Halitosis

Question 1

What is halitosis

Answer 1

noticeable unpleasant/ disagreeable odour of expired air

Question 2

Is halitsosis a symptom or diagnosis

Answer 2

symptom

Question 3

what is halitosis associated with

Answer 3

increase prevalence with age
more prevalent in males
associated with fasting
associated with higher protein diets

Question 4

Genuine halitosis classifications according to aetiological factors

Answer 4

physiological
pathologic

Question 5

physiological halitosis - morning breath cause

Answer 5

increased microbial activity during slleep
reduced saliva flow during sleep
fasting and starvation

Question 6

morning breath management

Answer 6

simple advice:
eating
routine OH
rinse with fresh water
tongue brushing

Question 7

foods associated with halitosis

Answer 7

garlic
onion
cabbage
cauliflower
radish
spicy foods
coffee
alcohol

Question 8

pathological halitosis - intra oral cause

Answer 8

often associated with oral sepsis/disease
Periodontal disease
pericoronitis
oral ulceration
acute herpetic gingivostomatitis
dry socket
post xla
xerostomia
infected tonsil
oral malignancy
poor appliance hygiene
mouth breathing
tongue coating

Question 9

primary cause of halitosis

Answer 9

production of volatile compounds by oral bacteria
- excessive bacterial reservoir on tongue
Bacteris produce theese coumpounds as result of breakdown of epithelial cells, salivary proteins, serum proteins, food debris

Question 10

Bacteria involved in halitosis

Answer 10

mainly. gram -ve proteolytic anaerobes
P. gingivalis
prevotella intermedia
T. Forsythia
Trepenoma denticola

Question 11

malodourous compound

Answer 11

volatile sulphur

Question 12

volatile sulphur feature

Answer 12

volatile

Question 13

other volatile compounds

Answer 13

Diamines
phenyl compounds

Question 14

halitosis management

Answer 14

OH and denture hygiene instruction
tongue cleaning
mouthwashes - chlorohex
dietary advice - remove food related causes, increased fluid intake
smoking cessation
alcohol reduction
perio tx
restroative tx
oral surgery

Question 15

extra oral causes
- haltiosis

Answer 15

alcohol
smoking
betel
solvents
disulfiram
cytotoxics
phenothiazines

Question 16

systemic disease - extra oral cause of halitosis

Answer 16

nasal and pharyngeal infections
resp pathology
GI pathology
metabolic conditions

Question 17

what is pseudo-halitosis

Answer 17

no objective evidence of malodour but pt convinced they have it

Question 18

what is halitophobia

Answer 18

pt persists in believing they have halitosis even after successful tx, despite evidence of absence of halitosis

Question 19

2 methods to asses halitosis

Answer 19

Organopleptic assessment
lab methods - halimerer, gas chromatography

Question 20

most common assessment of halitosis

Answer 20

organoleptic assessment

Question 21

Organoleptic assessment

Answer 21

clinican smells patients exhaled breath
pt closes their mouth for 1 min
pt and dentist face each other
pt should avoid halitosis associated food 4h hrs prior to test

Question 22

what is a halitmeter and what does it detect

Answer 22

portable gas monitor
detects VSC levels

Question 23

primary management to diagnose and manage

Answer 23

patient history/medical history
halitosis questionnaire
dietary causes - advce
Habits - smoking and alcohol cessation
treat oral diease

Question 24

who would you refer to

Answer 24

GMP
oral med
possible ENT