Halitosis

Question 1

what is halitosis?

Answer 1

bad breath

Question 2

what are 3 categories of halitosis?

Answer 2

genuine (physiologic, pathologic), pseudohalitosis, halitophobia

Question 3

what is the cause of physiologic halitosis?

Answer 3

the buildup of gram negative and anaerobic bacteria, which play a role in the overproduction of volatile sulfur compounds (VSCs) such as hydrogen sulfide, methyl mercaptan, dimethyl sulfide and other malodorous gases;

Intraoral conditions, e.g., periodontitis, that increase the depth of a periodontal pocket over time reduce oxygen tension, lower the pH and activate the decarboxylation of amino acids to malodorous diamines such as putrescine and cadaverine

Bacteria and fungi can also build up with the prolonged entrapment of food particles in the mouth, particularly at the back of the tongue, giving rise to a coated tongue and the production of VSCs.

Question 4

Oral pathologic halitosis is caused by?

Answer 4

disease or malfunction of the oral tissues (e.g., gingivitis, dental abscess, pericoronitis, oral ulcers, stomatitis, intraoral neoplasia or jaw osteonecrosis), and includes halitosis due to periodontal disease and xerostomia (dry mouth).

Question 5

what are the causes of xerostomia?

Answer 5

insufficient water intake, breathing through the mouth, medication use (e.g., anticholinergic agents), excessive use of alcohol-based mouthwash, radiation therapy, chronic medical conditions (e.g., depression), smoking and regular caffeine intake

Question 6

Extraoral pathologic halitosis refers to ?

Answer 6

malodor originating from sources other than the mouth

Question 7

what causes extraoral pathologic halitosis?

Answer 7

These may include the nasal, paranasal and laryngeal regions; the upper digestive tract (e.g., gastroesophageal reflux disease, peptic ulcer disease or Helicobacter pylori infection); the lungs; or disorders in any other body system (e.g., diabetes mellitus, hepatic cirrhosis, uremia, malignancy or internal bleeding). Nasal malodor is the most common origin of extraoral halitosis, and may be due to a nasal infection (e.g., sinusitis), problems affecting airflow or mucous secretions (e.g., polyps, postnasal drip) or craniofacial anomalies (e.g., cleft palate).​

Question 8

what are common causes of bad breath?

Answer 8

alcohol;
dental hygiene;
denture hygiene;
diet;
dry mouth;
mouthwash - long-term use;
time of day;
time of meal - irregular eating can lead to ketosis;
tobacco

Question 9

what are non pharm therapy?

Answer 9

good oral hygiene - brush at leasts bid, floss daily;
clean tongue - tongue cleanser or tongue scraper;
drink plenty of fluids, and clean the mouth after consuming dairy products, meat or fish;
increase saliva flow and tongue actions - chew sugarless gum and snacking on fibrous vegetables (raw carrots and celery) can help

Question 10

which mouth washes are effective?

Answer 10

chlorhexidine 0.12% - only for 1 week at a time;

cetylpyridinium-containing mouthwashes - regular use - reduce bad breath at 2-4 weeks;

zinc-containing mouthwashes 1% or higher - neutralize odoriferous breakdown products;

povidone iodine 1% - avoid in patients with thyroid disorder and pregnant/breastfeeding

essential oils (eucalyptol) - reducce moderate malodor;

Question 10

what are some natural products?

Answer 10

chlorophyll, parsley, menthol, mint