Articles from NCBI - Tongue Coating - 99% oral cases
Posted: Wed Nov 27, 2013 2:33 pm
[Halitosis--diagnosis and treatment]. - Chomyszyn-Gajewska M, Skrzypek A
http://www.ncbi.nlm.nih.gov/pubmed/23879006
Abstract
Halitosis (bad breath) applies to according to various authors--even 25-50% of the population. Volatile sulfur compounds are frequently encountered in the exhaled air. The article presents the most common causes of halitosis. It is believed that approximately 80-90% of thecauses of halitosis are located in the head area (mouth, ear, nose, throat), whereas the remaining cases correspond to systemic illness, such as of the stomach and lung, certain medications or food. This paper describes different means to assess halitosis, which can be helpful in determining the diagnosis. The article describes ways to treat the symptoms and causes of halitosis associated with oral cavity. In patients who have had another source of halitosis, additional diagnostic procedures and appropriate treatment must be performed. Given the prevalence of the problem of the malodour and its impact on the quality of everyday life, halitosis is a phenomenon that should not be underestimated. Thecauses need to be detected and an appropriate therapy must be performed. Patients with diagnosed halitophobia should be directed to appropriate specialists.
Tongue coating: related factors.
Department of Periodontology, Catholic University Leuven, Leuven, Belgium.
http://www.ncbi.nlm.nih.gov/pubmed/23278504
Abstract
AIM:
A clear relationship between tongue coating and oral malodour has been observed in many clinical trials. Why or when this coating is formed remains an open question. The aim of this study was to analyse possible factors related to the presence of tongue coating in a population complaining from oral malodour.
MATERIALS AND METHODS:
Patients were recruited from a halitosis clinic (UZ Leuven). Medical history, dietary and oral hygiene habits were retrieved via a questionnaire. Data were recorded on organoleptic score and level of sulphur compounds in breath, anatomical features of the tongue dorsum, amount of tongue coating (according to three indices: Miyazaki, Winkel and modified Winkel), tongue coating wet weight and salivary flow. The correlation between the presence of tongue coating and a series of parameters was analysed.
RESULTS:
The level of oral hygiene was the strongest determinant factor for the presence of tongue coating. Smoking, presence of a denture, periodontal status and dietary habits also correlated although less obvious.
CONCLUSION:
The presence of tongue coating appears to be related to several factors of which oral hygiene is the strongest.
Characteristics of patients complaining of halitosis and factors associated with halitosis.
Department of Preventive Dentistry, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Abstract
OBJECTIVES:
To describe the characteristics of patients who visited halitosis clinic and to investigate the factors that may associate withhalitosis.
MATERIALS AND METHODS:
Nine hundred and eleven patients, who visited halitosis clinic for consultations, underwent organoleptic tests and volatile sulfur compound (VSC) measurements with a portable sulfide monitor. The oral health of patients, including dental caries, oral hygiene and gingival inflammation status, was assessed. Questionnaires were used to obtain information on demographics, oral hygiene practices, and dietary habits.
RESULTS:
Of the 911 patients, more females than males visited the clinic. Patients' age ranged from 18 to 82 years (mean ± SD: 40.8 ± 14.1). Almost 30% of patients had complained of halitosis for over 5 years before looking into treatments. Approximately half of the patients self-perceived that they were unable to get close to others. Around 77% of patients had halitosis. Results of multiple logistic regressions for organoleptic scores and VSC values showed that tongue coating and tongue scraping were significantly associated with halitosis (p<0.05).
CONCLUSIONS:
Among these Chinese patients, over three quarters of patients had halitosis, and negative impacts on social communications were observed. Tongue coating was the most important factor responsible for halitosis. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved
Relationship between halitosis and periodontal disease - associated oral bacteria in tongue coatings.
Department of Hygiene and Oral Health Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
http://www.ncbi.nlm.nih.gov/pubmed/23890391
Abstract
AIM:
The objective of our study was to investigate the relationship between halitosis and oral bacteria in tongue coating (TC) and saliva samples from patients with halitosis, and to evaluate the effect of tongue cleaning on halitosis.
METHODS:
Ninety-four participants complaining of oral malodour were included in the study. Organoleptic (OR) values, volatile sulphur compound (VSC) concentrations determined by gas chromatography and TC scores were used as clinical parameters of halitosis. Quantitative real-time polymerase chain reactions were used to determine the numbers of periodontal disease-associated oral bacteria.
