Dawaa Reference

chronic

Halitosis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

ADA Council on Scientific Affairs: Management of Oral Malodor 2021 · Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)

Verified against3 documents
  • ADA Council on Scientific Affairs: Management of Oral Malodor 2021
  • Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)
  • Halitosis - disease-level clinical article (halitosis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • History-taking in halitosis should cover diet, smoking, medications, and symptoms like cough, fever, weight loss, dyspepsia, or heartburn pointing to a respiratory or GI cause [cough · fever · heartburn · indigestion · weight loss]
  • The patient is often unaware of it, and a routine dental or primary-care examination is what turns it up
  • The social harm is what brings the patient in: embarrassment, withdrawal, sometimes being stigmatised

Tests (5)

  • The organoleptic test - a clinician smelling the patient's exhaled breath through a tube, graded zero to five - is the most widely used and effective method
  • Gas chromatography can quantify volatile sulfur compounds at very low levels but is costly, non-portable, and used mainly for research
  • A portable sulfide monitor uses a disposable tube held in the mouth for five minutes while the patient breathes through the nose, detecting only sulfur-based odors
  • The BANA test detects specific anaerobic bacteria linked to bad breath through a colour-change reaction
  • The salivary incubation test is more sensitive than organoleptic testing but takes longer, incubating saliva anaerobically at 37 C for several hours

If not this — what else fits (3)

  • Diabetes mellitus, fever, or dehydration can also cause halitosis
  • Liver failure or renal failure can also cause halitosis
  • Tuberculosis is on the differential for halitosis

SourceStatPearls "Halitosis" - disease-level clinical article

Presentation findings are traced to the source above.

1

ORAL HYGIENE MEASURES AND TONGUE SCRAPING

1st line
Adult dose and duration

Brush teeth twice daily with fluoride toothpaste, floss interdentally daily, scrape posterior tongue dorsum gently with a tongue cleaner, and maintain adequate oral fluid intake - Ongoing continuous practice

Paediatric dose

Assist young children with daily tooth brushing and tongue cleaning; check for nasal foreign bodies if sudden severe unilateral odor

Dose source

ADA Council on Scientific Affairs: Management of Oral Malodor 2021

Why

Over 85% of halitosis originates from bacterial coat on the posterior tongue and interdental space; mechanical cleaning directly targets the primary source

Cautions
  • Refer to dentist if halitosis persists despite good oral hygiene to rule out periodontal disease or dental caries.
  • Evaluate for extra-oral causes: chronic sinusitis, tonsilloliths, GERD, diabetes (ketoacidosis), or hepatic/renal insufficiency.
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Halitosis - disease-level clinical article (halitosis-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - Fruity/acetone breath odor can signal diabetes (ketoacidosis) and ammoniacal breath odor can signal uremia/renal failure - systemic causes needing urgent recognition and a different pathway than oral hygiene measures.
3

CHLORHEXIDINE

add-on - not a substitute

Formoral.liquid

Adult dose and duration

Rinse mouth with 10 mL of 0.12% or 0.2% solution for 1 minute twice daily, separated from toothpaste by rinsing in between x 1-2 weeks maximum per course

Paediatric dose

(Children > 12 years: 10 mL twice daily. Not recommended in young children who may swallow mouthwash)

Dose by age
Over 12 years:10 mL twice daily
Dose source

Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)

Why

Antiseptic mouth rinse with broad antibacterial activity against the oral bacteria that produce volatile sulphur compounds; added to routine brushing and tongue cleaning as an adjunct, not a replacement for mechanical oral hygiene.

Cautions
  • Do not swallow oral rinse solution.
  • Prolonged use (> 2 weeks) causes temporary brown staining of teeth and tongue, and transient taste alteration.
  • Wait at least 30 minutes between tooth brushing and chlorhexidine rinse (or rinse thoroughly with water), as toothpaste surfactants (SLS) inactivate chlorhexidine (BNF 86).
  • Do not use straight after toothpaste - it inactivates chlorhexidine. Separate the two, rinsing the mouth in between, or use them at different times of day. A course of about one month is what the label describes; staining of the teeth is temporary.
Egyptian brands
Egyptian brandManufacturerIndicative price
CHLORHEXIDINE 0.5% 10*10 GAUZE DRESSING? different route - not oral liquidMINA PHARM3.40 EGP
CHLORHEXIDINE 0.5% 10*30CM GAUZE DRESSING? different route - not oral liquidMINA PHARM6.00 EGP
ELUGEL ORAL GEL 20 GM? different route - not oral liquidGLOBAL NAPI PHARMACEUTICALS > PIERRE FRANCE6.50 EGP
ANTISEPTOL 1MG/ML MOUTH WASH 120 ML? different route - not oral liquidKAHIRA9.00 EGP
RECARE ORAL GEL 30 GM? different route - not oral liquidUNIPHARMA CO. > UNIPHARMA14.95 EGP
ACETO-V VAGINAL WASH 250 ML? different route - not oral liquidHI-CARE > INTERPHARMA EGYCARE37.50 EGP
HEXITOL 1.25MG/ML MOUTH WASH 100 ML? different route - not oral liquidARAB DRUG COMPANY (ADCO)49.90 EGP
LARIES SOLUTION 250 ML? different route - not oral liquidSMARTEC > HEXA PHARMA INTERNATIONAL120.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.