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Preparations for the 4th edition of Clinical Periodontology and Implant Dentistry started in 2001 when all senior authors of the various chapters of the current text were identified and invited to join the team of contributors. The authors were selected because of their reputations as leading researchers, clinicians or teachers in Periodontology, Prosthetic Dentistry, Implant Dentistry and associated domains. Their task was simple but demanding; within your field of expertise, find all relevant information, digest the knowledge and present to the reader a "state of the art" text that can be appreciated by (i) the student of dentistry and dental hygiene, (ii) the graduate student of Periodontology and related domains and (iii) the practicing. | CHAPTER 24 Breath Malodor DANIEL VAN STEENBERGHE AND MARC QUIRYNEN Socio-economic aspects Etiology and pathophysiology Diagnosis Patient history Clinical and laboratory examination Treatment Conclusions Breath malodor means an unpleasant odor of the expired air whatever the origin may be. Oral malodor specifically refers to such odor originating from the oral cavity itself. A term like halitosis is synonymous with breath malodor but is not always understood by the general population. Breath malodor has long been a matter of concern. There are references to it in the Bible and in the Koran. Surprisingly enough until recently breath malodor has not been a matter of much interest in periodontology although its most frequent causes are plaque-related gingivitis and periodontitis. Even the literature concerning this subject is scarce. There was only one book on this topic in the nineteenth century Howe 1898 and it was not until the end of the twentieth century that two more books were devoted to the subject Rosenberg 1995 van Steenber-ghe Rosenberg 1996 . Joe Tonzetich from the University of British Columbia unfolded the biologic basis for oral malodor Tonzetich 1977 but his observations received only limited attention from clinicians even if oral or breath malodor is frequently encountered in any dental and especially periodontal office. SOCIO-ECONOMIC ASPECTS A transient breath malodor is noticed when waking up in the morning in more than half the adult population Morris Read 1949 . It does not deserve special attention since it is due to the xerostomia developed during sleep i.e. when salivary flow is reduced to a minimum. This with the ongoing intra-oral putrefaction explains the malodor when waking up. Morning breath odor disappears soon after the intake of food or fluid. The intra-oral placement of a toothpaste containing zinc salts and triclosan has the capacity to reduce the odor for several hours even in the absence of toothbrushing Hoshi van Steenberghe 1996 .