Getting ahead of halitosis
Individuals who have drug-related halitosis may need to take additional steps to prioritize oral health.
In a narrative review, investigators used the PubMed and EMBASE/OVID databases to identify studies published between 2020 and 2025 focused on drugs listing pathologic intra- and extra-oral halitosis as a potential adverse effect.
The investigators found many drugs linked to intra-oral halitosis (related to oral tissue conditions, e.g., periodontal disease/tongue coating) and halitosis-causing conditions. Drugs causing xerostomia and medication-related osteonecrosis of the jaw — implicated in halitosis — included anticholinergic drugs and antidepressants. Other drugs such as systemic retinoids, antiviral drugs and those used to treat anxiety, hypertension, pain, allergic conditions and congestion are known to carry a risk of xerostomia. In addition, antiresorptives, RANK-L inhibitors and antiangiogenic agents can result in medication-induced osteonecrosis of the jaw.
Further, drugs such as ranitidine, antifungals, aspirin and other nonsteroidal anti-inflammatory drugs, disulfiram, nitrates and nitrites and iodine-containing drugs could result in extra-oral halitosis (originating in the nasal passages, bloodborne odors, pulmonary or upper digestive tract).
Patients with halitosis were advised to visit their dentists and clinicians regularly to help manage halitosis and its root causes. For instance, dentists can tackle periodontal disease or dental decay, improve oral health, guide individuals on adequate oral hygiene techniques, provide treatments for xerostomia and offer adjuncts like therapeutic mouthwashes containing antimicrobial ingredients. Further studies are needed to better understand the mechanisms behind drug-related halitosis.
Read more: International Dental Journal
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