Offensive body odour is one of the greatest taboos in our society. Halitosis is a general term used to describe an unpleasant or offensive odour emanating from the oral cavity.
Several non-oral pathological conditions have been related to oral malodour, including infection of the upper and lower respiratory tracts, the gastrointestinal tract, and some metabolic diseases involving the kidneys or the liver, so called extra-oral halitosis. Extra-oral halitosis can be subdivided in halitosis from the upper respiratory tract including the nose, from the lower respiratory tract, and in blood-borne halitosis. In nearly all cases, patients with extra-oral halitosis have bad breath from both mouse and nose, except for extra-oral halitosis due to nose infection where patients may have bad breath only from the nose. This latter form of extra-oral halitosis is probably rare. The majority of patients with extra-oral halitosis have blood-borne halitosis.
However, most reports now agree that the most frequent sources of halitosis (80 to 90 %) exist within the oral cavity (intra-oral halitosis) and include bacterial reservoirs such as the dorsum of the tongue, saliva and periodontal pockets, where anaerobic bacteria degrade sulphur containing amino acids to produce the foul-smelling volatile sulphur compounds (VSC). VSC are the predominant elements of halitosis. Intra-oral halitosis is an enormous social handicap that can be treated effectively, especially by the use of a tongue scraper and certain mouth-rinses. It is of utmost importance to differentiate between extra-oral and intra-oral halitosis. Comparing nose breath with mouth breath can do this. This presentation will be focused on how to handle patients with halitosis in the dental office. Practical information will be given to support the halitosis therapy and treat this “last taboo”. |
