Halitosis is it just bad breath or is it something deeper

To begin, it is important to educate and coach your patient on proper oral hygiene by advising:

1. Brushing twice-daily with an antibacterial toothpaste such as Colgate Total, and interdental cleaning daily with floss, interdental brushes, picks or oral irrigation. Antibacterial toothpastes will assist in reducing bacteria which produce the VSCs that cause halitosis.
2. Remember to clean their tongue. The papillae on the tongue hold small food particles, bacteria and sloughed epithelial cells all of which degrade to form foul odors. Tongue cleaners are often available on the back of toothbrushes or there are devices just for tongue cleaning.
3. Rinsing with an antibacterial mouthrinse helps to reduce the oral bacterial load. You can advise your patients to rinse with a product that contains antibacterial active ingredients, such as Colgate Total 12 HR Pro-Shield Mouthwash which contains cetylpyridinium chloride (CPC), or an essential oils mouth rinse. Chlorhexidine gluconate rinse (prescription only), for example Colgate PerioGard, is indicated for use between dental visits as a component of a professional program for the treatment of gingivitis, and a powerful antimicrobial rinse. While not indicated for halitosis, it does reduce the level of bacteria present. Another option is a hydrogen peroxide mouth rinse, such as Colgate Peroxyl, which works by helping to remove debris through its oxygenating action. Some mouthwashes only use ingredients that mask the malodor and as a result only have a temporary effect after rinsing. Patients can also be advised to use a mouthrinse at a different time to brushing their teeth to allow for the fluoride in their toothpaste to be effective.

By treating diagnosed conditions such as periodontal disease and dental caries, including with the above recommendations, halitosis can be reduced.

Patients may also report other issues along with their bad breath, such as complaints of heartburn or a persistent cough which suggests GERD, or report complaints consistent with another systemic condition. If a systemic disease/condition is suspected as a potential cause, patients should be referred to a physician for diagnosis and treatment.