RESULTS:
There was a significant correlation between TC scores and OR values, methylmercaptan (CH3 SH) concentrations and VSC concentrations (Spearman's rank-correlation coefficient test, P < 0.01). There was also a positive correlation between the clinical parameters ofhalitosis and total bacterial numbers and Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus concentrations in the TC samples. However, there was no similar correlation with respect to the saliva samples. The participants were sub-divided into two groups based on whether they had the habit of tongue cleaning or not. The participants with the habit of tongue cleaning had significantly lower OR scores, VSC concentrations and P. intermedia, F. nucleatum and C. rectus levels than the other participants (Mann-Whitney U-test, P < 0.05).
CONCLUSION:
These results suggested that periodontal disease-associated oral bacteria in TCs are closely related to halitosis and that tongue cleaning may be an effective method for improving halitosis.
Halitosis: From diagnosis to management. – http://www.ncbi.nlm.nih.gov/pubmed/23633830 - Department of Periodontology, Kirikkale University Dental Faculty, Kirikkale, Turkey.
Abstract
Halitosis is formed by volatile molecules which are caused because of pathological or nonpathological reasons and it originates from an oral or a non-oral source. It is very common in general population and nearly more than 50% of the general population have halitosis. Althoughhalitosis has multifactorial origins, the source of 90% cases is oral cavity such as poor oral hygiene, periodontal disease, tongue coat, food impaction, unclean dentures, faulty restorations, oral carcinomas, and throat infections. Halitosis affects a person's daily life negatively, most of people who complain about halitosis refer to the clinic for treatment but in some of the people who can suffer from halitosis, there is no measurable halitosis. There are several methods to determine halitosis. Halitosis can be treated if its etiology can be detected rightly. The most important issue for treatment of halitosis is detection etiology or determination its source by detailed clinical examination. Management may include simple measures such as scaling and root planning, instructions for oral hygiene, tongue cleaning, and mouth rinsing. The aim of this review was to describe the etiological factors, prevalence data, diagnosis, and the therapeutic mechanical and chemical approaches related to halitosis.
Characteristics of 2000 patients who visited a halitosis clinic.
Department of Periodontology, Catholic University of Leuven, Kapucijnenvoer 33, Leuven BE-3000, Belgium. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/19811581
Abstract
AIMS:
The aim of this paper was to analyse the aetiology and characteristics of 2000 patients who visited a multidisciplinary bad breath clinic in Leuven, Belgium and to correlate organoleptic ratings with portable device measurements.
MATERIALS AND METHODS:
The characteristics and aetiology of breath malodour of two thousand consecutive patients who visited ahalitosis consultation were explored by means of a standard questionnaire and a clinical examination, including organoleptic scores provided by a trained and calibrated judge, and a portable bad breath detector (Halimeter).
RESULTS:
Most patients came without referral and had complaints for several years (mean: 7 years, SD: 8 years). For 76% of the patients, an oral cause was found [tongue coating (43%), gingivitis/periodontitis (11%) or a combination of the two (18%)]. Pseudo-halitosis/halitophobia was diagnosed in 16% of the cases; and ear, nose and throat/extra-oral causes were found in 4% of the patients. Most patients had an organoleptic score <3 and a Halimeter value <240 p.p.b.
CONCLUSIONS:
Even though it was observed that halitosis has a predominantly oral origin, a multidisciplinary approach remains necessary to identify ear, nose and throat or extra-oral pathologies and/or pseudo-halitosis/halitophobia.
Assessing the contribution of anaerobic microflora of the tongue to oral malodor.
Department of Biologic Materials Sciences, University of Michigan, Ann Arbor, USA.
Abstract
Research suggests that the tongue plays an important role in the production of oral malodor. To investigate the role of tongue surface characteristics and oral bacteria in halitosis development, the authors tested associations between odor measurements, volatile sulfur compound levels, periodontal parameters, tongue surface characteristics, presence of trypsinlike activity of organisms on the tongue and teeth and bacteriological parameters in 16 participants with complaints of oral malodor. The data indicate that the proteolytic, anaerobic flora residing on the tongue plays an essential role in the development of halitosis.
Nose
[Halitosis in two children caused by a foreign body in the nose].
Afd. Kindergeneeskunde, Academisch Ziekenhuis Vrije Universiteit, Amsterdam. [email protected]
Abstract
In two boys aged 4.5 and 1.5 years with halitosis a nasal foreign body was found. After removal the foetor disappeared. Little is known about the epidemiology of halitosis in children. Apart from specific odours with certain systemic disorders, local pathology such as chronic sinusitis, upper and lower respiratory tract infections and to a lesser degree gastrointestinal disorders may be the cause of the offensive smell. As in adults, bad breath in children is usually related to poor oral hygiene or disease of the oral cavity. The first-line treatment is proper oral hygiene and if necessary dental sanitization. In resistant cases further evaluation should be aimed at disclosing the causative pathology, in which case in children the possibility of a nasal foreign body should also be considered.
