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The commonest causes are orodental disease due to poor oral hygiene and inappropriate diet.

  • Exclude dental disease, malignancy (esp. nasopharyngeal carcinoma), pulmonary TB, hairy tongue, nasal and sinus infection

  • Consider drugs, e.g. isosorbide dinitrate, antidepressants

  • Avoid or limit onions, garlic, peppers, spicy salami and similar meats

  • Avoid or limit strong cheeses

  • Avoid sMurHand8_c08ive nips of alcohol

  • Brush teeth regularly during day—immediately after a meal

  • Rinse mouth out with water after meals

  • Avoid fasting for long periods during the day

  • Gargle with mouthwash regularly (e.g. Listerine, Cepacol Mint mouthwash, 0.2% aqueous chlorhexidine)

  • Use dental floss regularly to clean the teeth

  • Chew sugarless gum to moisten mouth

Tip: Use an oil/water wash (e.g. equal volumes of aqu. Cepacol and olive oil), gargle a well-shaken mixture and spit out, qid.

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