Halitosis en otorrinolaringología: una revisión de la literatura / Halitosis in otolaryngology: a review of the literature

RESUMEN La halitosis es un motivo de consulta frecuente y que puede repercutir de gran manera en la calidad de vida de quien la presenta. Puede dividirse en halitosis genuina, pseudohalitosis y halitofobia. De las halitosis genuinas, cerca del 90% son secundarias a patología de la cavidad oral. En otorrinolaringología, las principales causas responden a tonsilolitiasis, patología rinosinusal y cuerpos extraños nasales. Existen distintos métodos diagnósticos que permiten medir e identificar la halitosis, con sus beneficios y desventajas. Las medidas generales de higiene oral, así como intervenciones específicas deben estar basadas en la evidencia a cargo de un equipo multidisciplinario que permita garantizar mejores resultados.

ABSTRACT Halitosis is a frequent health problem, that can have a huge impact in the quality of life of those affected. It can be classified as genuine halitosis, pseudohalitosis and halitophobia. Of genuine halitosis, approximately 90% is originated from the oral cavity. In otorhinolaryngology, most frequent causes are tonsiloliths, rhinosinusitis and nasal foreign bodies. There are different diagnostic methods, each one with its benefits and disadvantages. General measures of oral hygiene, as specific interventions must be evidence-based in charge of a multidisciplinary team that guarantees better results.

Prevalence and Reasons of halitosis / Монголын Анагаах Ухаан

Introduction@#Halitosis (Latin word: halitus – to breathe), osostomia, stomatodysodia (fetor oris, fetor ex ore) is called bad breath. Halitosis prevalence has been found in European countries is 50-60%, in Germany the percentage is 66.7%, in the U.S population the percentage is 10-30%, and in the Russia the percentage is 30-50%. In Turkey, halitosis has been 14.5% among children and it has direct association with their age, oral hygiene, and caries severity. Among world population, 80-90% people have halitosis, and in terms of its prevalence it ranks after periodontal disease and dental caries diseases. Thus, to determine halitosis among Mongolians might help improve oral hygiene, prevent oral and other diseases.@*Goal@#To study assessed factors influenced halitosis and prevalence in Mongolia.@*Materials and Methods@#1492 patients who attended in dental clinic participated in this study. 16 questionary items were asked from a total of 1492 patients aged 19-55 years old who had anxious of halitosis. In clinical room, under the artificial light, using single-use examination tools, coloring-agent, periodontal probe, tongue-scraper and halimeter were used. </br> The studying “Reasons and prevalence for halitosis” was estimated processing result with spss-17 program, and conducted a descriptive analysis of the quantitative data that was used the basic biostatics method and indicated STUDENT- T criterion in the average data for the arithmetic in each indicator, standard variance, standard error and real limits. Each indicator (M) Standard variance Standard error (m) Real limits (c1-95%). </br> The ethics was discussed and approved in according to warrant by the Ethics Committee of Medical University in Novosibirsk, №085, 2015.@*Results@#Total 816 people conducted in our study; from them 60% has bad breath complaint. Those who said have bad breath, 24% don’t notice they have bad breath, 34% have noticed their bad breath and use mouth rinse in order to get rid of their problem and have never sought medical treatment about it. 10% people with halitosis have general factors causing this problem. These people had relatively healthy mouth and 2.1% of them have halitophobia or fear of having bad breath and constantly get checked with physician. </br> In our research, 20 to 50 and above year olds 816 people have included and out of them 40% were male and 60% were female (Table 2). From them, 61% had bad breath and 39% had not (Figure 1). In males 68% had bad breath, in females 56% had bad breath and these occur to be caused by local factors.</br> In finding causes of bad odors in people with halitosis, 90% had local problems and within local problems; smoking, poor oral hygiene, caries complication, and gum inflammation predominantly discovered. 10% had general and other problems of causes of bad breath (Figure 2). In people with halitosis, 10% had found with general factors influencing their bad breath problem. These people had relatively healthy mouth, and 2.1% of them have halitophobia or fear of having bad breath and constantly get checked with physician.</br> Local factors influencing halitosis include; smoking (37%), bleeding gum (28%), tongue biofilm (3.0+3.1), poor oral hygiene (1.5+1.4), periodontal pocket (4.2+3.87), denture (54.8%(. Using organoleptic method of measuring mouth odor, the mean point was 2.25±2.3. Using halitometer, average light sulfuric gas concentrate was 145±134.2 ppb. 20-29 year olds had 140±127.5, 30-39 year olds had 155±136.8, 40-49 year olds had 140±139.5, 50 and above aged people had 139±134.1 ppb, thus there were no association between age and mouth odor (Table 3).@*Conclusion@#</br>1. The Halitus is occurred 61%, And 68% - men, 56% - women, that is more common in Mongolian population. </br>2. The general condition of halitus that is taken 90% - oral environment, which of that is 37% - smoking, 28% - bleeding of gingival, 3.0-3.1% - coating of tongue, 1.5+1.4% poor oral cares, 4.2+3.87% - dental pathology, and 54.8% - artificial teeth. </br>3. The oral offensive odor was evaluated by organoleptic method that was 2.25+2.3 in average index (performance) and 145+134.2ppb in halitometres index.

La Halitosis: Definición, clasificación y factores etiológicos / The halitosis. Definition, classification and etiologic factors

Halitosis es el término empleado para describir el aliento desagradable producto de factores fisiológicos o patológicos, de origen bucal o sistémico. Se ha clasificado en tres categorías: halitosis verdadera, pseudohalitosis y halitofobia. La halitosis verdadera se subclasifica en halitosis fisiológica y halitosis patológica, esta última, a su vez, se clasifica, según su origen, en bucal y extrabucal. Los factores etiológicos se describen a través de la relación entre el patógeno, el huésped y el sustrato. La causa principal de esta condición es la putrefacción de sustratos proteicos, principalmente, por parte de los microorganismos gramnegativos. Esto genera compuestos sulfúricos volátiles, que constituyen los componentes más fétidos del mal aliento. Actualmente, se cree que los compuestos sulfúricos volátiles son responsables de la halitosis. Existe evidencia que demuestra que los compuestos sulfúricos volátiles resultan altamente tóxicos para los tejidos, aún en bajas concentraciones. La alteración de los tejidos del huésped favorece el establecimiento de un círculo vicioso que perpetúa el problema.

Halitosis is the term used to describe the unpleasant product of physiologic or pathological factors, of buccal or systemic origin. It has been classified in three categories: true halitosis, pseudohalitosis and halitofobia. The true halitosis is classified in physiologic halitosis and pathological halitosis, this last one, in turn, is classified, according to their origin, in buccal and extrabucal. The etiologic factors are described through the relationship among the pathogen one, the guest and the basis. The main cause of this condition is the rot of bases proteicos, mainly, on the part of the microorganism gramnegativos. This generates compound sulfuric volatile that constitutes the most fetid components in the halitosis. At the moment, it is believed that the volatile sulfuric compounds are responsible for the halitosis. There is evidence that demonstrates that the volatile sulfuric compounds are highly toxic for the tissues, still in low concentrations. The alteration of the guest tissues favors the establishment of a vicious circle that perpetuates the problem.