halitosis - Medical Dictionary

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halitosis		An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [ Articles \| Books \| Images \| Discussion groups ]

Additional comments : (Bad Breath) The classification of halitosis includes categories of genuine halitosis, pseudo-halitosis and halitophobia. Genuine halitosis is subclassified asphysiologic halitosis or pathologic halitosis. If oral malodour doesnot exist but the patient believes that he or she has oral malodour,the diagnosis would be pseudo-halitosis. If, after treatment for either genuine halitosis or pseudo-halitosis, the patient still believes that he or she has halitosis, the diagnosis would be halito-phobia. This classification allows the clinician to diagnose a psychological condition. K Yaegaki, JM Coil - J Can Dent Assoc, 2000 To avoid the mismanagement of halitosis patients, classifications of halitosis patients have been established. Genuine halitosis was subclassified as physiologic halitosis and pathologic halitosis. Pathologic halitosis was further categorized to oral pathologic halitosis and extraoral pathologic halitosis. Both pseudo-halitosis and halitophobia patients complain of the existence of halitosis, which is not offensive. Pseudo-halitosis cannot be treated by dental practitioners, and halitophobia patients must be referred to psychological specialists Yaegaki K, Coil JM. Compend Contin Educ Dent. 2000 Oct;21(10A):880-6, 888-9; quiz 890. Halitosis is caused primarily by bacterial putrefaction and the generation of volatile sulfur compounds. Ninety percent of patients suffering from halitosis have oral causes, such as poor oral hygiene, periodontal disease, tongue coat, food impaction, unclean dentures, faulty restorations, oral carcinomas, and throat infections. The remaining 10 percent of halitosis sufferers have systemic causes that include renal or hepatic failure, carcinomas, diabetes or trimethylaminuria. Spielman AI, Bivona P, Rifkin BR. N Y State Dent J. 1996 Dec;62(10):36-42. Since the origin of physiological halitosis is mainly the dorso-posterior region of the tongue,tongue cleaning is more effective than mouth rinsing. However, practitioners should always instruct their patients on how to brush their tongues to prevent harmful effects. Another approach using a chlorhexidine mouthwash is most effective in reducing oral malodour. However, chlorhexidine should not be used routinely; therefore, zinc-containing mouthwashes have been recommended for use. Yaegaki K, Coil JM, Kamemizu T, Miyazaki H. Int Dent J. 2002 Jun;52 Suppl 3:192-6. Free Full Text FOR THE DENTAL PATIENT - What you should know about bad breath J Am Dent Assoc, Vol 134, No 1, 135. Although it might be right under their noses, some people aren’t aware that they have offensive breath. Bad breath, or halitosis (pronounced "hal-i-TOE-sis"), is an unpleasant condition that often is cause for embarrassment. Certain foods, tobacco, alcohol and some prescription or over-the-counter drugs may cause mouth odors. In a small percentage of cases, bad breath may have a systemic origin (something that affects the body generally) such as a respiratory tract condition or other ailments. However, a major source of bad breath in healthy people is microbial deposits on the tongue, especially the back of the tongue, where a bacterial coating harbors organisms and debris that contribute to bad breath. Some studies have shown that simply brushing the tongue reduced bad breath measurements by 70 percent. Food stuck between teeth, around the gums and on the tongue may leave an unpleasant odor as it decays. Dentures that are not cleaned properly also can harbor odor-causing food and bacteria. Certain foods, such as garlic and onions, contribute to objectionable breath because they contain odor-causing compounds. When these compounds enter the bloodstream, they are transferred to the lungs, where they are exhaled. Using mouthwash temporarily masks mouth odor. Few studies have examined the long-term effectiveness of a particular mouthwash on reducing bad breath. Periodontal disease, a condition in which bacteria attack the tissues that surround and support teeth, may play a role in creating bad breath. Dry mouth, or xerostomia (pronounced "zero-STOW-me-uh"), is another condition that can cause bad breath. Under normal conditions, saliva removes many particles that cause odor. Dry mouth occurs when the flow of saliva decreases. Some medications, salivary gland problems or continuous mouth breathing also may contribute to bad breath. If you have dry mouth, your dentist may prescribe artificial saliva or suggest using sugarless candy and increasing your fluid intake. If your dentist rules out the above causes, and you practice good oral hygiene, including thorough tongue-brushing, bad breath may be the result of a local infection in the respiratory tract (nose, throat, windpipe, lungs), chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, or a liver or kidney ailment. If your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of your bad breath. Historical and social aspects of halitosis Rev Lat Am Enfermagem. 