Halitosis: An 8-Type Clinical Classification With Integrated Diagnostic and Therapeutic Algorithms.

Misclassification of halitosis frequently results in ineffective treatment. A clinical classification system is presented that organizes halitosis into eight types based on etiology and clinical presentation. Intraoral causes include tongue biofilm, periodontal disease, peri-implant disease, and xerostomia-associated halitosis, while extraoral causes comprise airway related conditions and metabolic/systemic disorders with pulmonary elimination of bloodborne compounds. Perceptual conditions are categorized as pseudohalitosis and halitophobia. A diagnostic workflow is proposed to guide clinicians in distinguishing etiologies.