Prevalencia de halitosis en niños y su asociación con la higiene bucal, caries dental, saburra lingual, tipo de respiración, edad y sexo / Prevalence of halitosis in children and its association with oral hygiene, dental caries, tongue coating, type of breathing, age, and sex

Resumen La halitosis es considerada como una condición anómala frecuente en la salud bucal y se define como un olor desagradable que emite la cavidad oral, nariz, vías respiratorias o aparato digestivo. Objetivo: Determinar la prevalencia de halitosis y su relación con los factores asociados como: higiene oral, caries, placa lingual, tipo de respiración, edad y sexo en niños de 5 a 12 años que asisten a la Escuela Giordano Bruno, de la Provincia de Pichincha - Ecuador. Materiales y métodos: Estudio observacional, descriptivo, transversal realizado en una población de 178 estudiantes de 5 a 12 años, la muestra fue de 122 niños seleccionados mediante un muestreo probabilístico. Se solicitó el consentimiento informado para participar en el estudio. La prevalencia de halitosis se evaluó con un monitor que detecta compuestos volátiles de sulfuro. Los factores asociados se midieron por medio del IHOS, el índice de lengua saburral de Winkel, la prueba con el espejo bucal y el índice ceo-d y CPO-D. Los datos se analizaron con la prueba de Chi cuadrado con un valor de significación de 0,05 y un Análisis de Regresión Logística Binaria. Resultados: La prevalencia de halitosis fue del 50% en los niños y se relacionó con saburralingual, higiene bucal, edad y sexo (p<0,05), pero no hubo asociación entre la halitosis, el tipo de respiración y la presencia de caries dental. Los niños que presentan saburra lingual tienen 177 veces mayor riesgo de presentar halitosis mientras que los que muestran una higiene bucal regular tienen 205 veces más riesgo de presentar halitosis. Conclusión: La prevalencia de halitosis en niños es alta y los principales factores de riesgo son la saburra lingual y la higiene bucal regular.

Abstract Halitosis is considered a frequent anomaly in oral health that is defined as an unpleasant odor that emits from the oral cavity, nose, respiratory tract or digestive system. Objective: To determine the prevalence of halitosis and its relationship with associated factors such as: oral hygiene, tooth decay, tongue plaque, type of breathing, age and sex in children aged 5 to 12 years who attend the Giordano Bruno School of the Province of Pichincha - Ecuador. Materials and methods: Observational, descriptive, cross-sectional study carried out in a population of 178 students aged 5 to 12 years, the sample consisted of 122 children selected through probability sampling. Informed consent was requested to participate in the study. The prevalence of halitosis was evaluated with a monitor that detects volatile sulfur compounds and the associated factors were measured by means of the IHOS, the Winkel coated tongue index, the oral mirror test and the ceo-d and CPO-D index. The data were analyzed with the Chi square test with a significance value of 0.05 and a Binary Logistic Regression Analysis. Results: The prevalence of halitosis was 50% in children and it was related to tongue coating, oral hygiene, age, and sex (p <0.05), there was no association between halitosis, type of respiration and the presence of dental caries. Children with tongue coating have a 177 times greater risk of halitosis, while children with regular oral hygiene have a 205 times greater risk of halitosis. Conclusion: The prevalence of halitosis in children is high and the main risk factors are tongue coating and regular oral hygiene.

Halitose: etiologia, diagnóstico e tratamento / Halitosis: etiología, diagnóstico y tratamiento / Halitosis: etiology, diagnosis and treatment

RESUMO Introdução: A halitose é um sinal da presença de mau cheiro ofensivo ao olfato humano, geralmente é provocada pela falta de higiene ou estilo de vida e afeta milhares de pessoas em todo o mundo. Objetivo: Realizar uma revisão de literatura a respeito da etiologia, diagnóstico e tratamento da halitose buscando proporcionar um maior embasamento cientifico com informações atualizadas para os profissionais da área. Métodos: O estudo caracterizou-se por uma busca de artigos na base de dados eletrônicos PubMed, Lilacs, Google Acadêmico e Scielo publicados entre 2014 e 2019, em inglês, português e espanhol. Foram consultados 52 trabalhos, destes, 28 foram selecionados após uma criteriosa filtragem. Análise e integração das informações: Diversas etiologias advindas da cavidade bucal podem provocar a halitose. Existem vários exames complementares para auxílio diagnóstico da halitose, tais como testes sialométricos, organoléptico e a análise de presença de saburra para o diagnóstico. Há diversos protocolos instituídos para o tratamento da halitose, desde procedimentos preventivos a curativos. Conclusão: No que concerne a etiologia, a halitose pode ocorrer por fatores fisiológicos ou patológicos; 90 porcento dos casos tem como origem a cavidade oral, podendo estar associada ao biofilme dentário, cárie, língua saburrosa, próteses mal adaptadas e cicatrização tecidual. O diagnóstico deve ser realizado por meio de um exame clínico criterioso. A utilização de questionários para colher informações como frequência, duração, quantidade de vezes que aparece no mesmo dia, hábitos e medicamentos utilizados ajudarão na elucidação do caso. O sucesso do tratamento depende do diagnóstico e da implementação de uma terapia relacionada com a causa-efeito e de uma abordagem multidisciplinar racional que se torna essencial para a obtenção de bons resultados, com objetivo de melhorar a saúde oral, bem como, seus efeitos individuais e sociais(AU)