Halitosis - Stomach
Halitosis and tongue coating in patients with erosive gastroesophageal reflux disease versus nonerosivegastroesophageal reflux disease. –
http://www.ncbi.nlm.nih.gov/pubmed/22437377
Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland. [email protected]
Abstract
OBJECTIVE:
The aim of this study was to investigate whether patients with diagnosed erosive gastroesophageal reflux disease (ERD) have an increased probability of halitosis and tongue coating compared to patients with nonerosive gastroesophageal reflux disease (NERD).
MATERIALS AND METHODS:
Sixty-six patients (33 males and 33 females) were recruited for the study and received an upper gastrointestinal endoscopy. The presence of ERD (n = 31) and NERD (n = 35) was classified based on the Los Angeles classification for erosive changes in the esophagus. Additionally, the patients filled in a questionnaire regarding their subjective assessment of halitosis, and an organoleptic assessment of halitosis, a measurement of oral volatile sulfur compounds (VSC) with the Halimeter, and a tongue coating index were performed. ERD and NERD subjects were compared with regard to Halitosis-related clinical and anamnestic findings.
RESULTS:
No statistically significant difference could be found between ERD and NERD patients regarding tongue coating index, organoleptic scores, and VSC values as well as self-perceived bad taste, tongue coating, and bad breath.
CONCLUSIONS:
These data suggest that halitosis is not typically associated with erosive gastroesophageal reflux disease and the presence of esophageal mucosal damage (ERD patients).
CLINICAL RELEVANCE:
The data of this investigation support the findings of interdisciplinary bad breath clinics that gastroesophageal refluxdisease is not a leading cause for halitosis.
[Bad breath--etiological, diagnostic and therapeutic problems].
Klinik für Hals-Nasen-Ohrenheilkunde am Städtischen Klinikum Görlitz, Deutschland.
http://www.ncbi.nlm.nih.gov/pubmed/10838713
Abstract
Oral malodor has many etiologies and is a clinical problem for many people. This paper reviews the causes and management of oral malador. In the majority of cases the problem has been shown to originate in the oral cavity. Oral malodor, a generic descriptor term for foul smells emanating from the mouth, encompasses ozostomia, stomatodysodia, halitosis (both pathological halitosis and physiological halitosis) and fetor oris or fetor ex ore. These latter terms, in turn, denote different sources of oral malodor. All conditions that favour the retention of anaerobic, mainly gram-negative, bacteria will predispose for the development of bad breath. In addition to periodontal pockets, the most important retention site is the dorsum of the tongue with its numerous papillae. During the night and between meals the conditions are optimal for odour production. Systemic pathological states, such as diabetes mellitus, uremia and hepatic diseases, induce metabolic products that are detectable as oral smells. It is always easy to recognize halitosis, but identifying the exact cause is more complex. The clinical labelling and interpretation of different oral malodors both contribute to the diagnosis and treatment of underlying disease. Treatment is directed at the underlying cause.
Gastrointestinal diseases and halitosis: association of gastric Helicobacter pylori infection.
Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, School of Medicine, Japan. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/12090454
Abstract
The relationship between gastrointestinal conditions and halitosis is discussed. Few reports have suggested that gastrointestinal diseases may cause halitosis. H. pylori infection, which causes gastric ulcers, is considered as a possible cause for halitosis. Intensity of malodour of mouth air was found to be higher in H. pylori-positive patients than in negative patients. The levels of hydrogen sulphide and dimethyl sulphide in mouth air were also significantly higher in the positive patients than in the negative patients (P<0.05). When odour strength in exhaled breath was compared between the two groups, no significant difference was found. Hence, H. pylori infection might not cause a systemic condition producing breath odour. Although there were no significant differences in periodontal parameters or tongue coating between the positive and negative groups, H. pylori may be a frequent contributor to the production of malodour even though its role had not been suspected before. Further study would be necessary to clarify the reason for the increase of volatile sulphur compounds (VSCs) level in H. pylori infection.
No significant association between halitosis and upper gastrointestinal endoscopic findings: a prospective study
Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/22340228
Abstract
BACKGROUND:
Previous studies have focused on the relationship between halitosis, gastroesophageal reflux disease and Helicobacter pylori. In this study we aimed to investigate the interaction between halitosis and upper gastrointestinal endoscopic findings.
