Genuine halitosis, pseudo-halitosis, and halitophobia: classification, diagnosis, and treatment.

Although tongue brushing and appropriate mouthrinses are both important and basic treatment measures for halitosis, other dental treatments are sometimes required. The treatment of genuine halitosis caused by oral conditions is not complex. In addition to genuine halitosis patients, psychosomatic halitosis patients also visit dental practitioners. Although psychosomatic halitosis is out of the treatment realm of dental practitioners, patients with this condition will still seek help from a dental practitioner. They often only receive treatment for genuine halitosis without referral to a psychological specialist. If these psychosomatic halitosis patients are incorrectly managed, the psychological condition might become worse than before the visit. To avoid the mismanagement of halitosis patients, classifications of halitosis patients have been established. Genuine halitosis was subclassified as physiologic halitosis and pathologic halitosis. Pathologic halitosis was further categorized to oral pathologic halitosis and extraoral pathologic halitosis. Both pseudo-halitosis and halitophobia patients complain of the existence of halitosis, which is not offensive. Pseudo-halitosis cannot be treated by dental practitioners, and halitophobia patients must be referred to psychological specialists. Clinicians need to examine the psychological condition of halitosis patients at the initial patient visit. A questionnaire prepared for the clinic at the University of British Columbia was found to be advantageous for this purpose.