What is Halitosis? Its Types, Diagnosis, Prevention and Treatment?
Commonly known as Bad Breath, Halitosis, is something that everyone at some point in time experiences. It can be most commonly experienced when you wake up in the morning. Halitosis could be Subjective and Objective both. In this era of the Covid-19 Pandemic, almost everybody is aware of how their breath smells due to the constant wearing of a mask. Halitosis could be mild to severe to disturbing at times. Halitosis definitely keeps people away due to its unpleasant nature and could cause embarrassment at times. Another medical term for Bad breath is Fetor Oris.
How does Halitosis develop?
When you eat food or drink beverages, some portion of it remains stuck in your mouth in between your teeth or on your tongue or some secretive place where it can stay longer. Now once these things are stuck, bacteria develop in your mouth due to the decay of the food particles stuck in your mouth. These bacteria are in variety and definitely not good for your mouth. They contribute to the development of Bad breath. That is the reason brushing your teeth is recommended 30 minutes after the meal. According to an article by Ken Yaegaki and Jeffrey M. Coil published on the Canadian Dental Association website, almost 50% of the population shows prevalence for Halitosis.
What are the types of Halitosis?
Halitosis is basically divided into three types: Genuine, Pseudo and Halitophobia. Let’s take a look at each one briefly.
The person genuinely suffers from Halitosis due to various reasons and it requires attention. Genuine Halitosis can be further classified into Physiologic and Pathologic.
In this type, the bad breath develops due to the decay of food or other particles on the surface of teeth, tongue, or any area inside the mouth. It is the most common cause of Halitosis and almost 90% of the cases fall under this type.
In this type, the Halitosis is due to certain underlying pathologic conditions or diseases. These conditions can range from mild to severe from Gum diseases to Oral cancers.
As the name suggests Pseudo means False. In this type of Halitosis, the person does not actually suffer from Halitosis but thinks that they have it. The person constantly believes that they have a bad breath. Even upon confirmation, they refuse to believe. The patients suffering from Pseudo Halitosis require counseling as their treatment part.
In this type, the patient once suffered Genuine Halitosis and got it under control but lives in a constant fear of developing bad breath again. These patients also require regular check-ups and counseling as their treatment.
How can you tell if you or your friend is suffering from Halitosis?
Well, I think your friend would definitely tell you that your mouth stinks rather than a stranger who would just maintain a safe distance in order to not hurt your feelings or make you feel embarrassed. You can self-smell your breath and identify too. However, the best way to find out is by visiting your Dentist. There are various methods by which your Dentist can diagnose your Halitosis. Those methods are:
This method is based on the sensory perception of your examiner. Your dentist would insert a small tube into your mouth, and you would be asked to blow air in it. The level of Bad odor is then recorded, and the diagnosis is done. Some patients get conscious while blowing the air, hence an area with a separation of patient and the examiner is created. To be sure, this examination should be done on 2-3 different occasions. This is the most convenient and widely used method for diagnosis.
The score card for Organoleptic measurement is as below:
|Score||Type of Odor||Description|
|0||No Bad Odor||The bad breath cannot be detected|
|1||Questionable Bad Odor||Some sort of odor is present but cannot be labeled as a bad odor|
|2||Slight Bad Odor||Bad Odor can be detected but very less|
|3||Moderate Bad Odor||Definite Bad odor and noticeable|
|4||Strong Bad Odor||Bad odor is present significantly but can be tolerated|
|5||Severe Bad Odor||Severe Bad Odor present which cannot be tolerated, and the person requires to cover their nose or step away.|
Gas Chromatography and Sulphide monitoring
This method is the most accurate when it comes to detecting bad odor. This method requires an equipment installation and a skilled operator. The equipment consists of a flame photometric detector which helps to detect Volatile Sulphur compounds in the mouth. These Volatile Sulphur compounds are the main reason for Bad Breath. However, these machines come with a limitation. First off, the installation is hectic and not all clinics can accommodate one of these. Secondly, they have different sensitivity to different gases like low for methyl mercaptan and high for Hydrogen sulphide.
Hence the best method of diagnosis would be Organoleptic Measurement.
How can you prevent Halitosis?
Well, we have a very detailed and well-structured article on Habits to prevent Halitosis. Go check it out at 13 Habits to Prevent Halitosis (Bad Breath) – Tricky Care
How can you treat Halitosis?
It is absolutely necessary to get rid of that bad smell. Different types of Halitosis require different treatment approaches. For the Physiologic type, a simple good oral hygiene practice that includes brushing twice a day or whenever necessary, flossing your teeth, cleaning your tongue thoroughly, and using a good oral rinse should keep the Bad Breath at bay. For the Pathologic type, proper diagnosis and treatment of the underlying disease should be done and a good oral hygiene should be maintained. The Pseudo Halitosis requires more of psychological support and counseling rather than physical. The patient requires assurance and support. Similar situation with Halitophobia. The patient should be counselled as well as instructed to keep their oral hygiene in check to avoid Halitosis.
The takeaway here is everyone suffers from Bad Breath and it is normal. We can prevent and treat Halitosis. There should not be any shame or feeling of embarrassment for that. You should take preventive measures and take care of your oral hygiene.