Diagnostic Technique for Assessing Halitosis Origin Using Oral and Nasal Organoleptic Tests, Including Safety Measures Post Covid-19

Abstract

Organoleptic tests are essential in the diagnosis and treatment of halitosis due to three main functions: (A) measuring halitosis, for which it is considered as the gold standard method; (B) helping patients to recover their self-confidence as they get more confident each time their breath is well evaluated; (C) assessing the origin of halitosis through oral and nasal organoleptic tests and by comparing mouth and nose exhaled air, which is possible for diagnosing oral, nasal or extraoral origins of halitosis with a very small error margin. Nevertheless, literature for organoleptic scales that recommend the use of nasal organoleptic tests and/or techniques to diagnose halitosis origin is scarce. Two significant aspects that must be contemplated seriously are the potential risk of cross infections following organoleptic tests as well as the lack of safety guidelines, especially with regards to the recent contagious potential of SARS-CoV-2 worldwide. An important safety aspect concerns avoiding performing organoleptic tests whenever feeling flu-like symptoms, such as fever, dry cough, or difficulty breathing. Also, individuals at higher risk for severe illness should not be elected examiners. Although a safer oral and nasal organoleptic technique is being proposed based on literature, organoleptic assessment should be temporarily suspended until the COVID-19 pandemic situation has normalized and further studies to evaluate the safety of different organoleptic tests methods are performed. Depending on the results of the tests a different origin of halitosis can be inferred, thus avoiding diagnostic errors and unnecessary treatments. The regular use of the present technique on patients and in research can provide more precise diagnostic results. It also allows patients to check their breath at home and consequently take some actions to solve or identify the causing issue in case an alteration is detected, as well as reinforces patients` self-confidence when receiving pleasant breath results after consecutive tests.