Halitosis (bad breadth) is a general term used to define an unpleasant or offensive odour emanating from the mouth regardless of the source whether from inside the mouth(oral) or outside of it (non-oral).
Halitosis can be classified into three main groups;
- Genuine halitosis (Physiologic & Pathologic)
1. Genuine Halitosis
– Physiological halitosis which is normal includes morning breath odour, odour that comes with tobacco smoking, taking certain foods and medication.
– Pathological halitosis the sources can be from inside the mouth(intra-oral) or outside of it (extra-oral). In about 90% of patients source is intra oral. It mainly results from bacteria breakdown of food particles and subsequent release of Volatile Sulphur Compounds (VSC).
2. Pseudo-halitosis occurs in people that are otherwise healthy and often report that bad breadth occurs why they feel their mouth is dry, heavy or in the case of a persistent bad taste, even without the presence of any food.
3. Halitophobia is an exaggerated fear of having Halitosis(bad breadth) and also referred as Delusional Halitosis. Sufferers show misappropriate concern and are obsessed with their breath.
Causes of bad breadth
1. Intra oral (from inside the mouth) causes of Pathological Halitosis is Poor oral hygiene; Dental caries; Periodontal diseases in particular Necrotizing Ulcerative Gingivitis (NUG) and Necrotizing Ulcerative Periodontitis (NUP); Pericoronitis; Dry Socket; Tongue Coating; Oral cancer and Xerostomia (dry mouth).
–Tongue coating is made up of desquamated epithelial cells, food debris, bacteria and salivary proteins and provide an ideal environment for generation of Volatile Sulphur Compounds (VSC) that contribute to Malodour.(bad odour)
2. Extra Oral origin (from outside the mouth) include Gastro-Intestinal Diseases; Infections or Malignancy in respiratory tract; Chronic Sinusitis and Tonsillitis; stomach, intestine, liver or kidney affected by systems diseases.
–Respiratory Diseases that cause halitosis include sinusitis, tonsillitis, malignancy, bronchiectasis, etc.
–Volatile Foodstuffs that can cause halitosis include garlic, onions and spiced foods.
3. Systemic Causes Include Liver Failure (Fetor Hepaticus), Kidney Failure (End Stage), Diabetic ketoacidosis, Acute Febrile Illness, Helicobacter Pylori Infection, Pyloric Stenosis or Duodenal Obstruction, Oesophageal Diverticulum, Gastro-Oesophageal Reflux Disease