Halitosis Flashcards
What is halitosis
noticeable unpleasant/ disagreeable odour of expired air
Is halitsosis a symptom or diagnosis
symptom
what is halitosis associated with
increase prevalence with age
more prevalent in males
associated with fasting
associated with higher protein diets
Genuine halitosis classifications according to aetiological factors
physiological
pathologic
physiological halitosis - morning breath cause
increased microbial activity during slleep
reduced saliva flow during sleep
fasting and starvation
morning breath management
simple advice:
eating
routine OH
rinse with fresh water
tongue brushing
foods associated with halitosis
garlic
onion
cabbage
cauliflower
radish
spicy foods
coffee
alcohol
pathological halitosis - intra oral cause
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
primary cause of halitosis
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
Bacteria involved in halitosis
mainly. gram -ve proteolytic anaerobes
P. gingivalis
prevotella intermedia
T. Forsythia
Trepenoma denticola
malodourous compound
volatile sulphur
volatile sulphur feature
volatile
other volatile compounds
Diamines
phenyl compounds
halitosis management
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
extra oral causes
- haltiosis
alcohol
smoking
betel
solvents
disulfiram
cytotoxics
phenothiazines
systemic disease - extra oral cause of halitosis
nasal and pharyngeal infections
resp pathology
GI pathology
metabolic conditions
what is pseudo-halitosis
no objective evidence of malodour but pt convinced they have it
what is halitophobia
pt persists in believing they have halitosis even after successful tx, despite evidence of absence of halitosis
2 methods to asses halitosis
Organopleptic assessment
lab methods - halimerer, gas chromatography
most common assessment of halitosis
organoleptic assessment
Organoleptic assessment
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
what is a halitmeter and what does it detect
portable gas monitor
detects VSC levels
primary management to diagnose and manage
patient history/medical history
halitosis questionnaire
dietary causes - advce
Habits - smoking and alcohol cessation
treat oral diease
who would you refer to
GMP
oral med
possible ENT