METHODS:
Patients who previously had dyspepsia and had undergone endoscopic examination were included in the study. Symptoms of dyspepsia were investigated by means of a questionnaire that investigated halitosis. Patients who suffered from objective halitosis (confirmed by questions both to the patient and their relatives) were further investigated. Patients with known local or systemic causes of halitosis or structural disorders at endoscopy were excluded.
RESULTS:
The study included 358 patients (121 men and 237 women) with dyspeptic symptoms. The patients with and without halitosis had mean ages of (39.4 ± 13.5) and (43.1 ± 14.9) years, respectively. Patients without halitosis were significantly older than those in the halitosisgroup (P < 0.05). Patients in the halitosis group had significantly higher frequencies of regurgitation, bloating and nausea (P < 0.05) when compared to patients without halitosis. Endoscopic findings, including esophagitis, open cardia, hiatal hernia, gastritis and duodenitis, were comparable in the two groups.
CONCLUSIONS:
The frequency of halitosis was high in patients with dyspepsia who underwent upper gastrointestinal endoscopy. Halitosishad a close relationship with several upper gastrointestinal symptoms, including regurgitation, nausea and bloating. There was no significant association between upper gastrointestinal endoscopic findings and halitosis.
The gastrointestinal aspects of halitosis.
Pediatric Department, Bnai Zion Medical Center, Kiryat-Ata, Haifa, Israel.
http://www.ncbi.nlm.nih.gov/pubmed/21152460
Abstract
BACKGROUND:
Halitosis is a common human condition for which the exact pathophysiological mechanism is unclear. It has been attributed mainly to oral pathologies. Halitosis resulting from gastrointestinal disorders is considered to be extremely rare. However, halitosis has often been reported among the symptoms related to Helicobacter pylori infection and gastroesophageal reflux disease.
OBJECTIVE:
To retrospectively review the experience with children and young adults presenting with halitosis to a pediatric gastroenterology clinic.
METHODS:
A retrospective chart review of patients diagnosed with halitosis as a primary or secondary symptom was conducted. All endoscopies were performed by the same endoscopist.
RESULTS:
A total of 94 patients had halitosis, and of the 56 patients (59.6%) who were recently examined by a dental surgeon, pathology (eg, cavities) was found in only one (1.8%). Pathology was found in only six of 27 patients (28.7%) who were assessed by an otolaryngology surgeon. Gastrointestinal pathology was found to be very common, with halitosis present in 54 of the 94 (57.4%) patients. The pathology was noted regardless of dental or otolaryngological findings. Most pathologies, both macroscopically and microscopically, were noted in the stomach (60% non-H pylori related), followed by the duodenum and the esophagus. Fifty-two of 90 patients (57.8%) were offered a treatment based on their endoscopic findings. Of the 74 patients for whom halitosis improvement data were available, some improvement was noted in 24 patients (32.4%) and complete improvement was noted in 41 patients (55.4%).
CONCLUSIONS:
Gastrointestinal pathology was very common in patients with halitosis regardless of dental or otolaryngological findings, and most patients improved with treatment
Complete article - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948765/
Eradication therapy in Helicobacter pylori-positive patients with halitosis: long-term outcome.
Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, Thessaloniki, Greece. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/17303947
Abstract
OBJECTIVE:
The aim of this study was to investigate the incidence and long-term outcome of halitosis before and after eradication therapy in patients with functional dyspepsia and Helicobacter pylori infection.
SUBJECTS AND METHODS:
Halitosis and dyspepsia-related symptoms were investigated by way of a questionnaire. Only patients with functional dyspepsia, H. pylori infection and no histological evidence of atrophy were included in the study. A total of 18 patients fulfilled these criteria and completed the study. Four to six weeks after the end of eradication treatment, endoscopy or [(13)C] breath test was performed to check for H. pylori in the gastric mucosa. Halitosis and dyspeptic symptoms were re-evaluated during and at the end of follow-up.
RESULTS:
H. pylori infection was eradicated in all patients, in the 14/18 patients (77.8%) with triple drug therapy, and the 4/18 patients (22.2%) with quadruple drug therapy. During the follow-up period (mean 55.8 +/- 21.3 months (range 6-108 months)) resolution of halitosis was observed in 16/18 patients (88.9%), while 2 patients (11.1%) (p < 0.001) continued to present with halitosis. Also, eradication therapy resulted in statistically significant relief of all dyspeptic symptoms, except bloating.