RESUMEN Introducción: Halitosis o mal olor es ofensivo al olfato humano, generalmente es provocada por la falta de higiene o estilo de vida y afecta a miles de personas en todo el mundo. Objetivo: Llevar a cabo una revisión de la literatura sobre la etiología, el diagnóstico y el tratamiento de la halitosis buscando proporcionar una mayor base científica con información actualizada para los profesionales en el campo. Métodos: El estudio se caracterizó por una búsqueda de artículos en la base de datos electrónica PubMed, Lilacs, Google Scholar y SciELO publicados entre 2014 y 2019, en inglés, portugués y español. Se consultaron 52 documentos, de los cuales 28 fueron seleccionados después de un filtrado cuidadoso. Análisis e integración de las informaciones: Diversas etiologías provenientes de la cavidad bucal pueden provocar la halitosis. Existen varios exámenes complementarios para ayudar a diagnosticar la halitosis, tales como pruebas sialométricas, organolépticas y el análisis de presencia de saburra para el diagnóstico. Hay varios protocolos instituidos para el tratamiento de la halitosis, desde procedimientos preventivos a curativos. Conclusiones: En cuanto a la etiología de la halitosis puede ocurrir debido a factores fisiológicos o patológicos. Aunque el 90 por ciento de los casos se originan en la cavidad bucal y pueden estar asociados con biopelículas dentales, caries, toques de lengua, prótesis mal adaptadas y cicatrización de tejidos. El diagnóstico debe hacerse mediante un examen clínico cuidadoso. El uso de cuestionarios para recopilar información como la frecuencia, la duración, la cantidad de veces que aparece el mismo día, los hábitos y los medicamentos utilizados ayudarán a dilucidar el caso. El tratamiento exitoso depende del diagnóstico y la implementación de la terapia de causa y efecto y de un enfoque multidisciplinario racional que es esencial para obtener resultados exitosos para mejorar la salud bucal y sus efectos individuales y social(AU)

ABSTRACT Introduction: Oral halitosis or malodor is offensive to the human sense of smell. It is often the result of poor hygiene or lifestyle and affects thousands of people worldwide. Objective: Conduct a literature review about the etiology, diagnosis and treatment of halitosis with the purpose of contributing a broader scientific basis of updated information for professionals in the field. Methods: The study was characterized by a search for papers published in the electronic databases PubMed, Lilacs, Google Scholar and Scielo between 2014 and 2019 in English, Portuguese or Spanish. A total 52 papers were consulted, of which 28 were selected after careful filtering. Data analysis and integration: Halitosis may be due to a variety of oral cavity etiologies. Several complementary tests are available which help diagnose halitosis, e.g. sialometric tests, organoleptic tests and analysis of the presence of saburra for the diagnosis. Several protocols have been implemented for the treatment of halitosis. These range from preventive to healing procedures. Conclusions: The etiology of halitosis may be due to physiological or pathological factors. Although 90 percent of the cases originate in the oral cavity and may be associated with dental biofilm, caries, tongue saburra, ill-fitted prostheses or tissue scarring, diagnosis should be based on careful clinical examination. Using questionnaires to gather information such as frequency, duration, number of times it appears on the same day, habits and medications will help elucidate the case. Successful treatment depends on the diagnosis and implementation of a cause-and-effect therapy and a rational multidisciplinary approach which is essential to obtain positive outcomes and improve oral health as well as its individual and social effects(AU)

Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents

OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.

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.

Estudo longitudinal da halitose por meio da cromatografia gasosa / Longitudinal study of halitosis through gas chromatography

Objetivos: correlacionar os exames organolépticos (método subjetivo) e a cromatografia gasosa (método objetivo) para diagnóstico conclusivo da halitose e avaliar o comportamento dos compostos sulfurados voláteis (CSVs) durante o manuseio clínico desta patologia. Metodologia: estudo longitudinal com 19 pacientes submetidos ao diagnóstico de halitose, com exames organolépticos (EOt1) e cromatografia gasosa (ECGt1) realizados durante a consulta inicial, com todos os pacientes oriundos do município de Ijuí, Rio Grande do Sul. Todos os 38 exames complementares foram confrontados entre si, por meio do teste estatístico Qui-Quadrado de independência. Para acompanhamento clínico da efetividade do tratamento da halitose e, consequentemente, análise do comportamento dos CSVs, outros quatro exames de cromatografia gasosa (ECGt2, ECGt3, ECGt4 e ECGt5) foram realizados para cada paciente, e todos (95) comparados entre si, pelo teste de Wilcoxon. Resultados: a correlação entre EOt1 e ECGt1 obteve concordância em 78,9% dos casos, indicando forte associação (p = 0,002) entre ambos. Ao avaliar a monitorização dos compostos sulfurados H2S, CH3SH e (CH3)2S, todos envolvidos em alguma fase da gênese da halitose, houve significativa redução de todos os compostos. Conclusões: os exames de cromatografia gasosa (objetivo) e organoléptico (subjetivo) são equivalentes para diagnóstico inicial da halitose, pois apresentaram correlação estatística significante. Em relação à monitorização do tratamento da halitose, a cromatografia gasosa se mostrou eficiente, apresentando altos índices de redução de todos os CSVs. (AU)

