There are numerous dental diseases and conditions which have great importance and consideration among the public. The most common ones being the dental caries ( tooth cavity), gum problems, discolored teeth, tooth sensitivity, toothache, malalignment of teeth, oral ulcers and problems with respect to wisdom teeth. The next huge complication faced by many individuals is bad breath.

At least once in this lifetime everyone would have or might experience bad breath and would also be in a state of not knowing the reason and solution for it. More than 30% of the human population complain about this problem. Some people may not be aware of their own breath malodour and might learn about it from a friend or relative which can bring discomfort and also make them lose confidence. This can have a negative impact on the individual’s quality of life and relationships.

Fundamentals of Bad breath / Halitosis / Breath malodor :

Breath malodor can be defined as subjective perception after smelling someone’s breath. It can be pleasant, unpleasant or disturbing.

There are 3 main categories of halitosis :

• ●  Genuine halitosis - Halitosis exists and can be diagnosed. This could be either physiological or pathological. Physiologic factors such as food intake, medication, smoking. Pathologic is due to any underlying diseases and disorders.

• ●  Pseudo-halitosis - Cannot be perceived by the dentist, though the patient might complain.

• ●  Halitophobia - psychiatric condition, patient believes the presence of bad breath even after treatment (obsessive compulsive disorder)

  The main cause or etiology are :

• ●  Gingivitis - disease of the gum

• ●  Periodontitis - disease of the gum and surrounding supporting structures of teeth

• ●  Tongue coating

Causes of halitosis can be categorized as two either extraoral or intraoral factors. Extraoral causes are further divided as blood-borne halitosis that includes exhalation of bad smelling metabolites from the lungs and non blood-borne which is any throat infections, nasal infections, lung diseases, stomach disorders.

Whereas the intraoral factors include accumulation of food remnants and bacteria on the surface of tongue, periodontal ( supporting structures of teeth ) infections, dental disorders like deep caries, food impaction and pus discharge due to infections and dry mouth (where production of saliva from salivary glands is reduced drastically).

Diagnosis of malodour:

Pre Consultation patient information
Anamnesis - Questioning patient - History, Hygiene, Habits Examination - using sulfur monitor, oropharyngeal examination

Treatment :

• ●  General oral hygiene instructions on correct brushing technique, tongue cleaning, use of dental floss, use of mouthrinse as instructed by the dentist.

• ●  In general, brushing twice daily, with the correct technique as advised by your dentist, use of small pea sized toothpaste that is fluoridated, is essential.

• ●  Quitting smoking, tobacco chewing and consumption of alcohol is necessary

• ●  Seek for medical attention to identify the root cause and check for underlying

  systemic disease like uncontrolled diabetes, liver disease, kidney failure.

• ●  Look out for a psychiatrist or therapist, incase of halitophobia.

FRESH BREATH, FRESH START !

Dr. Catherine Christy J, Dental Surgeon