Oral Malodor: A Review
Correspondence Address :
DR. VANDANA K.L., SENIOR PROFESSOR, DEPARTMENT OF PERIODONTICS, COLLEGE OF DENTAL SCIENCES, DAVANGERE-577004.e-mail: vanrajs@hotmail.com Phone: 08192-221316.
Breath malodor is a condition that health and social implications. The origin of oral malodor problems are related to both systemic and oral conditions. This paper provides a comprehensive review of the etiology of breath odor, its prevalence, diagnosis and treatment strategies for this condition.
Oral malodor, Breath malodor, Halitosis, Volatile Sulphur compounds, pseudo halitosis, Halitophobia, Organoleptic.
Introduction
It is likely that the majority of adults suffer from bad breath at least occasionally. Since bad breath usually comes from the mouth itself, the dentist should be the first professional whom individuals turn for help. In recent years, there has been a growing awareness that bad breath is a problem that the dental profession should recognize and address. Oral malodour is a phenomenon that is often oversimplified by the commercial dental industry, misunderstood by the general society, and not completely understood by the scientific community.
Bad breath has been recorded in the literature for thousands of years. The prophet Mohammed is said to have thrown a congregant from the mosque for having the smell of garlic on his breath. Malodour has been documented in the Bible, along with attempted remedies for treating it. The aetiologies of oral malodour are quite diverse. There are some patients whose oral malodour stems from psychological problems. These problems manifest either as a syndrome or simply a transitory perception of malodour. Aside from the pure psychological component, there is also socio-economic component that affects the perceived need for fresh breath and the heightened awareness of one’s breath. There are many devices available to measure volatile Sulphur compounds (VSCs). Despite these devices, oral judges still are employed for the assessment of oral odour.
There exist within the mouth many reservoirs (dorsum of the tongue, periodontal pockets, denture surfaces etc.) for bacteria. These are the areas where hygiene can be applied in an attempt to lessen the amounts of gases released by these bacteria.The purpose of this review paper is to review the factors relating to oral malodour and to express the psychological aspects along with various aetiology, diagnostic and treatment modalities .
Psychological and socio-economic aspects of malodour:
Among our many senses, smell is considered to be one of the more subjective, and it is open to emotional and cognitive influence. Smell can influence and be influenced by mood, lending a great deal of sensitivity. Because perception can skew or Among our many senses, smell is considered to be one of the more subjective, and it is open to emotional and cognitive influence. Smell can influence and be influenced by mood, lending a great deal of sensitivity. Because perception can skew or alter our awareness, many people may not think that they have “bad breath” until they may suffer from imaginary halitosis due to presumptions based on attitudes of other people.
In some situations it is in the individual’s perception of malodor which is not detectable by others which can be described as an actual syndrome. It was shown that certain personalities co-relate with the olfactory reference syndrome such as those with abscessing features, inferiority complexes, neuroticism, self criticisms, self observation, shyness and difficulty in expressing emotion. The impact of halitophobia can be minute or very deleterious, because some people go so far as to avoid social events, keep what are thought as safe distances from others and even talk sideways when engaged in conversation.
Seeing the importance to the individuals and the amount of time, money and energy expended, it is important that the scientific community do its best to help individuals who suffer from oral malodor or its related psychosis.
Considering these findings, it is important to understand the psychological component in perceptions of oral malodor. This prompts a need for psychological evaluation when treating patients for this disorder. The evaluation should be given significant weight when planning treatment for these patients. Expectation and perceptions of results are multifactorial for these patients, and thus very subjective. This complexity is an obstacle both in diagnosis and treatment, yet it may also serve as an avenue of treatment that should be addressed by the me
When looking at oral malodor, it is essential to understand that its origins are complicated. The influence of major corporations has resulted in heightened awareness of one’s breath and that of others. The practitioner, when presented with malodor patients, must not discount any reports by the patient and should follow a course of diagnosis, treatment and follow-up that any other condition deserves. Patients also should be referred for psychological evaluation if a psychological component is suspected in the complaint of malodor.
As 87% of malodor is caused by oral diseases, proper referral to the dentists specifically periodontists is necessary because of its association with periodontal diseases. It has been established that the same bacteria are responsible for the damage seen in periodontal disease and production of great amounts of VSCs and these VSCs are believed to be toxic.
Various methods of self assessment are available for patients who are intended, also various methods of diagnosis for the practitioners. Many products and treatments are available to deal with “bad breath”. Ultimately, with more research in the future, it will be possible to arrive at better diagnostic tools along with improved treatments and treatment options.
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