Halitosis

1. Seminar of halitosis Presented by: Fatima Abozaian Hafsa shaklawon Souad najmeddien

2. HALITOS I S

3. Definition Halitosis is a general term used to define an unpleasant odour emerge from the breath regardless of whether the odour from oral or non_oral sources : Originated from two words Halitus breath Osis disease

4. Synonyms Bad or foul breath Breath malodour Oral malodour Foetor oris

5. Common cause of halitosis 1_local factor: A_Oral disease B_Respiratory disease C_Voliate foodstuff 2_Systemic factor

6. 1_Local factor A_Oral disease Acute gingivitis Pericoronitis Oral ulceration ANUG Periodontitis Food impaction Xerostomia

7. B_respiratory disease Sinusitis Tonsillitis Bronchiectasis C_Voliate foodstuff Garlic Onions Spiced foods

8. 2_Systemic factor Respiratory tract infection Renal failure Diabetic Hepatic failure

9. Etiology Halitosis generally arises as a result of the bacterial decomposition of food particles,cells,blood and chemical compound of the saliva

10. Role of volatile sulphur compound in pathogenesis of halitosis Major compound implicate in halitosis VSCs_hydrogen sulfide,dimethyl sulfide,mercaptan Polyamide_putrescein,cadaverine

11. It increase the permeability of oral mucosa . It impairs oxygen utilization by host Reacts with cellular protein and interferes whit collagen maturation.

12. Classification 1_Genuine halitosis physiologic halitosis pathologic halitosis 2_Pseudo halitosis 3_halitophopia

13. 1_Genuine halitosis: Physiological halitosis Morning breath odour,tobacco smoking & certain food,Starvation , Medication ( Disulfaram,Antihistamine ) Pathological halitosis Intra oral OR extra oral origin _90% of patient oral cavity _bacteria ,volatile sulphus compound

14. Intra oral origin: Poor oral hygiene,dental caries, periodontal disease,tongue coating Extra oral origin: Respiratory tract infection Chronic sinusitis & tonsillitis, kidney,liver , stomach affected by systemic disease.

15. - 2_Pseudo halitosis Obvious malodour is not perceived by other,although the patient stubbornly complains of its existence,condition can be improved by counseling &simple oral hygiene measures 3_Haltophobia(delusional halitosis) Exaggerated fear of having halitosis

16. Diagnosis A_History 1_Onset/Duration 2_Constant/Intermittent 3_Self reported or reported by other 4_Systemic disease or medication 5_Currenty under stress

17. B_Examination 1_Tongue coating 2_Periodontal disease

18. C_Detection Self assessment test Wrist lick test Spoon test Dental floss test Saliva odour test

19. Some device used to detect halitosis : 1_Gas chromatography 2_Halimeter

20. Limitation of halimeter : 1_Some of the common sulfides such as mercaptan are not easily recorded 2_Very sensitive to alcohol ,so should avoid drinking alcohol or using alcohol containing mouth washes for at least 12 hours prior to being tested

21. Preventive measures Visit dentist regularly Brushing of teeth twice daily Periodical tooth cleaning Use of tongue scraper Flossing after brushing to remove food particles Chew gum freesugar

22. Management i_Mechanical reduction of intraoral nutrient and micro_organism i i_Chemical reduction of oral microbial load iii_Consevative of volatile sulfide compound iv_Masking the malodour

23. 1_Mechanical reduction of intraoral nutrient and micro_organism: Tongue cleaning Tooth brush Inter dental cleaning Chewing gum Professional periodontal therapy

24. 2_Chemical reduction of oral microbial load Chlorhexidine Essential oils Triclosan Hydrogen peroxide Stannous fluoride

25. 3_Conversion of volatile sulfide compound Metal salt solution: Various metal ions Zinc(Zn++): is an ions which bonds to the twice negatively charged sulfur radicals to reduce the expression of VSCs Toothpastes Chewing gum

26. 4_Masking the malodour Rinses Mouth sprays Lozenges containing volatiles Chewing gum

27. Thank you