Objectives: To correlate organoleptic evaluations (subjective method) and gas chromatography (objective method) for the conclusive diagnosis of halitosis and to examine the behavior of volatile sulfur compounds (VSC) during the clinical management of this pathology. Methodology: Longitudinal study with 19 patients diagnosed with halitosis through organoleptic evaluations (EOt1) and gas chromatography (ECGt1), both applied during the initial appointment. All patients were from the city of Ijuí, located in the state of Rio Grande do Sul, Brazil. All 38 complementary analyses were compared using the chi-square test of independence. Regarding the clinical follow-up on the effectiveness of halitosis treatment, and consequently the analysis of VSC behavior, four other gas chromatography tests (ECGt2, ECGt3, ECGt4, and ECGt5) were conducted with each patient, and all (95) were compared using the Wilcoxon test. Results: The correlation between EOt1 and ECGt1 showed concordance in 78.9% of cases, indicating a strong association (p=0.002). The evaluation of the monitoring of sulfate compounds H2S, CH3SH, and (CH3) 2S, which are all involved in some phase of the halitosis genesis, showed a significant reduction of all compounds. Conclusions: The gas and chromatography and organoleptic tests are equivalent for the initial diagnosis of halitosis because they presented significant statistical correlation. Regarding the monitoring of halitosis treatment, gas chromatography was efficient, presenting high reduction rates of all VSC. (AU)

Quiste óseo traumático mandibular: reporte de caso y revisión de la literatura / Mandibular traumatic bone cyst: case report and literature review

El Quiste Óseo Traumático de la mandíbula es una cavidad intraósea sin revestimiento epitelial, considerado Pseudoquiste. Ha recibido diversas denominaciones debido a su etiología y patogenia inciertas, como Quiste Óseo Traumático, Quiste Óseo Solitario, Quiste Óseo Idiopático, entre otros. Es una lesión asintomática, que a menudo se diagnostica accidentalmente durante el examen radiológico de rutina, como una radiolucencia unilocular con bordes festoneados cuando está localizado entre las raíces dentarias. Presentamos un caso raro de Quiste Óseo Traumático en la sínfisis mandíbular, identificado radiográficamente, en una paciente de 14 años sin historia clara de trauma, diagnosticado y tratado con éxito.

The Traumatic Bone Cyst of the mandible is an intraosseous cavity without an epithelial lining, considered a pseudocyst. It has received various names due to its uncertain etiology and pathogenesis, such as Traumatic Bone Cyst, Solitary Bone Cyst, Idiopathic Bone Cyst, among others. It is an asymptomatic lesion, which is often diagnosed accidentally during routine radiological examination, as a unilocular radiolucency with scalloped edges when located between the dental roots. We present a rare case of Traumatic Bone Cysts in the mandibular symphysis, identified radiologically, in a 14-year-old patient without clear history of trauma, diagnosed and successfully treated .

Assessment of the accuracy of portable monitors for halitosis evaluation in subjects without malodor complaint. Are they reliable for clinical practice?

Abstract Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. Objective: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. Material and Methods: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. Results: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. Conclusions: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Percepção e nível de conhecimento sobre halitose entre estudantes e pacientes / Perception and level of knowledge about halitosis among students and patients

O presente estudo analisou a percepção e o nível de conhecimento de estudantes e pacientes sobre halitose. Dois grupos de voluntários de ambos os gêneros, entre 18 e 60 anos, totalizando 225 participantes, responderam a um questionário que continha oito questões relativas à percepção, às causas e ao tratamento da halitose. O grupo de pacientes (P) consistiu-se de 150 indivíduos que procuraram os serviços odontológicos da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará, Brasil, e o grupo de estudantes (S), de 75 alunos de Odontologia da mesma Universidade. No grupo P, 45,3% dos participantes acreditava ter halitose, já no grupo S, esse percentual foi de apenas 16,2%. Em relação às causas e aos tratamentos da halitose, encontrou-se que o grupo P assinalou mais opções relacionadas com o correto conhecimento sobre halitose quando comparados com o grupo S. É possível concluir que os pacientes relataram maior percepção da halitose do que os estudantes, bem como têm demonstrado maior conhecimento sobre a origem e tratamento da halitose.

