Health Renaissance 2011; Vol 9 (No. 2):106-111 Halitosis: a social problem Review Article

allow initiation of the proper etiologic treatment. Although gingivitis, periodontitis, and tongue coating are by far the most common causes of malodor, a clinician cannot take the risk of overlooking the other, more challenging diseases. Several non-oral pathologic conditions have been related to oral malodor, including infection of the upper and lower respiratory tracts, the gastrointestinal tract, and some metabolic diseases involving the kidneys and the liver.2 Socio-economic aspects Breath malodor is a considerable social and/or relational problem. Everyone must have experienced breath odor that is unpleasant if not unbearable when a person is speaking at close proximity. Subjects who believe they produce malodor can adopt avoidance patterns like keeping a distance when speaking to others or holding their hand in front of the mouth while speaking. Even more disturbing is the fact that a number of subjects imagine they have bad breath when they may not have. This imaginary breath odor, also called halitophobia,3 has been associated with Halitosis: a serious social proble