CONCLUSION:
Eradication of H. pylori in patients with functional dyspepsia and halitosis results in sustained resolution of halitosis during long-term follow-up in the majority of cases. This finding supports the existence of a link between H. pylori infection and halitosis and suggests that H. pylori eradication might be considered in patients with halitosis.
http://www.ncbi.nlm.nih.gov/pubmed/23879006
Abstract
Halitosis (bad breath) applies to according to various authors--even 25-50% of the population. Volatile sulfur compounds are frequently encountered in the exhaled air. The article presents the most common causes of halitosis. It is believed that approximately 80-90% of thecauses of halitosis are located in the head area (mouth, ear, nose, throat), whereas the remaining cases correspond to systemic illness, such as of the stomach and lung, certain medications or food. This paper describes different means to assess halitosis, which can be helpful in determining the diagnosis. The article describes ways to treat the symptoms and causes of halitosis associated with oral cavity. In patients who have had another source of halitosis, additional diagnostic procedures and appropriate treatment must be performed. Given the prevalence of the problem of the malodour and its impact on the quality of everyday life, halitosis is a phenomenon that should not be underestimated. Thecauses need to be detected and an appropriate therapy must be performed. Patients with diagnosed halitophobia should be directed to appropriate specialists.
Tongue coating: related factors.
Department of Periodontology, Catholic University Leuven, Leuven, Belgium.
http://www.ncbi.nlm.nih.gov/pubmed/23278504
Abstract
AIM:
A clear relationship between tongue coating and oral malodour has been observed in many clinical trials. Why or when this coating is formed remains an open question. The aim of this study was to analyse possible factors related to the presence of tongue coating in a population complaining from oral malodour.
MATERIALS AND METHODS:
Patients were recruited from a halitosis clinic (UZ Leuven). Medical history, dietary and oral hygiene habits were retrieved via a questionnaire. Data were recorded on organoleptic score and level of sulphur compounds in breath, anatomical features of the tongue dorsum, amount of tongue coating (according to three indices: Miyazaki, Winkel and modified Winkel), tongue coating wet weight and salivary flow. The correlation between the presence of tongue coating and a series of parameters was analysed.
RESULTS:
The level of oral hygiene was the strongest determinant factor for the presence of tongue coating. Smoking, presence of a denture, periodontal status and dietary habits also correlated although less obvious.
CONCLUSION:
The presence of tongue coating appears to be related to several factors of which oral hygiene is the strongest.
Characteristics of patients complaining of halitosis and factors associated with halitosis.
Department of Preventive Dentistry, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Abstract
OBJECTIVES:
To describe the characteristics of patients who visited halitosis clinic and to investigate the factors that may associate withhalitosis.
MATERIALS AND METHODS:
Nine hundred and eleven patients, who visited halitosis clinic for consultations, underwent organoleptic tests and volatile sulfur compound (VSC) measurements with a portable sulfide monitor. The oral health of patients, including dental caries, oral hygiene and gingival inflammation status, was assessed. Questionnaires were used to obtain information on demographics, oral hygiene practices, and dietary habits.
RESULTS:
Of the 911 patients, more females than males visited the clinic. Patients' age ranged from 18 to 82 years (mean ± SD: 40.8 ± 14.1). Almost 30% of patients had complained of halitosis for over 5 years before looking into treatments. Approximately half of the patients self-perceived that they were unable to get close to others. Around 77% of patients had halitosis. Results of multiple logistic regressions for organoleptic scores and VSC values showed that tongue coating and tongue scraping were significantly associated with halitosis (p<0.05).
CONCLUSIONS:
Among these Chinese patients, over three quarters of patients had halitosis, and negative impacts on social communications were observed. Tongue coating was the most important factor responsible for halitosis. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved
Relationship between halitosis and periodontal disease - associated oral bacteria in tongue coatings.
Department of Hygiene and Oral Health Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
http://www.ncbi.nlm.nih.gov/pubmed/23890391
Abstract
AIM:
The objective of our study was to investigate the relationship between halitosis and oral bacteria in tongue coating (TC) and saliva samples from patients with halitosis, and to evaluate the effect of tongue cleaning on halitosis.
METHODS:
Ninety-four participants complaining of oral malodour were included in the study. Organoleptic (OR) values, volatile sulphur compound (VSC) concentrations determined by gas chromatography and TC scores were used as clinical parameters of halitosis. Quantitative real-time polymerase chain reactions were used to determine the numbers of periodontal disease-associated oral bacteria.
