This document discusses halitosis (bad breath) including its causes, diagnosis, and treatment. It notes that halitosis is typically caused by volatile sulfur compounds produced by bacteria in the oral cavity. Common causes include poor oral hygiene, dry mouth, dental problems, smoking, certain foods, and underlying health conditions. Diagnosis involves a medical history, examination of the mouth, and devices to measure volatile compounds. Treatment depends on the underlying cause but generally involves improving oral hygiene and hygiene habits as well as treating any dental problems or underlying health issues.

1. Halitosis Ousamah Ahmad
Oral Diagnosis II

3. Origin of HALITOSIS
New Latin, from Latin halitus breath, from halare to
breathe — more at exhale
First Known Use: 1874

4. Definition of Halitosis
Bad breath (halitosis) can be embarrassing and may
cause anxiety. It's no wonder store shelves are
overflowing with gum, mints, mouthwashes and
other products designed to combat this condition.
But many of these products are mere temporary
measures.a condition of having fetid breath
Certain foods, health conditions and habits are
among the causes of bad breath. In many cases,
that can improve bad breath with proper dental
hygiene

5. Pathogenesis of Halitosis
It is generally known and agreed that VSC's
(Volatile Sulfur Compounds)
are responsible for the odor,
and that 80-90% of these come from oral sources.
VSC's are produced by bacterial
and cellular degradation,
and include hydrogen sulphide,
methyl mercaptan and dimethyl sulphide.
The nature of the odor may vary in intensity
(strength of the smell) and quality (the type of odor).

6. Causes , Prevalence of Halitosis
Food. The breakdown of food particles in
and around your teeth can cause a foul odor.
Eating foods containing certain oils is another
source of bad breath. Onions and garlic are
the best-known examples, but other
vegetables and spices also can cause bad
breath.

7.  Dental problems. Poor dental
hygiene and periodontal disease can be a
source of bad breath.
 Dry mouth. Saliva helps cleanse your
mouth, removing particles that may cause
bad odors. A condition called dry mouth
(xerostomia) can contribute to bad breath
because production of saliva is decreased.

8. Diseases. In about 10 percent of bad
breath cases, the bad odors do not come
from the mouth (extra-oral halitosis). For
example, illnesses, such as some cancers
and metabolic disorders, can cause a
distinctive breath odor as a result of
chemicals they produce. Diabetes and kidney
or liver failure can lead to a fishy smell.

9.  Mouth, nose and throat conditions.
 Tobacco products. Smoking dries out your
mouth and causes its own unpleasant mouth
odor.

10. Risk Factors Associated With Halitosis
Non-disease related Disease related
Oral
• Inadequate oral hygiene • Candidasis
• Long periods of mouth closing
(i.e., morning breath after sleep) • Cancer
• Xerostomia (e.g., dry mouth due to
mouth breathing, medication)
• Gingivitis
• Tongue coatings • Mouth infection, inflammation, ulceration
• Periodontitis

11. Medications can cause bad breath
An unfortunate side effect of a number of medications is halitosis.
Here are a few medications that are known to cause bad breath.
 Triamterene - This diuretic, which is used to treat high blood
pressure and edema, lists halitosis as one of its side effects,
Paraldehyde - It treats seizures and may also be used by
healthcare professionals as a sedative,
Disulfiram - Used to treat alcoholism, this drug has a number of
unpleasant side effects, including high blood pressure, restlessness and
halitosis.
Antihistamines –

12. signs and symptoms of bad breath:
 You frequently have a bitter taste in your
mouth
 A white or yellow coating on your tongue
 People seem to avoid direct contact with you
and they step back from you when you are
talking to them
 People around you offer mints or chewing
gum
 A smelly odor when you open your mouth

13. Diagnosis and classification of
halitosis
 Oral Malodor Patient Types
 Type I—Those who have it and know it
 Type II—Those who have it but deny or do not
know they have it
 Type III—Those that do not have it, but think
they do.

15. Some specific pieces of equipment
have been developed to help the
dentist diagnose halitosis. These
are known as the halimeter and
the periotemp.
Device For Halitosis!

16. Medical History
 Due to many possible causes of bad
breath, diagnosis of the origin of
halitosis is essential for its treatment.
The first step to making a proper
diagnosis is the taking of a complete
medical history. Some of the
questions you may ask are:
?

17.  When is the last time you visited the dentist?
 What are your oral hygiene habits? a) Brush
daily b) Brush & floss daily c)Brush, floss,
and rinse daily
 Do you use an over-the-counter mouth rinse
regularly? a)Yes? What brand? b) No?
?

18.  When you sleep do you breathe through your
mouth?
 Are you taking any medication?
 Are you on a special diet?
 Do you smoke?
?

19. Treating halitosis
There is no one treatment for halitosis. The
treatment will depend on what is causing the
problem
 Raise the problem with patients directly
 Dental expertise required
 professional dental cleaning *

20.  restoration of fillings
 cleaning of dental prostheses
 examination of prosthetics
 Daily oral hygiene measures
 tongue cleaning for mechanical removal of tongue
coatings
Treating halitosis

21. Halitosis Drugs

22. Halitosis Drugs
 Chlorhexidine
Chlorhexidine is a chemical antiseptic, prescribed for gingivitis, cleansing skin and
wound areas
 Cimetidine
Cimetidine is a histamine H2-receptor antagonist, prescribed for heartburn and peptic
ulcers. ...
 Ranitidine
Ranitidine is an antacid, antireflux agent & antiulcerant, prescribed for peptic ulcer. ..
. Cetylpyridinium chloride (CPC): It is used in most lozenges, mouthwashes,
toothpastes, breath sprays, throat sprays, and nasal sprays. It is a chemical
antiseptic and acts mostly by the bactericidal mode of action i.e. it kills the bacteria.
 Chlorine dioxide: It is used as a disinfectant and oxidizer and is very effective in
killing pathogenic microbes like fungi
List of drugs used to treat the medical condition called Halitosis

23. Halitophobia ” Delusion halitosis
 One quarter of the patients seeking professional
advice on bad breath suffer from a highly
exaggerated concern of having bad breath, known
as halitophobia, delusional halitosis, or as a
manifestation of Olfactory Reference Syndrome.
These patients are sure that they have bad breath,
although many have not asked anyone for an
objective opinion. Halitophobia may severely affect
the lives of some 0.5–1.0% of the adult population

24. That’s it
Thank you