Bad breath that continues for a long period of time is often referred to as chronic halitosis. It's a condition that has been around for a very long time, but it is only in last century that we have started to may much attention to it, and only in the last decade that we have made any real progress in finding ways to deal with the problem. Essentially, it has been viewed as an issue of personal hygiene, rather than a health problem, and health professions, therefore, have not addressed it.

Perceptions of chronic halitosis have changed. A few health professionals - dentists, dental hygienists, physicians, and microbiologists - realized that bad breath was a problem faced by a lot of people, and that it was often caused by factors beyond the individual's control. The need for a specialized area of research and treatment soon led to the development of the first halitosis clinic. These clinics draw in people who have suffered from bad breath and fruitlessly sought a solution, giving specialists a population of patients that help them learn more about the condition and how it can be managed.

The halitosis clinic may be the driving force behind its own demise: experience has indeed provided a great deal of knowledge about how to cure chronic halitosis and many sufferers can now benefit from this acquired knowledge without having to attend a clinic. New products are on the market and oral hygiene regimens that work have been identified. Since the vast majority of chronic halitosis cases are caused by the same thing (the proliferation of anaerobic bacteria in the mouth), most cases can now be self-treated or addressed in the dental office. The remainder of cases, associated with underlying disease, will probably come under the management of other specialties.

So what have we learned from the halitosis clinic? Most cases of long term bad breath are caused by a shift in the bacterial population in the mouth towards anaerobic species that produce sulfur compounds. As for how to cure chronic halitosis, it begins with good oral hygiene, including regular cleaning of the tongue, and includes cleansing the mouth with a mouthwash that will kill or remove many of the unwanted bacteria and restore the bacterial population to a normal balance. For some people, there may indeed be a cure, with the bacterial balance maintaining itself after a treatment period of months to years. For many, the treatment regimen will have to be a lifetime commitment.