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HALITOSIS Dr. Shafaq Salim

Halitosis→Latin word :

Halitosis → Latin word  halitus   (breathed air), and  osis  (pathologic alteration)

PowerPoint Presentation:

Halitosis is bad or sour smelling breath. It may indicate other health problems!!!


organisms Porphyromonas gingivalis Prevotella intermedia Fusobacterium nucleatum Bacteroides forsythus Treponema denticola



Physiological oral::

Physiological oral: Oral Hygiene Plaque & Calculus Diet Coated tongue Starvation, Morning breath Gingivitis/ Periodontitis Percoronitis / Peri-implantitis Interdental food impaction ANUG/NUP Post-extraction, Dry socket Caries Improper Brushing and Flossing Habits (Mouth breathing, thumb sucking) Faulty fillings, Overhangs Fixed bridgework Appliances– Orthodontic, Prosthodontic Denture hygiene Medicines Xerostomia Ulcerations, Abrasions, Wounds Neoplasias

Physiological Nasal & respiratory::

Physiological Nasal & respiratory: Bronchitis Bronchiectasis Lung Abscess Pleuritis Pneumonia Neoplasia , Mucous Stagnation/Infection Tobacco Smokers Obstruction , Nasal- discharge, Tonsillitis, t onsoliths , Laryngitis, Stagnation and Infection Malignancies

Physiological pathological others:

Physiological pathological others Constipation Poor hydration Menstruation Lungs release blood-borne catabolic products Stomach Gastritis Liver Hepatitis Kidney Nephritis Pancreas Diabetes mellitus (Ketosis) Anorexia/Bulimia nervosa IgA deficiency Xerostomia ( Sjogrens , Radiation therapy, Stress)

Systemic smells:

Systemic smells Diabetes - ketoacidosis - acetone smell Cirrhosis, liver failure - "mousy", "musty" smells Renal failure - fishy smell Leukemia - "decaying blood" smell


psychological Detectable only by patient-no apparent cause Halitophobia Patients often refuse to accept objective findings Associated with anxiety or depression

volatile sulfur compounds (VSC):

volatile sulfur compounds (VSC) Hydrogen sulfide, methyl mercaptan , other thiols , and dimethyl sulfide, collectively referred to as volatile sulfur compounds (VSC), are the principal malodorants in chronic halitosis.  These compounds are generated by anaerobic bacteria Located principally on the back of the tongue


diagnosis 3-tests

PowerPoint Presentation:

The patient is asked to come to the office during the period he/she feels the halitus is at its worst. He is also asked not to use mouth rinses and the toothbrush at least two hours before the test. The test consists on asking the patient to breathe deeply inspiring the air by nostrils and expiring by mouth, while the examiner sniffs the odor at a distance of 20 cm, considering it unpleasant or not in a scale of 0 to 5. Self-examination can be relevant as it involves the patient in the process. Licking his/her own wrist, smelling it after a while, reflects the saliva contribution to oral malodor. Examiners must also use an objective test such as Halimeter ®


halimeter Device for objective assessment of oral malodor. They detect the VSC quantitatively and correlate them with specific diseases. It has a digital display, which records the quantity of VSC in parts per billion (ppb). Halimetry values are considered normal if below 150 ppb. The Halimeter ®  does not record all the odor vectors present in the breathed air.

Management :

Management OHI: Brushing, Flossing, Gargle, Rinse Tongue scraper Prosthesis: Hygiene, Repair, or Replace Remove all plaque Rectify cause Patient education

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