This study aimed to assess individual perception and level of knowledge of students and patients about halitosis. Two groups of volunteers of both genders between 18 and 60 years old, totaling 225 subjects, answered a questionnaire containing eight questions relating to perception, causes, and treatment of halitosis. The group of patients (P) consisted of 150 individuals seeking dental services at the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Brazil, and the Group of students (S) consisted of 75 students of Dentistry at the same University. In Group P, 45.3% of participants believed they had halitosis, while in Group S, this percentage was only 16.2%. In matters relating to the causes and treatment of halitosis, it was found that the Group P marked more options related to the correct knowledge about halitosis when compared to Group S. It is possible to conclude that patients reported greater halitosis perception than students, and also that they showed a better knowledge about the halitosis etiology and treatment.

Halitosis: fisiología y enfrentamiento / Halitosis: physiology and approach

La halitosis corresponde a una enfermedad muy prevalente en nuestro medio. Presentando gran importancia en nuestra sociedad actual, debido a los altos estándares de higiene e importancia de la imagen propia, puede traer consecuencias psicológicas importantes a quienes la padecen. Más del 85% de la halitosis se debe a la acción de bacterias anaerobias, quienes a través de la degradación de proteínas producen compuestos llamados CSV, que producen el mal olor. El 98% de las causas de halitosis se debe a enfermedades donde es necesaria la evaluación de profesionales de la salud bucal y otorrinolaringólogos, quienes deben trabajar en conjunto para una recuperación óptima del problema. Las mediciones organolépticas siguen siendo el gold standard. Aquí se presenta un novedoso método de screening medidor, el medidor B/B, el que ha mostrado buenos resultados. Se muestra en esta revisión un algoritmo diagnóstico propuesto en la Revista de Otorrinolaringología de Brasil, quienes recomiendan este protocolo diagnóstico para minimizar costos y optimizar recursos. Permitiendo un tratamiento adecuado y buen pronóstico.

Halitosis is a very prevalent disease in our environment, with great importance in our society, due to the high standards of hygiene and the importance of self-image, it can bring important suffer and psychological consequences. Over 85 % of halitosis is produced by the action of anaerobic bacteria, who through protein degradation produce the liberation of compounds called CSV that produce odor. A 98% of the causes of halitosis are due to diseases where the assessment of oral health professionals and otolaryngologists is important, and who must work together for optimal recovery of the problem. The organoleptic measurements remain the "gold standard." In this review a novel method of screening meter is presented, the meter B/ B, which has shown good results. This papers shown a proposed a ENT diagnostic algorithm, who recommend a diagnostic protocol to minimize costs and optimize resources, allowing proper treatment and good prognosis.

Halitosis en otorrinolaringología / Halitosis in otolaryngology

La halitosis es una afección muy prevalence en la población mundial que genera un gran impacto en la calidad de vida de los pacientes y es un motivo frecuente de consulta en la práctica clínica diaria en otorrinolaringología, presentándonos un gran desafío para el manejo de esta condición. En general se considera que es exclusiva de la odontología, por lo que resulta interesante revisar en este artículo los factores etiológicos involucrados y los avances en diagnóstico y tratamiento.

Halitosis is a very prevalent disease in the world population that generates a great impact on the quality of life of patients and is a frequent complaint in daily clinical practice in otolaryngology, presenting us with a great challenge for the management of this condition. It is generally considered to be exclusive of dentistry, so it is interesting to review in this article the etiological factors involved and advances in diagnosis and treatment.

Sistemas de evaluación y registro de la halitosis / Systems of evaluation and registry of the halitosis

La halitosis, también conocida como mal olor de la boca, es una condición común que afecta millones de personas. Este término describe una gama de olores desagradables emitidos en el aliento, con una variedad de causas que usualmente resultan de la putrefacción bacteriana dentro de la cavidad bucal. Miyazaki y cols.1 publicaron una clasificación de los diferentes tipos de halitosis en tres categorías: pseudohalitosis, halitofobia y halitosis genuina. Frecuentemente las personas que sufren de mal aliento lo desconocen, mientras que otros están convencidos que sufren de mal olor de la boca aunque no exista tal evidencia, es decir, muchas personas emiten mal aliento por años sin percatarse y otras sobreestiman su propio mal olor, teniendo actitudes obsesivas y evitando las interacciones sociales. Existen varios métodos para evaluar la halitosis y muchos investigadores usan métodos combinados para identificar sujetos con halitosis. Este artículo está basado en la revisión bibliográfica de las técnicas y estrategias utilizadas en el análisis clínico del mal olor de la boca, en razón que los pacientes con halitosis, frecuentemente no tienen una base objetiva y esperan un diagnóstico por parte del odontólogo.

Bad breath, also known as halitosis, is a common condition concern for millions of people. It is a broad term describing a range of unpleasant or offensive odors emitted in the breath, which can have a variety of causes, usually by result of microbial putrefaction within the oral cavity. Miyazaki et al.1 were published a classification system for different types of halitosis in three categories: pseudohalitosis, halitophobia and genuine halitosis. Often, people suffering from bad breath remain unaware of it, whereas others remain convinced that they suffer from foul oral malodor, although there is no evidence for such. Many people emit bad breath for years without being at all aware of it and others greatly overestimate their own oral malodor and are consequently prone to obsessive behavior, avoid social interactions. Several methods are available in the market for the measurement of halitosis. Most clinicians and researchers have used a combination methods assessment to identify subjects with halitosis. In this article, we focus on the clinical techniques and strategies used for the clinical analysis of oral malodor, because, the patient's complaint of bad breath does not appear to have an objective basis and expect effective diagnosis from dental practitioner.

