Halitosis , , Malodor , Bad breath

Halitosis Ousamah Ahmad Oral Diagnosis II

Origin of HALITOSISNew Latin, from Latin halitus breath, from halare to breathe — more at exhaleFirst Known Use: 1874

Definition of Halitosis

Bad breath (halitosis) can be embarrassing and may cause anxiety. It's no wonder store shelves are overflowing with gum, mints, mouthwashes and

other products designed to combat this condition. But many of these products are mere temporary

measures.a condition of having fetid breathCertain foods, health conditions and habits are

among the causes of bad breath. In many cases, that can improve bad breath with proper dental

hygiene

Pathogenesis of Halitosis

It is generally known and agreed that VSC's) Volatile Sulfur Compounds( are responsible for the odor,

and that 80-90% of these come from oral sources .VSC's are produced by bacterial

and cellular degradation, and include hydrogen sulphide ,

methyl mercaptan and dimethyl sulphide .The nature of the odor may vary in intensity

) strength of the smell (and quality (the type of odor) .

Causes , Prevalence of Halitosis

Food. The breakdown of food particles in and around your teeth can cause a foul odor. Eating foods containing certain oils is another

source of bad breath. Onions and garlic are the best-known examples, but other

vegetables and spices also can cause bad breath .

Dental problems. Poor dental hygiene and periodontal disease can be a source of bad breath.

Dry mouth. Saliva helps cleanse your mouth, removing particles that may cause bad odors. A condition called dry mouth (xerostomia) can contribute to bad breath because production of saliva is decreased.

Diseases. In about 10 percent of bad breath cases, the bad odors do not come from the mouth (extra-oral halitosis). For example, illnesses, such as some cancers and metabolic disorders, can cause a distinctive breath odor as a result of chemicals they produce. Diabetes and kidney or liver failure can lead to a fishy smell.

Mouth, nose and throat conditions. Tobacco products. Smoking dries out your

mouth and causes its own unpleasant mouth odor.

Risk Factors Associated With Halitosis

Non-disease related Disease related

Oral• Inadequate oral hygiene• Candidasis

• Long periods of mouth closing (i.e., morning breath after sleep)• Cancer

• Xerostomia (e.g., dry mouth due to  mouth breathing, medication) 

• Gingivitis

• Tongue coatings  • Mouth infection, inflammation, ulceration 

 • Periodontitis

Medications can cause bad breath

An unfortunate side effect of a number of medications is halitosis. Here are a few medications that are known to cause bad breath.

Triamterene - This diuretic, which is used to treat high blood pressure and edema, lists halitosis as one of its side effects,

Paraldehyde - It treats seizures and may also be used by healthcare professionals as a sedative,

Disulfiram - Used to treat alcoholism, this drug has a number of unpleasant side effects, including high blood pressure, restlessness and halitosis.

Antihistamines –

signs and symptoms of bad breath:

You frequently have a bitter taste in your mouth

A white or yellow coating on your tongue People seem to avoid direct contact with you

and they step back from you when you are talking to them

People around you offer mints or chewing gum

A smelly odor when you open your mouth

Diagnosis and classification of halitosis

Oral Malodor Patient Types Type I—Those who have it and know it Type II—Those who have it but deny or do not

know they have it Type III—Those that do not have it, but think

they do.

Some specific pieces of equipment have been developed to help the dentist diagnose halitosis. These are known as the halimeter and

the periotemp .

Device For Halitosis!

Medical History

Due to many possible causes of bad breath, diagnosis of the origin of halitosis is essential for its treatment. The first step to making a proper diagnosis is the taking of a complete medical history. Some of the questions you may ask are:

?

When is the last time you visited the dentist?

What are your oral hygiene habits? a) Brush daily b) Brush & floss daily c)Brush, floss, and rinse daily

Do you use an over-the-counter mouth rinse regularly? a)Yes? What brand? b) No?

?

When you sleep do you breathe through your mouth?

Are you taking any medication?

Are you on a special diet?

Do you smoke?

?

Treating halitosis

There is no one treatment for halitosis. The treatment will depend on what is causing the problem

Raise the problem with patients directly

Dental expertise required

professional dental cleaning *

restoration of fillings

cleaning of dental prostheses

examination of prosthetics

Daily oral hygiene measures

tongue cleaning for mechanical removal of tongue coatings

Treating halitosis

Halitosis Drugs

Halitosis Drugs

ChlorhexidineChlorhexidine is a chemical antiseptic, prescribed for gingivitis, cleansing skin and

wound areas

CimetidineCimetidine is a histamine H2-receptor antagonist, prescribed for heartburn and peptic

ulcers. ...

RanitidineRanitidine is an antacid, antireflux agent & antiulcerant, prescribed for peptic ulcer. ..

. Cetylpyridinium chloride  (CPC): It is used in most lozenges, mouthwashes, toothpastes, breath sprays, throat sprays, and nasal sprays. It is a chemical antiseptic and acts mostly by the bactericidal mode of action i.e. it kills the bacteria.

Chlorine dioxide: It is used as a disinfectant and oxidizer and is very effective in killing pathogenic microbes like fungi

List of drugs used to treat the medical condition called Halitosis

Halitophobia ” Delusion halitosis

One quarter of the patients seeking professional advice on bad breath suffer from a highly exaggerated concern of having bad breath, known as halitophobia, delusional halitosis, or as a manifestation of Olfactory Reference Syndrome. These patients are sure that they have bad breath, although many have not asked anyone for an objective opinion. Halitophobia may severely affect the lives of some 0.5–1.0% of the adult population

That’s itThank you