Periodontology

ORAL MALODOR

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INTRODUCTION:

Halitosis – or chronic bad breath – is something that mints, mouthwash or a good brushing can’t solve. Unlike “morning breath” or a strong smell that lingers after a tuna sandwich, halitosis remains for an extended amount of time and may be a sign of something more serious. 

CLASSIFICATION :

  1. BASED ON ETIOLOGY :
  • Local factors of pathological origin : poor oral hygiene , extensive caries, periodontal disease , cysts , tumors .
  • Local factors of non pathological origin : stagnation of saliva associated with food debris , dentures, excessive smoking .
  • Systemic factors of pathological origin : diabetes mellitus, liver failure, lung abscess , tuberculosis .
  • Systemic factors of non pathological origin : diet like garlic , onion , meat , excessive alcohol consumption.
  • Xerostomia :conditions like sjogren’s syndrome, radiation therapy.

2. BASED ON PATIENT’S CRITERIA :

  • Genuine halitosis
  • Pseudo halitosis
  • Halitophobia

PATHOGENSIS OF MALODOR :

ETIOLOGY :

  1. Physiological halitosis
  • mouth breathing
  • medications
  • aging and poor dental hygiene
  • fasting / starvation
  • tobacco
  • foods like onion , garlic and alcohol

2. Pathological halitosis:

  • periodontal infection
  • stomatitis
  • xerostomia
  • faulty restorations
  • unclean dentures
  • oral cancers
  • candidiasis
  • nasal infections
  • GERD
  • bronchitis, pneumonia
  • diabetes mellitus
  • renal failure
  • fever

DIAGNOSIS :

  1. Review of medical , dental , personal history
  2. Clinical examination : tongue coating, mouth breathing , xerostomia
  3. Complete periodontal examination
  4. Measurement of malodor : gas chromatography . halimeters, BANA test , chemiluminescence , diamond probe

TREATMENT :

  • Brush your teeth after you eat.
  • Floss at least once a day.
  • Brush your tongue.
  • Clean dentures or dental appliances. .
  • Avoid dry mouth.
  • Adjust your diet. .
  • Regularly get a new toothbrush.
  • Schedule regular dental checkups.
  • Regular use of halita solution which reduces the levels of volatile sulfur compounds .

References: Essentials of clinical periodontology . Shantipirya reddy 5th edition

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