[Contemporary views on etiology and pathogenesis of halitosis]

Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. There is the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC) produced by bacteria. Halitosis is caused mainly by tongue coating and periodontal disease. Bacterial metabolism of amino acids leads to metabolites including many compounds, such as indole, skatole and volatile sulphur compounds (VSC), hydrogen sulphide, methyl mercaptan and dimethyl sulphide. They are claimed to be the main etiological agents for halitosis. The paper reviews the prevalence and distribution of halitosis, oral malodour, its aetiology, concepts of general and oral health and diseases. Eating, smoking and drinking habits and understanding of halitosis as a social norm has been highlighted. It is a public social health problem. The dental professionals should be aware of the cultural perceptions of halitosis among racially and culturally diverse populations. In general, physicians and dentists are poorly informed about the causes and treatments for halitosis.