Efeito do tratamento periodontal full-mouth e convencional na redução da halitose / Effect of periodontal treatment full-mouth and conventional in the reduction of halitosis

A halitose se caracterizada pela emanação de um odor desagradável onde cerca de 90% de se origina dentro da cavidade oral. Estudos têm demonstrado uma relação direta entre a doença periodontal e o odor ofensivo do hálito. O presente estudo teve como objetivo avaliar a frequência e distribuição de halitose em um grupo de pacientes com doença periodontal em um estudo transversal observacional (n=112) e, em um estudo intervencionista, avaliar o efeito do tratamento periodontal full-mouth e convencional na redução da halitose em um grupo de pacientes com doença periodontal. Os pacientes responderam a uma anamnese, tiveram seu hálito mensurado pelo halímetro e teste organoléptico, além de realizados Índice de placa visível, Índice de sangramento gengival, Índice de saburra lingual e exame periodontal completo. No estudo 2, os pacientes foram submetidos a seis distintas formas de tratamento: terapia periodontal em sessão única, terapia convencional em quadrantes e, um grupo controle, com somente instrução de higiene oral. Todas as modalidades subdivididas: com e sem raspagem lingual diária. No primeiro estudo os resultados mostraram que, tanto para teste organoléptico quanto para o halímetro, houve maior grau de halitose nos grupos de idades mais avançadas, nos que relataram sangramento gengival e escovação menos que três vezes ao dia. Ainda no teste organoléptico a escovação de língua gerou diferença estatística. Não houve diferença estatística entre as medidas de halitose entre teste organoléptico e halímetro. Foram encontrados aproximadamente 75% de pacientes periodontais com halitose. No segundo estudo os resultados mostraram superioridade conforme análise do halímetro para 30, 60 e 90 dias para os grupos de raspagem em sessão única contra raspagem por quadrantes. Sendo todos os grupos superiores ao controle. Não houve diferença na abordagem com ou sem a raspagem de língua. De acordo com o teste ...

Halitosis is characterized by the emission of an unpleasant odor about 90% originates in the oral cavity. Studies have shown a direct relationship between periodontal disease and the offensive odor of breath. The present study aimed to determine the prevalence of halitosis in patients with periodontal disease in an observational cross-sectional study (n = 112) and, in an intervention study, the patients have had six distinct forms of treatment (n = 90) to verify the efficacy of full- vs. partial-mouth disinfection in the control of halitosis. Patients answered an interview, they have had their breath collected by halimeter, they have evaluated by organoleptic test, and visible plaque index, gingival bleeding index, index of tongue coating and periodontal examination. In the second step, patients have been submitted to six different forms of treatment: periodontal therapy in one session, conventional therapy in quadrants, and the control group, with only oral hygiene instruction. All types split: with and without tongue scraping daily. The first study results shown for both organoleptic test as halimeter, a greater degree of halitosis in the older age groups, we have reported that gum bleeding and brushing less than three times per day. Still in organoleptic test brushing of tongue generated statistical difference. There was no statistical difference between the measures between halitosis and organoleptic test halimeter. There was about 75% og periodontal patients with halitosis. In the second study the results shown the superiority analysis as halimeter for 30, 60 and 90 days for groups of scraping in single session against scraping by quadrants. Being all groups superior from control. There was no difference in approach with or without tongue scraping. According to the organoleptic test, there was no difference between the four types of periodontal treatment compared to the control groups. The same ...

Efeito do tratamento periodontal full-mouth e convencional na redução da halitose / Effect of periodontal treatment full-mouth and conventional in the reduction of halitosis

A halitose se caracterizada pela emanação de um odor desagradável onde cerca de 90% de se origina dentro da cavidade oral. Estudos têm demonstrado uma relação direta entre a doença periodontal e o odor ofensivo do hálito. O presente estudo teve como objetivo avaliar a frequência e distribuição de halitose em um grupo de pacientes com doença periodontal em um estudo transversal observacional (n=112) e, em um estudo intervencionista, avaliar o efeito do tratamento periodontal full-mouth e convencional na redução da halitose em um grupo de pacientes com doença periodontal. Os pacientes responderam a uma anamnese, tiveram seu hálito mensurado pelo halímetro e teste organoléptico, além de realizados Índice de placa visível, Índice de sangramento gengival, Índice de saburra lingual e exame periodontal completo. No estudo 2, os pacientes foram submetidos a seis distintas formas de tratamento: terapia periodontal em sessão única, terapia convencional em quadrantes e, um grupo controle, com somente instrução de higiene oral. Todas as modalidades subdivididas: com e sem raspagem lingual diária. No primeiro estudo os resultados mostraram que, tanto para teste organoléptico quanto para o halímetro, houve maior grau de halitose nos grupos de idades mais avançadas, nos que relataram sangramento gengival e escovação menos que três vezes ao dia. Ainda no teste organoléptico a escovação de língua gerou diferença estatística. Não houve diferença estatística entre as medidas de halitose entre teste organoléptico e halímetro. Foram encontrados aproximadamente 75% de pacientes periodontais com halitose. No segundo estudo os resultados mostraram superioridade conforme análise do halímetro para 30, 60 e 90 dias para os grupos de raspagem em sessão única contra raspagem por quadrantes. Sendo todos os grupos superiores ao controle. Não houve diferença na abordagem com ou sem a raspagem de língua. De acordo com o teste...