2006 Sep-Oct;14(5):821-3. Buccal odors have always been a factor of concern for society. This study aims to investigate the historical and social base of halitosis, through systematized research in the database BVS (biblioteca virtual em saude - virtual library in health) and also in books. Lack of knowledge on how to prevent halitosis allows for its occurrence, limiting quality of life. As social relationships are one of the pillars of the quality of life concept, halitosis needs to be considered a factor of negative interference. Education in health should be accomplished with a view to a dynamic balance, involving human beings' physical and psychological aspects, as well as their social interactions, so that individuals do not become jigsaw puzzles of sick parts. Detection and measurement of oral malodour in periodontitis patients Indian J Dent Res. 2006 Jan-Mar;17(1):2-6. BACKGROUND & OBJECTIVES: Malodour has been correlated with the concentration of volatile sulphur compounds produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal sites and the dorsum of the tongue. The aim of this study was to detect malodour in mouth air organoleptically and using a portable sulphide monitor and to correlate it with the clinical parameters, halitosis linked toxins and BANA using tongue and subgingival plaque samples. The halitosis grading is also correlated with the microbial colonies of the subgingival plaque sample. METHODS: 20 patients with chronic periodontitis with 5-7 mm pocket depth, radiographic evidence of bone loss and presence of oral malodour participated in this study. Assessment of mouth air was done organoleptically and by using a portable sulphide monitor. The clinical parameter, plaque index (PI), gingival index (GI), gingival bleeding index (BI), were obtained from all the areas. Samples for BANA and to detect halitosis linked toxins were taken from the dorsal surface of the tongue and periodontal pockets ranging 5-7 mm. Halitosis related microbial colonies were identified using anaerobic culturing from the subgingival plaque. RESULTS: The scores of PI, GI, BI and sample that tested positive for halitosis linked toxins and with the halitosis grading were not significant. The presence of tongue coating and the halitosis grading and toxin levels were significant. BANA has shown to be non contributory due to technical problems. Anaerobic culture has shown to identify Streptococcus, Bacteroides, Fusobacterium, Porphyromonas and Prevotella colonies. INTERPRETATION & CONCLUSION: The results confirmed that there was no correlation between the clinical parameters, halitosis linked toxins and halitosis grading. The microbial colonies have shown to correlate with the presence of oral malodour. Oral malodor associated with internal resorption J Oral Sci. 2006 Jun;48(2):89-92. We report a case of oral malodor associated with internal resorption. A 39-year-old male attended our hospital complaining of oral malodor. Utilizing organoleptic measurement, the halimeter test and gas chromatography, it was diagnosed as a strong halitosis caused by oral origin. The pocket probing depth of tooth 21 was 10 mm, and X-ray examination revealed a vertical bone loss around this tooth. The patient had received periodontal treatment at two dental offices previously, but the periodontal conditions and oral malodor persisted. We performed an initial periodontal preparation, however a deep pocket remained. We therefore performed a surgical inspection including flap reflection, and found that the tooth had a large perforating defect in the distal surface. The extracted tooth had multiple perforating defects covered with granulation tissues on all root surfaces including the root apex. Taking into consideration the anamnesis and X-ray examination of the extracted tooth, internal absorption was considered to have been the cause of the multiple perforating defects. After extraction of the causative tooth, oral malodor dramatically decreased. To our knowledge, this is the first report of an oral malodor associated with internal resorption. The aetiology and treatment of oral halitosis: an update Hong Kong Med J. 2004 Dec;10(6):414-8. Halitosis refers to the condition of offensive mouth odour. More than 90% of cases of halitosis originate from the oral cavity. The implicated bacteria (Fusobacterium nucleatum, , and Tannerella forsythensis) are located in stagnant areas in the oral cavity, such as the dorsal surface of tongue, periodontal pockets, and interproximal areas. These bacteria proteolyse the amino acids releasing volatile sulphur compounds. The management of halitosis involves determining and eliminating the causes, which includes identifying any contributory factors, because certain medical conditions are also associated with characteristic smells. Professional advice should be given on oral hygiene and diet, and treatments should include dental scaling, and root planing of the associated periodontal pockets to reduce the bacterial loading. In addition to the normal oral hygiene practice, tongue cleaning and use of mouthwash are advocated. This paper discusses the common aetiological factors, classification of oral halitosis, and its treatment.

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