Bad Breath - Halitosis

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Definition

Any bad smell carried in the breath.

 

Incidence

The incidence in the general population is approximately 0.5-1%. Often individuals are unaware of the condition and they may suffer social consequences. There are individuals who suffer from halitophobia and believe that they have bad breath.

 

Etiology

The majority of cases are secondary to degradation of protein material by bacteria. The production of amino acid produces offensive gases.

  1. Dental
    1. Plaque formation
    2. Food between teeth
    3. Dental caries
    4. Diseases of the gums
  2. Postnasal Drip- may be related to sinusitis and chronic rhinitis
  3. Nasal- sinusitis, obstruction from polyps or foreign objects placed in the nose by children
  4. Tonsils-may have bad odors associated with infection of the tonsils or tonsilloliths
  5. Dry mouth-saliva naturally cleanses the mouth and rids bacteria. Drugs associated with producing dry mouth may produce bad breath.
  6. Diet
  7. Tobacco
  8. Menstruation
  9. Systemic illnesses- diabetes, uremia, liver failure, lung infections and abscesses
  10. Halitophobia.

 

Diagnosis

  1. Physician verifies complaint of patient or parent
  2. Record time of day smell noted
  3. Oral hygiene history and physical exam
  4. Underlying illnesses
  5. Scrap the posterior tongue with a spoon or tongue blade and let sit for 10 minutes. Smell the contents

 

Treatment

  1. Promote oral hygiene and dental care.
  2. Flossing when children are old enough
  3. Clean tongue with soft brush
  4. Mouthwash and chewing gum
  5. Keep mouth moist and well hydrated
  6. Treat underlying medical conditions

 

References

  1. Rosenberg Mel, Robinson Gary, Amir Erica. Beating Bad Breath. Contemporary Pediatrics March 2002

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