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MODULE 6 > PERIO - halitosis > Flashcards

PERIO - halitosis Flashcards

1
Q

what does the term halitosis derive from?

A

halitus - latin for breath
osis - greek for abnormal or diseased

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2
Q

what is halitosis?

A

a symptom caused by a wide range of intra and extra oral conditions

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3
Q

what is the epidemiology of halitosis?

A

increased prevalence with age
more prevalent in males
associated with fasting
associated with high protein diets

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4
Q

what us halitosis classified in to?

A

genuine halitosis
sub divided into
- physiological
- pathological

Psychogenic halitosis
sub divided into
- pseudo-halitosis
- halitophobia

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5
Q

what is pseudohalitosis?

A

no objective evidence of malodour, but pt thinks they have it

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6
Q

what is haitophobia?

A

pt persists in believing they have halitosis despite firm evidence for the absence of halitosis

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7
Q

where does most halitosis originate from?

A

90% from the mouth

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8
Q

what is physiological halitosis?

A

morning breath - common and transient
resolves after eating and OH

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9
Q

how is physiological halitosis caused?

A

increased microbial activity during sleep
reduced saliva flow during sleep (circadian rhythm)
fasting and starvation can also cause

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10
Q

what advice is given for physiological halitosis?

A

eating
OHI
rinsing with fresh water
tongue brushing/ scraping

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11
Q

what foods are associated with halitosis?

A

garlic
onion
cabbage
cauliflower
radish
spicy foods
coffee
alcohol

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12
Q

what are intra oral causes of halitosis?

A

perio disease/ poor OH/ food packing
pericoronitis
oral ulceration
acute herpetic gingivostomatitis
dry sockets
post xLA blood clots
xerostomia
tonsilitis
oral malignancy
poor oral appliance hygiene
mouth breathing
tongue coating

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13
Q

why does tongue coating cause halitosis?

A

chronic bacterial growth and putrefaction

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14
Q

what is the primary cause of halitosis?

A

production of volatile compounds by oral bacteria
- excessive bacterial reservoir on the tongue
- periodontal bacterial deposits

bacteria produce these compounds as the result of the breakdown of:
- epithelial cells
- salivary proteins
- serum proteins vie GCF
- food debris

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15
Q

what bacterial species are responsible for halitosis?

A

no single bacterial species responsible
mainly gram-negative proteolytic anaerobes

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16
Q

what are the volatile sulphur compounds? and what do they smell like?

A

methyl mercaptan - rotten cabbage smell
hydrogen sulphide - rotten egg smell
dimethyl sulphide - unpleasantly sweet smell

17
Q

what are the major compounds responsible for halitosis?

A

VSCs - if the compounds are completely dissolved in the saliva they wont cause halitosis

18
Q

what VSC are associated with garlic and onions?

A

garlic
allyl mercaptan
allyl methyl sulphide

onion
methyl propyl sulphide

19
Q

what type of toothpaste may have beneficial effects on halitosis?

A

triclosan and copolymer containing
baking soda containing

20
Q

what types of mouthwashes may be helpful for halitosis?

A

chlorhexidine and cetylpyridinium containing

chlorine dioxide (ultraDEX) - neutralises VSCs

21
Q

what are the general extra oral factors causing halitosis?

A

drugs
systemic disease
smoking and alcohol

22
Q

what are the drug induced extra oral causes of halitosis?

A

alcohol
tobacco
betel
solvents
disulfiram
cytotoxins
phenothiazines
amphetamines

23
Q

what systemic diseases may cause halitosis?

A

nasal and pharyngeal infections
respiratory pathology
GI pathology
metabolic conditions

24
Q

what type of metabolic conditions may cause halitosis?

A

diabetes (ketoacidosis)
renal failure (uremic breath)
hepatic failure

25
Q

what are the 2 principle assessment methods of halitosis?

A

organoleptic assessment
laboratory methods: halimeter, gas chromatography

26
Q

describe organoleptic assessment for halitosis?

A

pt closes mouth for 1min
pt and dentist face each other 10cm away
pt exhales

27
Q

how do you assess intra or extra oral cause of halitosis through organoleptic assessment?

A

malodour exhaled from nose with mouth closed - may indicate source of problem from nose, sinuses, resp or GI tracts

28
Q

what is the gold standard lab method of assessing halitosis?

A

gas chromatography - differentiates and quantifies specific compounds

29
Q

what is the OralChroma sensitive too when assessing halitosis?

A

hydrogen sulphide
methyl mercaptan
dimethyl sulphide

MODULE 6 (69 decks)

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