Halitosis (Bad Breath)
Halitosis is a widespread condition and believed to affect one-quarter of the population around the world; also, most people have this condition from time to time. Breath malodor may be an important factor in social communication, and therefore may be the origin of concern not only for a possible health condition but also for frequent psychological alterations leading to social and personal isolation.
The most conspicuous malodorous compounds are termed volatile Sulphur compounds (VSCs), with hydrogen sulphide, methyl mercaptan, and dimethyl sulphide accounting for roughly 90% of the VSCs. A number of oral bacteria, especially Gram-negative anaerobic (bacteria that live without oxygen) species found in the subgingival plaque, produce a diverse array of malodorous compounds as byproducts of their metabolism, including VSCs and short-chain organic acids.
Halitosis can arise from a variety of sources, including sinuses, gastrointestinal tract, ingested food, lungs, and, most frequently, the oral cavity. Oral production of malodorous substances is most commonly associated with byproducts of bacterial metabolic degradation and occurs on oral surfaces, in periodontal pockets, and especially on the dorsal tongue surface. These products result from microbial fermentation of proteins, peptides, and mucins found in saliva, blood, gingival crevicular fluid, lysed neutrophils, desquamated epithelial cells, and any residual food retained on the oral surfaces. Assessment and management of halitosis is of paramount importance in enhancing the overall health; moreover, dentists and oral hygiene play a significant role in combating halitosis by reducing the oral microbial stack.