2. Halitosis from the Latin halitus for breath
= malodour = foetor ex ore
- unpleasent odors in breathing
- mainly in adult 30% over 60 year
- psichogenic basis
- to be the third most frequent reason for
seeking dental aid
- 85-90% orginates in the mouth itself
3. - morning breath - a low salivary flow
- oral cleansing during
sleep
- during the day :
- foods : garlic, onion or spices
- habits (smoking, drinking alcohol)
- oral bacterial activity anaerobes
5. Porphyromonas gingivalis
Prevotella intermedia
Fusobacterium nucleatum
Bacteriodes forsythus
Treponema denticola
produce the chemicals that cause malodour
The tongue is the location of organisms above
8. Odors are due to the breakdown of certain
proteinsindividual amino acids
Certain aminoacids foul gases
Forexamples : breakdown cystein &
methionine hidogen sulfide
methyl mercaptan
Volatile sulfur compounds stastically
associated with malodour
11. Volatile sulphur
compounds
Cysteine desulphydrase
Methionine desulphydrase
M A L O D O U
R URu R
Debris
Blood
Aminoacids
Cysteine
Methionine
Oral
bacteria
P. gingivalis
F. nucleatum
Prev. intermedia
B. forsythus
T. denticola
SYSTEMIC
Lungs
Gastrointesti
nal
Hepatic
Renal
diabetes
Dimethyl
disulphide
(CH₃)₂SH
Methyl
mercaptan
CH₃SH
Hydrogen
sulphide
H₂S
Psychogenic
12. HALITOSIS
Is there objective
halitosis?
Recently ingested foods
such as
garlic, curry, onion, duria
n, etc?
Drugs :
alcohol, chloral, nitrites/nitrates
, DMSO, cytotoxics, phenothiazi
nes, amphetamines or smoking
Foods
Psychogenic, psychosis or
cerebral tumour
Drugs/smoking
responsible?
Oral sinus or pharyngeal
infections?
Xerostomia?
Respiratory disease, hepatic
disease, renal
disease, gastrointestinal
disease, diabetes mellitus, or
other condition
See “dry mouth”
Abcess, dry
socket, pericoronitis, acute
ulcerative
gingivitis, tonsilitis, sinusitis or
nasal or foreign body
No
Yes
Yes
Yes
Yes
No
Ye
s
N
o
N
o
N
o
15. Dentures can produce accumulation of
microbial plaque ( bacteria and/or yeast)
on and in the fitting surfaces of the
denture and underlying mucosa
The plaque undergoes sequential development
is colonized by organisms
The decreased salivary flow
A low PH under the denture
inflammation denture –related
stomatitis
16. - full history
- examination
- assessment of halitosis
- volatile sulphur compounds halimeter
- oral flora
18. - Patient education
- Treating the cause
- Avoiding smoking, foods such as
onion, garlic etc
- Good oral hygiene : tooth
brushing, flossing, tongue cleaning (before
going to bed)
- Oral antiseptics
- Denture care
19.
20. Wearing a denture encourage food
accumulation , the denture plaque and
fitting surface be infected with
microorganism usually C. albican
- Keep as clean as natural teeth
- Clean both surfaces inside and outside
after meal and at night using washing
up liquid , toothbrush and warm
water hold it over a basin
containing water
21. - should be left out overnight and keep
them in water it may distort if
allowed to dry out
- An infection are increased if the
denture are worn 24 hours a day
22. If the denture is infested with microorg
should be removed
Denture left out the mouth at night
Clean , disinfected
Stored in an antiseptic denture cleanser
Denture soak solutions containing
benzoic acid eradicate C albicans from
denture surface internal surface of
prosthesis
Chlorhexidine : reduction palatinal infection
Mucosal infection by brushing the palate
using antifungal for 4 weeks