Bad breath or Halitosis (oral malodour) is an unpleasant odour of the mouth. It is a common complaint for both genders and for all age groups. Nearly more than 50% of the general population in developed countries have halitosis.
Bad breath affects a person's daily life, causes social and psychological discomfort for individuals and affect their relation with other people.
Mild transient bad breath which often arises after sleep is common and generally not regarded as halitosis. It is termed as “morning halitosis.”
Some people complain of halitosis yet there is no measurable halitosis, even with objective testing, this may be a symptom of delusion or mono symptomatic hypochondriasis (self oral malodour). It is known as HALITOPHOBIA or PSEUDOHALITOSIS.
Such people may wrongly perceive other’s actions as an indicator that their breath is offensive so they adopt a variety of behaviours to overcome their perceived problem like covering the mouth while talking, keeping a distance from other people, or avoiding social interactions. These patients may become fixated with teeth cleaning, tongue cleaning and frequently use mints, chewing gums, mouthwashes, and sprays to reduce their distress.
Halitosis has numerous causes and origins.
Poor Oral hygiene:
SOURCES OF HALITOSIS:
Source of 90% cases of bad breath is oral cavity such as food impaction in between teeth, gum diseases, dry mouth or reduced flow of saliva. Dry mouth or decreased flow of saliva reduces self-cleaning of the mouth and inadequate cleaning of the mouth causes halitosis.
Not maintaining hygiene of orthodontic fixed appliances, wearing dentures and not cleaning them regularly, throat infections, oral ulcers and oral carcinomas may cause bad breath.
Non-oral reasons such as sinus (upper respiratory tract infections), diabetes (diabetic ketoacidosis), lung and kidney diseases (end stage renal failure), gastrointestinal disease such as gastroesophageal reflux disease (GERD), menstruation (menstrual breath) accounts for 9% of halitosis cases.
In 1% of patients, the source of halitosis is diets or drugs.
Diagnosis of bad breath or halitosis, and assessment of its severity is very important to find out if it is genuine halitosis or pseudo-halitosis or halitophobia.
COMMON DIAGNOSTIC METHODS:
OTHER DIAGNOSTIC METHODS:
For treatment of halitosis, detecting the cause or determining its source, by detailed clinical examination is important.