RESULTS:
There was a significant correlation between TC scores and OR values, methylmercaptan (CH3 SH) concentrations and VSC concentrations (Spearman's rank-correlation coefficient test, P < 0.01). There was also a positive correlation between the clinical parameters ofhalitosis and total bacterial numbers and Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus concentrations in the TC samples. However, there was no similar correlation with respect to the saliva samples. The participants were sub-divided into two groups based on whether they had the habit of tongue cleaning or not. The participants with the habit of tongue cleaning had significantly lower OR scores, VSC concentrations and P. intermedia, F. nucleatum and C. rectus levels than the other participants (Mann-Whitney U-test, P < 0.05).
CONCLUSION:
These results suggested that periodontal disease-associated oral bacteria in TCs are closely related to halitosis and that tongue cleaning may be an effective method for improving halitosis.
Halitosis: From diagnosis to management. – http://www.ncbi.nlm.nih.gov/pubmed/23633830 - Department of Periodontology, Kirikkale University Dental Faculty, Kirikkale, Turkey.
Abstract
Halitosis is formed by volatile molecules which are caused because of pathological or nonpathological reasons and it originates from an oral or a non-oral source. It is very common in general population and nearly more than 50% of the general population have halitosis. Althoughhalitosis has multifactorial origins, the source of 90% cases is oral cavity such as poor oral hygiene, periodontal disease, tongue coat, food impaction, unclean dentures, faulty restorations, oral carcinomas, and throat infections. Halitosis affects a person's daily life negatively, most of people who complain about halitosis refer to the clinic for treatment but in some of the people who can suffer from halitosis, there is no measurable halitosis. There are several methods to determine halitosis. Halitosis can be treated if its etiology can be detected rightly. The most important issue for treatment of halitosis is detection etiology or determination its source by detailed clinical examination. Management may include simple measures such as scaling and root planning, instructions for oral hygiene, tongue cleaning, and mouth rinsing. The aim of this review was to describe the etiological factors, prevalence data, diagnosis, and the therapeutic mechanical and chemical approaches related to halitosis.
Characteristics of 2000 patients who visited a halitosis clinic.
Department of Periodontology, Catholic University of Leuven, Kapucijnenvoer 33, Leuven BE-3000, Belgium. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/19811581
Abstract
AIMS:
The aim of this paper was to analyse the aetiology and characteristics of 2000 patients who visited a multidisciplinary bad breath clinic in Leuven, Belgium and to correlate organoleptic ratings with portable device measurements.
MATERIALS AND METHODS:
The characteristics and aetiology of breath malodour of two thousand consecutive patients who visited ahalitosis consultation were explored by means of a standard questionnaire and a clinical examination, including organoleptic scores provided by a trained and calibrated judge, and a portable bad breath detector (Halimeter).
RESULTS:
Most patients came without referral and had complaints for several years (mean: 7 years, SD: 8 years). For 76% of the patients, an oral cause was found [tongue coating (43%), gingivitis/periodontitis (11%) or a combination of the two (18%)]. Pseudo-halitosis/halitophobia was diagnosed in 16% of the cases; and ear, nose and throat/extra-oral causes were found in 4% of the patients. Most patients had an organoleptic score <3 and a Halimeter value <240 p.p.b.
CONCLUSIONS:
Even though it was observed that halitosis has a predominantly oral origin, a multidisciplinary approach remains necessary to identify ear, nose and throat or extra-oral pathologies and/or pseudo-halitosis/halitophobia.
Assessing the contribution of anaerobic microflora of the tongue to oral malodor.
Department of Biologic Materials Sciences, University of Michigan, Ann Arbor, USA.
Abstract
Research suggests that the tongue plays an important role in the production of oral malodor. To investigate the role of tongue surface characteristics and oral bacteria in halitosis development, the authors tested associations between odor measurements, volatile sulfur compound levels, periodontal parameters, tongue surface characteristics, presence of trypsinlike activity of organisms on the tongue and teeth and bacteriological parameters in 16 participants with complaints of oral malodor. The data indicate that the proteolytic, anaerobic flora residing on the tongue plays an essential role in the development of halitosis.
Nose
[Halitosis in two children caused by a foreign body in the nose].
Afd. Kindergeneeskunde, Academisch Ziekenhuis Vrije Universiteit, Amsterdam. [email protected]
Abstract
In two boys aged 4.5 and 1.5 years with halitosis a nasal foreign body was found. After removal the foetor disappeared. Little is known about the epidemiology of halitosis in children. Apart from specific odours with certain systemic disorders, local pathology such as chronic sinusitis, upper and lower respiratory tract infections and to a lesser degree gastrointestinal disorders may be the cause of the offensive smell. As in adults, bad breath in children is usually related to poor oral hygiene or disease of the oral cavity. The first-line treatment is proper oral hygiene and if necessary dental sanitization. In resistant cases further evaluation should be aimed at disclosing the causative pathology, in which case in children the possibility of a nasal foreign body should also be considered.
