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Oral malodor affects a large percentage of the human population. Bad breath bacteria is commonly known as halitosis. Halitosis is caused by the accumulation of food debris and dental bacterial plaque on the teeth and tongue. This can result from poor oral hygiene and gingivitis. Halitosis can be divided into two categories: extra-oral halitosis (EOH) and intra-oral halitosis (IOH). The likelihood of increasing halitosis may be due to periodontal diseases, dry mouth, smoking, alcohol consumption, dietary habits, diabetes, and obesity [1]. The development of bad breath bacteria can lead to feeling embarrassed, social difficulties and nervousness, resulting in the inability to approach people. Halitosis originates from the respiratory system. Diseases of the respiratory system cause the expiration of gas that gives off bad odor from the oral cavity and nose [2]. The existence of any foreign bodies will cause inflammation and a bad smell. Quite frankly, oral malodor in healthy individuals can be caused by tonsillitis, drugs, gastrointestinaldiseases, and metabolic diseases.
There are several measurable techniques used to detect halitosis. For instance, organoleptic measurement, portable sulfide monitor, chemical sensors, salivary incubation test, ammonia monitoring and Polymerase Chain Reaction (PCR). An organoleptic measurement is a simple but widely used method. A plastic tube is placed in the mouth of the patient and the patient is told to slowly breathe into the tube [3]. The examiner will then evaluate the smell from the other side of the tube. A portable sulfide monitor is considered a portable device. The individual keeps their mouth closed for 5 minutes. Then, the individual inserts a single-use tube connected to the sulfide monitor into their mouth while breathing from the nose [3]. The level of compounds within an electrochemical reaction will then be detected and evaluated. The chemical sensor measurement consists of six sensitivity and selectivity. This method typically has a positive correlation with other measurement methods. In the method of a salivary incubation test, the saliva is collected in a glass tube. It incubates for 37 Celsius for several hours in an anaerobic medium. Although, this test is less effective when scented food is eaten, fragrant cosmetic use, and cigarette consumption are detected.
The use of an ammonia monitoring helps detect ammonia released by the oral bacteria. This device consists of a pump that draws the expiratory air into the ammonia gas detector and a disposable tube that is inserted into the individual’s mouth [3]. The individual then rinses their mouth with urea and blows into the tube which the ammonia concentration can be read from a scale [3]. Lastly, a polymerase chain reaction test is a rapid and specific diagnostic technique. A PCR test has been a popular detection system for many years. A quantitative analysis of the microorganisms causing VSCs producing bacteria from oral specimens such as saliva, tongue coating, and subgingival plaque can be performed [3]. Dentists often diagnose halitosis through the use of an individual’s history or the mouth odor during a dental exam [4]. If the dentist cannot find the cause, he or she will refer you to an appropriate specialist.
Halitosis which is known as “bad breath” is a major health problem that affects many individuals. Despite the negative impact it may have on an individual, it can certainly be managed. An Initial periodontal treatment may alleviate the depth of the periodontal pockets and severity of gingival inflammation and can eliminate halitosis causing bacteria [5]. Good oral hygiene is another method that can help manage bad breath. A proper brush, dental floss, and interdental brush usage are very important in oral hygiene. This can prevent oral bacteria build up in the mouth. However, if an individual has a tongue coating, it is a sign of halitosis. Cleaning of the tongue by properly brushing, and using a tongue scraper or tongue cleaner is essential. To prevent halitosis, it is key to keep your saliva flowing by eating healthy foods in order to create more moisture. It is also important to visit your dentist on a daily basis. Regular check-ups can help find problems such as gum disease, dry mouth and infections.
Ultimately, good oral hygiene is highly important because the health of your mouth, teeth, and gums can affect your general health. Without proper oral hygiene, bacteria can reach levels that can cause tooth decay and gum disease. Saliva’s purpose is to wash away food and neutralize the acids produced by the bacteria in your mouth. Therefore, a reduction in saliva flow can increase your risk for oral health problems. Good oral hygiene prevents the risk of health complications, tooth loss and an overall negative effect on your health. Remember, keep your teeth plaque-free and practice good oral hygiene!
References
1. Hampelska, K., Jaworska, M., Babalska, Z., and Karpinski, T., (2020, August). The Role of Oral Microbiota in Intra-Oral Halitosis. The National Institute of Medicine. PubMed Central. The Role of Oral Microbiota in Intra-Oral Halitosis (nih.gov)
2. Porter, S., Scully, C., (2006). Oral malodour (halitosis). The National Institute of Medicine. PubMed Central.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570844/pdf/bmj33300632.pdf
3. Bicak, D., (2018, February). A Current Approach to Halitosis and Oral Malodor-A Mini Review. The National Institute of Medicine. PubMed Central. TODENTJ-12-322.pdf (nih.gov)
4. John Hopkins Medicine (2021). Halitosis (Bad Breath). John Hopkins. Halitosis (Bad Breath) | Johns Hopkins Medicine
5. Colak, H., (2018). Halitosis: From diagnosis to management. The National Institute of Medicine. PubMed Central. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633265/
Contributors:
Author: Melissa Del Rio
Editor: Kayjah Taylor
Health Scientist: Chantelle Moore
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