Halitosis is characterized by the emission of an unpleasant odor about 90% originates in the oral cavity. Studies have shown a direct relationship between periodontal disease and the offensive odor of breath. The present study aimed to determine the prevalence of halitosis in patients with periodontal disease in an observational cross-sectional study (n = 112) and, in an intervention study, the patients have had six distinct forms of treatment (n = 90) to verify the efficacy of full- vs. partial-mouth disinfection in the control of halitosis. Patients answered an interview, they have had their breath collected by halimeter, they have evaluated by organoleptic test, and visible plaque index, gingival bleeding index, index of tongue coating and periodontal examination. In the second step, patients have been submitted to six different forms of treatment: periodontal therapy in one session, conventional therapy in quadrants, and the control group, with only oral hygiene instruction. All types split: with and without tongue scraping daily. The first study results shown for both organoleptic test as halimeter, a greater degree of halitosis in the older age groups, we have reported that gum bleeding and brushing less than three times per day. Still in organoleptic test brushing of tongue generated statistical difference. There was no statistical difference between the measures between halitosis and organoleptic test halimeter. There was about 75% og periodontal patients with halitosis. In the second study the results shown the superiority analysis as halimeter for 30, 60 and 90 days for groups of scraping in single session against scraping by quadrants. Being all groups superior from control. There was no difference in approach with or without tongue scraping. According to the organoleptic test, there was no difference between the four types of periodontal treatment compared to the control groups. The same...

Condiciones bucales y sistémicas asociadas a la halitosis genuina / Oral and systemic conditions associated with genuine halitosis

La Halitosis es definida como un olor desagradable u ofensivo que emite la cavidad bucal, usualmente tiene una causa bucal, particularmente derivada del metabolismo bacteriano sobre los sustratos y aminoácidos que contienen azufre. Durante mucho tiempo, fue concebida como una consecuencia de la enfermedad periodontal, hoy en día se sabe que, ocasionalmente el consumo de ciertos medicamentos, disfunciones metabólicas, respiratorias, hormonales y otras alteraciones sistémicas pudieran ser el factor etiológico del mal olor de la boca, por lo que el propósito de esta investigación es analizar las condiciones bucales y sistémicas asociadas a la halitosis genuina en los pacientes que acuden a los postgrado de Periodoncia, Prótesis y Endodoncia de la Facultad de Odontología de la Universidad Central de Venezuela (FdeOUCV) partir del sistema de registro organoléptico. 38 pacientes diagnosticados con halitosis, durante el período Marzo-Octubre 2010, fueron evaluados a partir de un consentimiento informado admitiendo su participación en el estudio, por medio de un cuestionario con una escala de medición de actitudes y respuestas, una historia de halitosis, un examen clínico para establecer la presencia o no de enfermedad periodontal, la valoración organoléptica en diversos lugares de la cavidad bucal (Rosenberg y Mc Culloch, 1992) y el índice de cubierta lingual (Winkel, 2003). El criterio de exclusión estaba determinado por la ingesta de antibióticos durante tres semanas previas al examen, no obstante ningún paciente fue excluido por esta situación. Se realizó el análisis cualitativo y cuantitativo respectivo. Se encontró una diferencia estadísticamente significativa p<0,1 en el grupo con salud periodontal con respecto al grupo con enfermedad periodontal, en los aspectos relacionados con la sensación de hambre, sequedad y mal gusto en la boca y en relación con actitudes específicas asociadas a eructos, alejarse de otras personas...

The halitosis usually has a oral cause, particularly derived from the bacterial metabolism on the substrates and amino acids that contain sulfur. During long time, it was conceived like a consequence of the periodontal disease, nowadays knows that, occasionally the metabolic, respiratory, hormonal medicine consumption certain, dysfunctions and other systemic alterations could badly be the etiological factor of the scent of the mouth, reason why the intention of this investigation is to analyze the oral and systemic conditions associated to the genuine halitosis in the patients who go to the Periodoncia, Prosthesis and Endodontic of the Faculty of Dentistry of the Central University of Venezuela (FDOUCV) from the system of organoleptic registry. 38 patients diagnosed with halitosis, during the period March-October 2010, were evaluated from an informed consent admitting their participation in the study, by means of a questionnaire with a scale of measurement of attitudes and answers, a history of halitosis, a clinical examination to establish the presence or not of periodontal disease, the organoleptic valuation in diverse places of the oral cavity (Rosenberg and Mc Culloch, 1992) and the index of lingual cover (Winkel, 2003). The exclusion criterion was determined by the antibiotic ingestion during three weeks previous to the examination, despite no patient was excluded by this situation. The qualitative and quantitative analysis was made. Was a statistically significant difference p< 0.1 in the group with respect to the group with periodontal disease, in the aspects related to the sensation of hunger, dryness and badly taste in the mouth and in relation to specific attitudes associated to belches, to move away of other people, oral breathing and ingestion of liquids and candies, as well as in the index of lingual cover degree eight (8)....