Halitosis - Stomach
Halitosis and tongue coating in patients with erosive gastroesophageal reflux disease versus nonerosivegastroesophageal reflux disease. –
http://www.ncbi.nlm.nih.gov/pubmed/22437377
Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland. [email protected]
Abstract
OBJECTIVE:
The aim of this study was to investigate whether patients with diagnosed erosive gastroesophageal reflux disease (ERD) have an increased probability of halitosis and tongue coating compared to patients with nonerosive gastroesophageal reflux disease (NERD).
MATERIALS AND METHODS:
Sixty-six patients (33 males and 33 females) were recruited for the study and received an upper gastrointestinal endoscopy. The presence of ERD (n = 31) and NERD (n = 35) was classified based on the Los Angeles classification for erosive changes in the esophagus. Additionally, the patients filled in a questionnaire regarding their subjective assessment of halitosis, and an organoleptic assessment of halitosis, a measurement of oral volatile sulfur compounds (VSC) with the Halimeter, and a tongue coating index were performed. ERD and NERD subjects were compared with regard to Halitosis-related clinical and anamnestic findings.
RESULTS:
No statistically significant difference could be found between ERD and NERD patients regarding tongue coating index, organoleptic scores, and VSC values as well as self-perceived bad taste, tongue coating, and bad breath.
CONCLUSIONS:
These data suggest that halitosis is not typically associated with erosive gastroesophageal reflux disease and the presence of esophageal mucosal damage (ERD patients).
CLINICAL RELEVANCE:
The data of this investigation support the findings of interdisciplinary bad breath clinics that gastroesophageal refluxdisease is not a leading cause for halitosis.
[Bad breath--etiological, diagnostic and therapeutic problems].
Klinik für Hals-Nasen-Ohrenheilkunde am Städtischen Klinikum Görlitz, Deutschland.
http://www.ncbi.nlm.nih.gov/pubmed/10838713
Abstract
Oral malodor has many etiologies and is a clinical problem for many people. This paper reviews the causes and management of oral malador. In the majority of cases the problem has been shown to originate in the oral cavity. Oral malodor, a generic descriptor term for foul smells emanating from the mouth, encompasses ozostomia, stomatodysodia, halitosis (both pathological halitosis and physiological halitosis) and fetor oris or fetor ex ore. These latter terms, in turn, denote different sources of oral malodor. All conditions that favour the retention of anaerobic, mainly gram-negative, bacteria will predispose for the development of bad breath. In addition to periodontal pockets, the most important retention site is the dorsum of the tongue with its numerous papillae. During the night and between meals the conditions are optimal for odour production. Systemic pathological states, such as diabetes mellitus, uremia and hepatic diseases, induce metabolic products that are detectable as oral smells. It is always easy to recognize halitosis, but identifying the exact cause is more complex. The clinical labelling and interpretation of different oral malodors both contribute to the diagnosis and treatment of underlying disease. Treatment is directed at the underlying cause.
Gastrointestinal diseases and halitosis: association of gastric Helicobacter pylori infection.
Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, School of Medicine, Japan. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/12090454
Abstract
The relationship between gastrointestinal conditions and halitosis is discussed. Few reports have suggested that gastrointestinal diseases may cause halitosis. H. pylori infection, which causes gastric ulcers, is considered as a possible cause for halitosis. Intensity of malodour of mouth air was found to be higher in H. pylori-positive patients than in negative patients. The levels of hydrogen sulphide and dimethyl sulphide in mouth air were also significantly higher in the positive patients than in the negative patients (P<0.05). When odour strength in exhaled breath was compared between the two groups, no significant difference was found. Hence, H. pylori infection might not cause a systemic condition producing breath odour. Although there were no significant differences in periodontal parameters or tongue coating between the positive and negative groups, H. pylori may be a frequent contributor to the production of malodour even though its role had not been suspected before. Further study would be necessary to clarify the reason for the increase of volatile sulphur compounds (VSCs) level in H. pylori infection.
No significant association between halitosis and upper gastrointestinal endoscopic findings: a prospective study
Department of Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/22340228
Abstract
BACKGROUND:
Previous studies have focused on the relationship between halitosis, gastroesophageal reflux disease and Helicobacter pylori. In this study we aimed to investigate the interaction between halitosis and upper gastrointestinal endoscopic findings.
METHODS:
Patients who previously had dyspepsia and had undergone endoscopic examination were included in the study. Symptoms of dyspepsia were investigated by means of a questionnaire that investigated halitosis. Patients who suffered from objective halitosis (confirmed by questions both to the patient and their relatives) were further investigated. Patients with known local or systemic causes of halitosis or structural disorders at endoscopy were excluded.
