The International Society of Breath Odor Research was created in Leuven Belgium in 1995 at the occasion of the second International Workshop on Oral Malodor. Indeed, inspired by the first workshop organized in Israel in 1993 by Mel Rosenberg, a second conference was organized by Daniel van Steenberghe and Mel Rosenberg. It gathered 140 scientists and clinicians from 16 countries representing everything from ENT to dentistry and from gastroenterology to periodontology. Since 1995, seven ISBOR conferences have taken place throughout the world including Herzliya 1993, Leuven 1995, Vancouver 1997, Los Angeles 1999, Tokyo 2001, London 2004, and Chicago 2007. The eighth ISBOR international conference will be in Dortmund, Germany in April 2009.

The aim of ISBOR, as defined in the constitution, seeks to “promote research and dissemination of research findings in all aspects related to breath odor.” Until two decades ago, the knowledge of this very relevant social and health issue was limited, and its teaching anecdotal, ISBOR has been able to raise the awareness of and interest in the implications of breath odor for general health care. ISBOR represents a unique multidisciplinary gathering of people convinced that cross-fertilization is beneficial for the advancement of science and patient care.

An elderly man suffered bad breath for months. His personal environment did not foster discussion, as family and social problems were already numerous and his character continued to worsen due to the social isoloation. Finally he visited the house doctor who sent him through for a gastroscopy which appeared to be negative. He then went to an outpatient clinic for breath malodor. The clinicians discovered ample tongue coating and sub par oral hygiene. He was instructed on the effects of poor oral hygiene and encouraged to focus on improving his habits. During one of several follow-up meetings, a portable sulfide monitor confirmed improvement. Still some breath malodor was present on some days. Finally during a new visit, the refractory nature of his complaints prompted a blood test, which confirmed diabetes, a result of his obesity. Had a proper breath analysis methodology been used from the start, invasive investigations could have been avoided, a lot of time could have been saved, and proper treatment for his diabetes could have initiated earlier.

As members of the scientific community conducting research with links to breath odor analysis, we continually face questions about the value of our inquiries. Despite bad breath being a prominent social problem and eventually serving as one of the chief complaints to seek medical help, the taboo nature of the subject has rendered it one of the least studied areas. We understand the considerable knowledge the health-care community can gain from further exploration of the origin(s) of breath odor, its unintended consequences, and its application as a diagnostic tool for several health problems which otherwise need invasive procedures to be detected.

We aim to create multi-disciplinary, cross-specialty, and international collaborations. We have generated interest in almost every field of human health, including epidemiology, periodontology, ENT, systemic diseases, gastro-intestinal, pulmonary, diagnostic systems, gas chromatography, dentistry, pathophysiology, therapy, psychology/psychiatry, and behavioral health. We have convened six international meetings resulting in dialogue among diverse scientific backgrounds, which has continued to lead to great discovery. This was already evident at the first meeting in Leuven where several ENT surgeons heard for the first time that tonsillary crypts were similar to periodontal pockets, including calculus or at the Vancouver meeting, the sensory physiologists were surprised to hear of the psychological components of smell.

ISBOR aims to provide a forum for collaboration and serve as a catalyst for the collection of scientific data needed to:

・ identify the various types of breath malodor, if indeed more than one type exists

・ understand the pathophysiology of malodor

・ recommend safe and effective treatments based on the pathophysiology

・ educate on the use of breath odor analysis as a diagnostic tool for other health maladies

Breath malodor is a complex clinical condition and we aim to support the many scientific and clinical disciplines to build a community of knowledge to further understand the implications and its treatment. It will be beneficial for patients and their environment who suffer from the complaint but also open new frontiers in the screening for rare diseases or the early diagnosis of sometimes previously undetected diseases.