Halitosis: an overview of epidemiology, etiology and clinical management

Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5 percent of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC) produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

Clinical knowledge of dentists and physicians on the diagnosis and treatment of the patient complaining of halitosis / Conhecimento clínico de dentistas e médicos sobre diagnóstico e tratamento do paciente com queixa de halitose

PURPOSE: To evaluate the knowledge of dentists and physicians about the diagnosis and treatment of the patient complaining of halitosis. METHODS: Data were collected from a sample of healthcare professionals (81 dentists and 19 physicians) from the city of João Pessoa, Brazil. A structured questionnaire was used to record the professional knowledge about halitosis: frequency, diagnosis, treatment and predisposing factors. RESULTS: Physicians and dentists reported overall different responses based on their clinical knowledge and practice: patient's complaint of halitosis (63 percent and 38 percent for physicians and dentists, respectively); halitosis as the main complaint (42 percent and 23 percent); perception of halitosis among patients (10 percent and 67 percent), professional information to the patient about the halitosis (58 percent and 89 percent). Periodontal disease, poor oral hygiene and caries were regarded as the most common causes of halitosis for dentists, but physicians believed that oral cavity changes, sinusitis and reflux disease were the main etiological factors. CONCLUSION: The results suggest that there is not a high agreement between dentists and physicians regarding halitosis diagnosis and treatment.

OBJETIVO: Avaliar o conhecimento de dentistas e médicos sobre o diagnóstico e tratamento do paciente com queixa de halitose. METODOLOGIA: Os dados foram coletados em uma amostra de profissionais de saúde (81 dentistas e 19 médicos) na cidade de João Pessoa, Brasil. Um questionário estruturado foi utilizado para registrar o conhecimento profissional clínico sobre halitose: frequência, diagnóstico, tratamento e fatores predisponentes. RESULTADOS: Médicos e dentistas relataram em geral diferentes respostas com base em eu conhecimento e prática clínica: queixa de halitose entre os pacientes (63 por cento e 38 por cento para médicos e dentistas, respectivamente); halitose como queixa principal (42 por cento e 23 por cento); percepção da halitose entre os pacientes (10 por cento e 67 por cento); informação profissional ao paciente sobre a halitose (58 por cento e 89 por cento); realização do tratamento da halitose pelo profissional (68 por cento e 65 por cento). Os dentistas apontaram doença periodontal, higiene bucal deficiente e cárie como as causas comuns de halitose, enquanto que os médicos relataram alterações bucais, sinusite e doença por refluxo como os principais fatores etiológicos. CONCLUSÃO: Os resultados sugerem que não há alta concordância entre médicos e dentistas sobre fatores relacionados ao diagnóstico e tratamento da halitose.

Halitosis

Halitosis is a broad term describing a range of unpleasant or offensive odours emitted in the breath, due to multiple causes.2 Volatile sulphur compounds may be the main source of oral malodor. The source may be oral or non-oral. Non-oral causes of bad breath are mostly related to systemic conditions and/or drugs prescribed by the physicians to treat medical conditions such as diabetes, liver disorder, kidney malfunctioning, pulmonary disease etc. Medications which reduce salivary flow like antipsychotics, narcotics, antidepressants, decongestants, antihistamines and antihypertensives may also be responsible.3 Oral causes of bad odor are mainly the gram-negative anaerobic bacteria, especially those localized at posterior surface of the tongue and within the surface of tongue and in throat. Oral malodours were drastically reduced after treating chronic periodontitis. Diagnosis can be confirmed by one of the 3 techniques which are; Organoleptic measurement, Gas Chromatography and Sulphide Monitoring. The treatment plan comprises elimination of the causative agent and improvement of the oral health status

Estudo comparativo entre procedimentos diagnósticos para halitose: uma abordagem preliminar / Comparative study of diagnostic procedures for halitosis: a preliminary approach

