Oral malodor, also known as bad breath, has multiple potential causes including physiological, intraoral, and extraoral factors. Physiological causes include mouth breathing and certain foods, while intraoral causes often involve periodontal infections and tongue coating harboring microorganisms. Extraoral sources can be nasal/sinus infections, gastrointestinal diseases, or pulmonary issues. Treatment involves reducing substrates and microorganisms mechanically through scaling and brushing, chemically with antimicrobial mouthwashes, and masking malodor with gum or sprays. A thorough examination is needed to determine the etiology and guide proper treatment.

1. ORAL MALODOR
PRESENTED BY .
LAHANUL HAMD TP

2. INTRODUCTION
•Breath odor can be defined as the subjective perception after smelling someone's
breath. it can be pleasant, unpleasant or even disturbing, if not repulsive.
•Synonyms:
• breath malodor
• halitosis
• bad breath,
• fetor ex ore; stomata dysodynia

3. CLASSIFICATION
•Genuine halitosis
• Physiologichalitosis
• Patholagic halitosis- Intraoral
- Etraoral
• Pseudo halitosis
• Halitophobia.

4. ETIOPATHOGENESIS
• TWO PATHWAYS OF BAD BREATH :
1. Increase of certain metabolites in blood circulation escaping via lungs while
breathing and it is commonly referred as extraoral halitosis
2. Increase in bacterial load or amount of substrate for these bacteria at the
lining surfaces of oropharyngeal cavity, the respiratory tract or esophagus

5. CAUSES
1. PHYSIOLOGIC CAUSES
• Mouth breathing
• Medications
• Ageing and poor hygiene
• Fasting or starvation
• Tobacco
• Foods (onion,garlic,etc..)
• Alcohol

6. 2. INTRAORAL CAUSES
• Periodontal infection:- responsible for pathogenesis of periodontitis and
production of volatile sulphur compounds(VSCs)
Volatile sulphur compounds are:- hydrogen sulfide
methyl mercaptan
dimethyl sulfide
• Tongue coating which harbor microorganisam
• Somatitis
• Xerostomia
• Faulty restorations retaining food and bacteria
• Unclean denture
• Oral pathologic lesions
• Crowding of teeth

7. 3. EXTRAORAL CAUSES
• Nasal infection – Eg: rhinitis, sinusitis, postnasal drip
• Diseases of GIT – Eg: hiatus hernia, GERD, carcinoma
• Pulmonary infections – Eg: chronic bronchitis, pneumonia, tuberculosis
• Hormonal changes – Eg: pregnancy, menopause, menstruation
• Systamic diseases – Eg: DM, renal failure, cirrhosis of liver, blood dyscrasias

8. EXAMINATION
•Medical History
•Clinical and Laboratory Examination
•Self examination
•Oropharyngeal examination
Portable volatile sulfur monitor Gas chromatography

9. TREATMENT OF ORAL MALODOR
•Mechanical reduction of intraoral nutrients (substrates) and microorganisms
•Chemical reduction of oral microbial load
•Rendering malodorous gases nonvolatile
•Masking the malodor

10. MECHANICAL
• Scaling
• Breshing
• Tongue cleaning
• Proper restoration
• Denture cleaning

11. CHEMICAL
• Chlorhexidine mouthwash
• Essential oils
• Triclosan
• Chlorin dioxide
• Hydrogen peroxid

12. CONVERSION OF VOLATILE SULFUR COMPOUNDS
• Metal salt solution
• Toothpaste
• Chewing gum

13. MASKING
• Breshing
• Mouthspray
• Chewing gum

14. CONCLUSION
•Breath malodor has important socio-economic consequences.
•A proper diagnosis and determination of the etiology allows the
proper etiological treatment to be instituted quickly.
•Although gingivitis, periodontitis and tongue coating are by far the
most common causes, other more challenging diseases should not
be overlooked.
•This can be dealt with either by a trial therapy to deal quickly with
intra-oral causes or by a multidisciplinary consultation.

15. REFERENCES
• Carranza
• Internet

16. THANK YOU