RESULTS:
The study included 358 patients (121 men and 237 women) with dyspeptic symptoms. The patients with and without halitosis had mean ages of (39.4 ± 13.5) and (43.1 ± 14.9) years, respectively. Patients without halitosis were significantly older than those in the halitosisgroup (P < 0.05). Patients in the halitosis group had significantly higher frequencies of regurgitation, bloating and nausea (P < 0.05) when compared to patients without halitosis. Endoscopic findings, including esophagitis, open cardia, hiatal hernia, gastritis and duodenitis, were comparable in the two groups.
CONCLUSIONS:
The frequency of halitosis was high in patients with dyspepsia who underwent upper gastrointestinal endoscopy. Halitosishad a close relationship with several upper gastrointestinal symptoms, including regurgitation, nausea and bloating. There was no significant association between upper gastrointestinal endoscopic findings and halitosis.
The gastrointestinal aspects of halitosis.
Pediatric Department, Bnai Zion Medical Center, Kiryat-Ata, Haifa, Israel.
http://www.ncbi.nlm.nih.gov/pubmed/21152460
Abstract
BACKGROUND:
Halitosis is a common human condition for which the exact pathophysiological mechanism is unclear. It has been attributed mainly to oral pathologies. Halitosis resulting from gastrointestinal disorders is considered to be extremely rare. However, halitosis has often been reported among the symptoms related to Helicobacter pylori infection and gastroesophageal reflux disease.
OBJECTIVE:
To retrospectively review the experience with children and young adults presenting with halitosis to a pediatric gastroenterology clinic.
METHODS:
A retrospective chart review of patients diagnosed with halitosis as a primary or secondary symptom was conducted. All endoscopies were performed by the same endoscopist.
RESULTS:
A total of 94 patients had halitosis, and of the 56 patients (59.6%) who were recently examined by a dental surgeon, pathology (eg, cavities) was found in only one (1.8%). Pathology was found in only six of 27 patients (28.7%) who were assessed by an otolaryngology surgeon. Gastrointestinal pathology was found to be very common, with halitosis present in 54 of the 94 (57.4%) patients. The pathology was noted regardless of dental or otolaryngological findings. Most pathologies, both macroscopically and microscopically, were noted in the stomach (60% non-H pylori related), followed by the duodenum and the esophagus. Fifty-two of 90 patients (57.8%) were offered a treatment based on their endoscopic findings. Of the 74 patients for whom halitosis improvement data were available, some improvement was noted in 24 patients (32.4%) and complete improvement was noted in 41 patients (55.4%).
CONCLUSIONS:
Gastrointestinal pathology was very common in patients with halitosis regardless of dental or otolaryngological findings, and most patients improved with treatment
Complete article - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948765/
Eradication therapy in Helicobacter pylori-positive patients with halitosis: long-term outcome.
Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, Thessaloniki, Greece. [email protected]
http://www.ncbi.nlm.nih.gov/pubmed/17303947
Abstract
OBJECTIVE:
The aim of this study was to investigate the incidence and long-term outcome of halitosis before and after eradication therapy in patients with functional dyspepsia and Helicobacter pylori infection.
SUBJECTS AND METHODS:
Halitosis and dyspepsia-related symptoms were investigated by way of a questionnaire. Only patients with functional dyspepsia, H. pylori infection and no histological evidence of atrophy were included in the study. A total of 18 patients fulfilled these criteria and completed the study. Four to six weeks after the end of eradication treatment, endoscopy or [(13)C] breath test was performed to check for H. pylori in the gastric mucosa. Halitosis and dyspeptic symptoms were re-evaluated during and at the end of follow-up.
RESULTS:
H. pylori infection was eradicated in all patients, in the 14/18 patients (77.8%) with triple drug therapy, and the 4/18 patients (22.2%) with quadruple drug therapy. During the follow-up period (mean 55.8 +/- 21.3 months (range 6-108 months)) resolution of halitosis was observed in 16/18 patients (88.9%), while 2 patients (11.1%) (p < 0.001) continued to present with halitosis. Also, eradication therapy resulted in statistically significant relief of all dyspeptic symptoms, except bloating.
CONCLUSION:
Eradication of H. pylori in patients with functional dyspepsia and halitosis results in sustained resolution of halitosis during long-term follow-up in the majority of cases. This finding supports the existence of a link between H. pylori infection and halitosis and suggests that H. pylori eradication might be considered in patients with halitosis.