04. What types of halitosis are there?

Changes in the odour of exhaled air can be classified in different ways. For example, based on their intensity, from unperceivable odours to highly unpleasant odour (various scientific scales exist, such as the Rosenberg Self-Esteem Scale, the Seemann scale, etc.)) They can be classified according to frequency (occasional, intermittent, reactive or continuous, or chronic); according to duration (brief, long); according to odour type, to name a few.

“There are over 80 possible causes of halitosis”.

It is important to point out that the patterns of manifestation of halitosis usually reflect the causes that trigger it. For example, halitosis brought on by liver cirrhosis is usually very intense, chronic, of a longer duration, and usually has a very distinctive odour (foetor hepaticus i.e. a sweet musty smell to the breath). However, remember that there over 80 possible causes of halitosis, so cases can also be classified according to cause (etiological classification).

As for their clinical significance, halitosis can be physiological (no medical treatment is needed, e.g. halitosis in an individual after waking up) or pathological (medical treatment is needed, e.g. Zenker’s diverticulum).

Lastly, as regards categorising patients who seek treatment for halitosis, the classification system most widely used in science is that of Miyazaki or Yaegaki, which groups halitosis sufferers into type 1 or “genuine” (when it is detectable by a third party); type 2 or “pseudohalitosis” (when there is only the self-perception of halitosis, but third parties or measuring apparatus do not detect it) and type 3 or “halitophobia” (obsessive psychiatric disturbance).