terms bad ordour, breath malodor, halitosis, bad breath, or fetor ex ore can be applied.
Even once his/her life breath is present at a given time .
Halitosis can lead to personal discomfort and social embarrassment, and it remains one of the biggest taboos of society.
Halitosis - physiological - pathological
Physiological¶
It is by definition, does reflect pathology.
Transient disturbing odors caused by food intake (e.g., garlic, onions, and certain spices), smoking, or medications (e.g., metronidazole) do not reveal a health problem and are common examples of physiologic halitosis.
The same is true for “morning” bad breath, as habitually experienced on awakening. This malodor is caused by decreased salivary flow and increased putrefaction during the night, and it spontaneously disappears after breakfast or after oral hygiene measures.
gastrointestinal tract,ENT, Systemic metabolism
Pathological¶
Mechanism of pathology of oral ordour¶
It is the result of the degradation of organic substrates by anaerobic bacteria. During the process of bacterial putrefaction, peptides and proteins present in saliva, food debris, gingival crevicular fluid, interdental plaque, shed epithelial cells, postnasal drip, and blood are hydrolyzed to sulfide-containing and non–sulfide-containing amino acids, which can be further metabolized. The proteolytic degradation of sulfur-containing amino acids (cysteine, cystine and methionine) by gram-negative bacteria produces sulfurcontaining gases such as hydrogen sulfide (H2S) and methylmercaptan (CH3SH).
Tongue¶
The dorsal tongue mucosa, with an area of 25 cm3, has a very irregular surface topography.19,129 The innumerable depressions in the tongue surface are ideal niches for bacterial adhesion and growth, sheltered from cleaning actions.
Moreover, desquamated cells and food remnants also remain trapped in these retention sites and consequently can be putrefied by the bacteria
A relationship between periodontitis and oral malodor has been shown. However, periodontally healthy patients can suffer from halitosis, not all patients with gingivitis and/or periodontitis complain about bad breath, and some disagreement exists in the literature over to what extent oral malodor and periodontal disease are related.8,119,136 Bacteria associated with gingivitis and periodontitis are indeed able to produce VSCs.61,84,88,97,98,149 Several studies have shown that VSC levels in the mouth correlate positively with the depth of periodontal pockets (the deeper the pocket, the more bacteria,
Dry mouth¶
Saliva has an important cleaning function in the oral cavity. Patients with xerostomia often present with large amounts of plaque on teeth and extensive tongue coating. The increased microbial load and the escape of VSCs when salivary flow is reduced explain the strong breath malodor.
Extraoral¶
Systemic disease and metabolism Gastrointestinal tract Ear,nose and throat
Diagnosis¶
Treatment¶
Poor oral hygiene (90%),Tongue coating (51%),Dry mouth, gingivitis or periodontitis are predominant cause of oral and gastrointestinal tract,ENT, Systemic metabolism and diseases are play minor role.
Oral hygiene garlic food intake, Physiological processes treated by resins like chlorhexidine, hydrogen peroxide Tongue coating treated by floss to remove the coating. Dry mouth treated by frequent water intake.
Pathology needs specific treatments
Masking the Malodor Treatment with rinses, mouth sprays, or lozenges containing volatiles with a pleasant odor has only a short-term effect.
Halitosis can further differentiate into genuine and pseudo Genuine is true present. Pseudo is false belief.