Halitosis
Problems with bad breath
Halitosis, also known as bad breath, is defined as a set of unpleasant odours that are emitted from the mouth. It is considered a social problem and is related to poor oral hygiene or diseases of the oral cavity, although, at times it may be a sign of another type of pathology.
Problems with bad breath
Halitosis, also known as bad breath, is defined as a set of unpleasant odours that are emitted from the mouth. It is considered a social problem and is related to poor oral hygiene or diseases of the oral cavity, although, at times it may be a sign of another type of pathology.
Intraoral halitosis (90% of cases)
Comes from the oral cavity itself. In 41% of this cases, it is due mainly to the existence of active periodontal disease and the accumulation of oral biofilm (bacterial plaque) on the tongue. It may also be caused by other situations including: periodontal problems, tooth decay, smoking habit, etc.
Extraoral halitosis (10% of cases)
Originates outside the oral cavity. Mainly due to systemic disorders of the upper/lower respiratory tract, of the digestive system, as well as liver or kidney diseases.
Non-pathological
- Morning breath: during sleep the flow of saliva decreases, which facilitates the uncontrolled growth of bacteria that produce malodorous gases.
- Age: Older people are more likely to suffer regressive changes in their salivary glands and for the quality and quantity of saliva to be affected, even with good oral hygiene.
- Dentures: dentures and bridges can enable the accumulation of food debris.
- Drugs: some medications cause xerostomia (dry mouth), including anticholinergics, antidepressants, etc. Saliva helps to clean the oral cavity and to reduce bad odours.
- Smoking: smoking causes a characteristic breath odour that can last a few days, even after having stopped smoking.
- Fasting
- Dieting: after ingesting certain foods (onion, garlic) or consuming alcohol.
Pathological
- Periodontal disease, caries.
- Deficient oral hygiene: failure to remove oral biofilm (bacterial plaque), causes bacterial growth. Places where bacteria tend to accumulate include the tongue, interproximal spaces, subgingival area, abscesses.
- Ulcerative causes: traumatic, infectious ulcers, stomatitis.
- Pharynx: viral, bacterial or fungal infections.
- Radiation- and chemotherapy-induced necrosis in patients with malignancies.
- The causes of extraoral halitosis may be: nasal (sinusitis), digestive diseases, respiratory diseases, systemic diseases (uncontrolled diabetes mellitus, renal infection, liver dysfunction, Sjogren’s syndrome, rheumatoid arthritis, etc.).
In general, halitosis is difficult to diagnose, as it is unlikely for one to detect their own bad breath, and therefore, most cases of halitosis are diagnosed in the dental office. Different fundamental aspects are involved in the examination of a patient with halitosis:
- Condition of general health
- Lifestyle
- Oral condition
- Hygiene habits
Solutions
- Use antimicrobial agents such as Chlorhexidine at low concentrations (0.05%), Cetylpyridinium Chloride and Zinc Lactate.
- Get a professional dental cleaning.
- Acquire good oral hygiene habits: proper brushing, interproximal cleaning and complete tongue cleaning (with a tongue cleaner together with a mouthwash, gargling to reach the back of the tongue).