Concerns of bad breath may be divided into genuine and non-genuine cases. Non-genuine cases occur when someone feels they have bad medical problems in dentistry scully pdf free download but someone else cannot detect it. The treatment depends on the underlying cause.
While there is tentative benefit from the use of a tongue cleaner it is insufficient to draw clear conclusions. It is believed to become more common as people age. 1 billion per year on mouthwash to treat the condition. This is known as intra-oral halitosis, oral malodor or oral halitosis. This biofilm results in the production of high levels of foul odors. Volatile sulfur compounds are associated with oral malodor levels, and usually decrease following successful treatment. Other parts of the mouth may also contribute to the overall odor, but are not as common as the back of the tongue.
Normal appearance of the tongue, showing a degree of visible white coating and normal irregular surface on the posterior dorsum. The presence of halitosis-producing bacteria on the back of the tongue is not to be confused with tongue coating. Bacteria are invisible to the naked eye, and degrees of white tongue coating are present in most people with and without halitosis. Patients with periodontal disease were shown to have sixfold prevalence of tongue coating compared with normal subjects.
Halitosis patients were also shown to have significantly higher bacterial loads in this region compared to individuals without halitosis. However, advanced periodontal disease is a common cause of severe halitosis. This is accomplished by subgingival scaling and root planing and irrigation with an antibiotic mouth rinse. VSC in halitosis that is caused by periodontal disease and gingivitis. Indeed, VSC may themselves have been shown to contribute to the inflammation and tissue damage that is characteristic of periodontal disease. However, not all patients with periodontal disease have halitosis, and not all patients with halitosis have periodontal disease.
Although patients with periodontal disease are more likely to suffer from halitosis than the general population, the halitosis symptom was shown to be more strongly associated with degree of tongue coating than with the severity of periodontal disease. Another possible symptom of periodontal disease is a bad taste, which does not necessarily accompany a malodor that is detectable by others. Food debris becomes trapped, undergoes slow bacterial putrefaction and release of malodorous volatiles. Food packing can also cause a localized periodontal reaction, characterized by dental pain that is relieved by cleaning the area of food packing with interdental brush or floss. The plastic is actually porous, and the fitting surface is usually irregular, sculpted to fit the edentulous oral anatomy. These factors predispose to bacterial and yeast retention, which is accompanied by a typical smell. VSC were reported in women.
Smoking is linked with periodontal disease, which is the second most common cause of oral malodor. Volatile foodstuffs may leave malodorous residues in the mouth, which are the subject to bacterial putrefaction and VSC release. However, volatile foodstuffs may also cause halitoisis via the blood borne halitosis mechanism. Theoretically, there are several possible mechanisms of both objective and subjective halitosis that may be involved.
There is disagreement as to the proportion of halitosis cases which are caused by conditions of the tonsils. Some claim that the tonsils are the most significant cause of halitosis after the mouth. Individuals afflicted by the above conditions often show additional, more diagnostically conclusive symptoms than bad breath alone. They are sure that they have bad breath, although many have not asked anyone for an objective opinion.
Bad breath may severely affect the lives of some 0. Research has suggested that self-evaluation of halitosis is not easy because of preconceived notions of how bad we think it should be. Patients often self-diagnose by asking a close friend. A better way would be to lightly scrape the posterior back of the tongue with a plastic disposable spoon and to smell the drying residue.
Furthermore, since breath odor changes in intensity throughout the day depending on many factors, multiple testing sessions may be necessary. If bad breath is persistent, and all other medical and dental factors have been ruled out, specialized testing and treatment is required. Hundreds of dental offices and commercial breath clinics now claim to diagnose and treat bad breath. When used properly, this device can be very effective at determining levels of certain VSC-producing bacteria. However, it has drawbacks in clinical applications. Certain foods such as garlic and onions produce sulfur in the breath for as long as 48 hours and can result in false readings.
The Halimeter is also very sensitive to alcohol, so one should avoid drinking alcohol or using alcohol-containing mouthwashes for at least 12 hours prior to being tested. This analog machine loses sensitivity over time and requires periodic recalibration to remain accurate. It is accurate in measuring the sulfur components of the breath and produces visual results in graph form via computer interface. The level of odor is usually assessed on a six-point intensity scale.
Two main classification schemes exist for bad breath, although neither are universally accepted. North American society, especially with regards halitophobia. The classification assumes three primary divisions of the halitosis symptom, namely genuine halitosis, pseudohalitosis and halitophobia. The Tangerman and Winkel classification was suggested in Europe in 2002. Any halitosis symptom is potentially the sum of these types in any combination, superimposed on the physiologic odor present in all healthy individuals. Efforts may include physical or chemical means to decrease the numbers of bacteria, products to mask the smell, or chemicals to alter the odor creating molecules. A 2006 Cochrane review found tentative evidence that it might decrease levels of odor molecules.