title: Halitosis--an assessment protocol proposal.
abstract: Halitosis is an embarrassing symptom with a significant social impact. Halitosis affects millions of people worldwide and many resources are spent annually in products to improve halitus, unsuccessfully. The study of halitosis in a scientific basis is justified once halitosis causes social restriction, decreases life quality and may be an indication of serious diseases.
  
  
  OBJECTIVE
  To elaborate a protocol for halitosis assessment in order to minimize costs, avoid unnecessary tests and provide a guideline for diagnosis.
  
  
  METHODS
  The protocol was created based on the literature and on the authors personal experiences, adopting an evidence-based anamnesis.
  
  
  RESULTS
  There are many causes of halitosis and most of them are related to the oral cavity; others are related to otolaryngologic and respiratory diseases. Gastrointestinal diseases, liver/renal impairment and other metabolic syndromes are less frequent, but also important causes of halitosis.
  
  
  CONCLUSIONS
  There are important costs involved in halitosis assessment and treatment, including medical appointments, specialist assessment, and complementary tests. Such costs would be minimized by adopting a protocol of evidence-based anamnesis and a flowchart for a rational clinical investigation.
authors.affiliation: Specialist, Dentist - CECOM-UNICAMP.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Coelho Dal Rio
authors.affiliation: PhD. Professor of Otolaryngology and Head and Neck Surgery - Dept. of OPHT / ENT - FCM - UNICAMP, Coordinator of the Graduate Course - Medical Sciences - FCM-UNICAMP, Coordinator of the Laser Medicine Multidisciplinary Unit - HC-UNICAMP.
authors.forename: Ester Maria
authors.initials: EM
authors.lastname: Danielli Nicola
authors.affiliation: PhD in Surgery - FCM-UNICAMP, Adjunct Professor - Medical School of Jundiaí.
authors.forename: Antônio Roberto
authors.initials: AR
authors.lastname: Franchi Teixeira
mesh_terms: D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D006209:Halitosis / Q000209:etiology*; D006801:Humans; D008487:Medical History Taking