A Conceptual Scheme for Counseling Patients With Oral Malodor: The P-LI-SS-IT System

As mentioned earlier, we have adapted a model that has been used successfully by school counselors, social workers, nurses, clergymen, and health aides when counseling persons with sexuality concerns and problems. The P-LI-SS-IT system is flexible and adaptable to many settings and to whatever amount of time is available. The model allows for a range of treatment choices geared to the level of competence of the individual clinician. The first three levels involve “brief therapy,” and most patient bad breath problems can be successfully resolved at these levels. The fourth and final level involves “intensive therapy” and is reserved for those patients whose problems require more complex therapy. At this level, it is important the clinician have the appropriate training and experience to provide a highly individualized therapeutic program. This may include a referral for either medical assessment or psychological counseling.


This information discusses how the P-LI-SS-IT model may be applied to the dental setting for discussing the personally sensitive topic of breath odor concerns with patients. Let’s return to the scenarios presented earlier and outline some helpful responses using the P-LI-SS-IT model.