydrogen peroxide, essential oils
  • Neutralisation of VSC  e.g. metal ions with an affinity for sulphur
  • Professional periodontal therapy (if indicated)
  • Management of possible systemic causes
  • Referral to a clinical psychologist in cases of halitophobia