Oral Malodor: A Common Oral Problem

Abstract

Oral malodor, also called halitosis or bad breath, is universally experienced condition that has a variety of etiologic factors. It is extremely common and majority of adult population have had it at some point in time. Halitosis may be physiological, pathological, and sometimes psychological also. Although numerous non-oral sites and many different causes have been correlated to bad breath, an estimated 80 percent to 90 percent of all bad breath odors originate from the mouth, and bacteria are directly responsible for most of the offensive gases. Specific groups of bacteria have been identified with the production of oral malodor, in particular, gram-negative, anaerobic bacteria. The unpleasant smell of breath mainly originates from volatile sulfide compounds (VSCs), especially hydrogen sulfide (H 2 S), methylmercaptan (CH3SH), and dimethylsulfide [(CH 3 ) 2 S] result from the proteolytic degradation of peptides present in saliva, shed epithelium, food debris and gingival crevicular fluid (GCF). This article reviews the etiology, diagnosis, and treatment of oral malodor and gives a brief description of Halitosis Associated Life-quality Test (HALT) questionnaire, a specific 20-item quality-of-life measure for halitosis. The tongue plaque coatingResearch suggests that the tongue is the primary site in the production of oral malodor. The dorsoposterior surface of the tongue has been identified as the principal location for the intraoral generation of VSCs [12]. A variety of index systems for tongue coating has been developed over the years. Miyazaki et al divides the tongue into three sections and the presence or absence of tongue coating is registered as follows: Score 0 = none visible, Score 1 = less than one third of tongue dorsum is covered, Score 2 = between one and two thirds, Score 3 = more than two thirds [13]. Winkel et al divides the tongue into six sections, three in the posterior and three in the anterior part of the tongue. Each sextant is categorized as: Score 0 = no coating present, Score 1 = presence of a light coating, Score 2 = presence of a distinct coating. The resulting Winkel tongue coating index (WTCI) is obtained by adding all six scores (Figure 1) [14].

The correlation between occurrence of dental caries and oral health-related quality of life (OHRQoL) of elderly population in Yogyakarta Special Region

“…On the other hand, dental caries can also cause bad breath that may decrease self convidence of someone. 4 In the psychosocial aspect, speech and eating difficulties can impair social interactions which may cause some patients to avoid social engagements where it affects the OHRQoL. 31 Social interactions may also be affected due to a decreased selfesteem caused by difficulties in speech and mastication.…”

“…3 Dental caries can also cause bad breath. 4 In highly progressed cases, an infection can spread from the tooth to the surrounding soft tissues. Complications may include inflammation of the tissue around the tooth, tooth loss, and infection or abscess formation.…”

Treponema Denticola and Porphyromonas Gingivalis as Bioindicator Oral Hygiene Status and Organoleptic Score in Mouth Breathing Children

“…According to Saini, the activity of proteolytic anaerobic bacteria mainly generates VSCs with 90% of its major components consist methyl mercaptan (CH 3 SH), hydrogen sulfide (H 2 S), and dimethyl sulfide [(CH 3 ) 2 S] [4,7]. These gas-producing anaerobic Gram-negative bacteria include Treponema denticola, Porphyromonas gingivalis, Fusobacterium nucleatum, and Tannerella forsythia [8].…”

“…These gas-producing anaerobic Gram-negative bacteria include Treponema denticola, Porphyromonas gingivalis, Fusobacterium nucleatum, and Tannerella forsythia [8]. The bacteria will degrade protein compounds derived from saliva, gingival crevicular fluid, plaque, tongue dorsal, and desquamated epithelial cells [7].…”

Etiological Factors, Diagnoses, and Treatments of Halitosis: A Review update

“…While dental diseases have been strongly associated with such condition, there is considerable evidence that dentally healthy individuals can exhibit significant levels of halitosis. Proteolytic activity by microorganisms over the tongue and teeth results the foul-smelling compounds, and is the most common cause of such problems 10 . This foetor ex ore can have major detrimental social activities for the…”