Objetivo: Comparar a percepção e diagnóstico da halitose a partir de quatro procedimentos. Método: A amostra foi de 40 indivíduos do sexo masculino sem doenças sistêmicas ou problemas periodontais, não portadores de próteses ou aparelhos ortodônticos e nem usuários de antibióticos ou colutórios. Foram testados a autopercepção do hálito, percepção do hálito pelo "juiz do odor"; aferição dos Compostos Sulfurados Voláteis (CVS) pelo Brath Alert®; sialometria em repouso e estimulada com hiperbolóide e; teste BANA. Os resultados foram comparados pelos testes de Fisher, Qui-quadrado e Pearson com significância para 5%. Resultados: Observou-se que a autopercepção foi falha quando comparada à medição de CVS não sendo significante ao teste de Correlação de Pearson (p-valor > 0,01); já a avaliação pelo "juiz do odor" e a mesma medição de CVS obtiveram valores mais semelhantes, sendo essa correlação significante (p-valor < 0,01); a remoção da saburra foi fator determinante na diminuição dos CVS medidos, diminuindo de 16 para 2 o número de participantes com níveis 3 e 4, sendo significante o teste de Pearson (p-valor < 0,01); A comparação entre a presença de bactérias BANA positivas e halimetria foi significante (p-valor < 0,01) pelo teste de Fischer; a baixa produção de saliva em repouso também se mostrou influente, sendo nesse processo significante ao teste do Qui-quadrado. Conclusões: A auto-percepção é um procedimento falho para o diagnóstico. A avaliação organoléptica é importante no diagnóstico clínico da halitose. A saburra lingual relaciona-se com a formação dos compostos sulfurados voláteis. A presença de bactérias BANA positivas está associada a altos níveis de halimetria. A quantidade de produção de saliva fisiológica em repouso interfere nos níveis de compostos sulfurados voláteis.

Objective: To compare the diagnosis of halitosis with an individual's perception of halitosis through four different procedures. Method: Forty male individuals were conveniently selected for this study. The volunteers were free of systemic or periodontal diseases, had no dental prostheses and were not receiving orthodontic treatment. Also, the volunteers were not using any anti biotic treatment or mouth rinses. Four methods were applied in addition to the individual's auto-perception: organoleptic testing, oral malodor measurement, BANA test and measurement of both stimulated and resting whole saliva. Results: There was a significant correlation between the sulfide monitor test and the organoleptic testing (Pearson's test, p<0.01). There was also a positive association between the BANA and sulfide monitor tests (Fisher's exact test, p<0.01). Moreover, the results of the sulfide monitor test were lower after the removal of the tongue's bacterial plaque (p<0.01). There was a significant relationship between the resting whole saliva rate and the sulfide monitor test (Chi-square test, p<0.01). However, there was no correlation between sulfide monitor levels and the individual's auto-perception (Pearson's test, p>0.01). Conclusions: It is possible to conclude that: the individual's auto-perception is not reliable for the diagnosis of halitosis; organoleptic testing evaluation is important for the clinical diagnosis of halitosis; the plaque at the tongue dorsum is related to the formation of volatile sulfuric compounds; the presence of BANA-positive bacteria is related to higher levels of volatile sulfuric compounds; the amount of resting whole saliva interferes with the levels of production of volatile sulfuric compounds.

Halitose: etiologia, diagnóstico e classificação / Halitosis: etiology, diagnostic and classification

A halitose é uma condição bastante comum e que pode ocorrer de forma transitória ou persistente em qualquer período da vida do indivíduo. A maioria dos casos, classificados como patológicos, originam-se de alterações na cavidade bucal como saburra lingual e doença periodontal ou de alterações extrabucais como problemas respiratórios, desordens gastrointestinais e metabólicas. Uma minoria dos casos, classificados como pseudo-halitose ou halitosefobia, caracteriza-se pela inexistência de evidências objetivas da presença de mau hálito, apesar da queixa frequente do indivíduo. Para identificação desses diferentes tipos de halitose, vários recursos diagnósticos podem ser utilizados. Dessa forma, o objetivo deste trabalho foi revisar a literatura a respeito da etiologia, métodos diagnósticos e classificação da halitose, a fim de facilitar o seu reconhecimento e a elaboração de seu plano de tratamento pelos profissionais da saúde bucal

[Halitosis]

Oral malodor also called halitosis is an unpleasant odor excelled from the nose or mouth by expiration. The prevalence of halitosis is reported up to 50% and the first healthcare workers who help this kind of patients are dental practitioners. Halitosis is a multifactorial disease divided to genuine halitosis, pseudohalitosis, and halitophobia. The most common cause of halitosis is oral cavity [80-90%]. The oral etiologies of halitosis are xerostomia, periodontal diseases, mucosal ulcers, tongue coating, dental implants, and oral infections.If the patient believes to have halitosis, it is called pseudohalitosis, and if the treatment for genuine or pseudohalitosis is accomplished but the patient insists to have it, it is called halitophobia. The anaerobic gram-negative bacteria are the major factor of halitosis. The most appropriate methods to detect and measure oral malodor are organoleptic based on the examiner's perception of mouth odor, gas chromatography, and sulphide monitoring. Mechanical oral hygiene techniques such as proper use of mouth brushes, dental flosses and tongue brushes should be instructed to patients. They should rather to put fibrous foods in their daily diet and drink large amounts of water and keep their dentures clean. Antiseptic mouth washes are considered as a supplementary method to decrease oral malodor, and chlorhexidine is the most effective one