Published: 2021-08-27

Halitosis as a key diagnostic factor to systemic diseases in the primary care

Marwah Yakoop Abdullah, Anhar Abdullah Mansour, Abdulrahman Ahmed Abusallama, Faisal Thaib Alenazi, Hussain Ali Almumtin, Hamdan Ahmed Althubyani, Alhnoof Abdullah Alwimny, Haya Baher Aldamanhori, Norah Abdulmohsen Alsuwailem, Abeer Ali Aloufi, Gharam Moghdeb Alruwaili


Halitosis might be associated with reduced quality of life for the affected patients as a result of the personal and social embarrassments it might cause. The adequate identification and diagnosis of the underlying condition causing halitosis are important to achieve adequate treatment and prevention of many systemic diseases or even neoplasms. In this literature review study, we have discussed the potential role of halitosis in the diagnosis and identification of systemic diseases. We have discussed many diseases as diseases related to the gastrointestinal tract and liver, others related to metabolic and endocrinal disorders. Furthermore, psychological factors might attribute to pseudo-halitosis, while true halitosis comes secondary to oral and extraoral factors and physiological conditions. Poor oral hygiene might be the only reason for oral malodor, while many oral conditions might also contribute to the development of halitosis. Additionally, some conditions might have a characteristic bad smell, which might significantly enhance the diagnostic value and help clinicians. However, further examination and evaluation should also be conducted to prevent a potential overlap between the different conditions. On the other hand, some extra-oral disorders do not have a characteristic oral smell, which indicates that halitosis alone cannot adequately establish a proper diagnosis. Therefore, raising awareness about seeking medical attention when suffering from halitosis is recommended to achieve better outcomes and help clinicians draw efficacious prevention programs.


Halitosis, Family medicine, Systemic diseases, Diagnosis

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