Halitosis

Summary of diagnostic strategy model

1. Q. Probability diagnosis

1. Dietary habits Orodental disease Dry mouth, e.g. on waking Smoking/alcohol

2. Q. Serious disorders not to be missed

1. Malignancy:

■ lung, oropharynx, larynx, stomach, nose, leukaemia Pulmonary tuberculosis Quinsy Lung abscess

Blood dyscrasias/leukaemia

Uraemia

Hepatic failure

3. Q. Pitfalls

1. Nasal and sinus infection Systemic infection Appendicitis Bronchiectasis Hiatus hernia Rarities

Pharyngeal and oesophageal diverticula

Sjogren's syndrome

Scurvy

4. Q. Seven masquerades checklist

A. Depression x

Diabetes x acetone

Drugs x

Anaemia -

Thyroid disease -

Spinal dysfunction -

5. Q. Is the patient trying to tell me something?

1. Possible manifestation of psychogenic disorder.

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