Also known as: Bad breath — Foul breath
Introduction
Halitosis is the term used to describe a foul odour emanating from the oral cavity.
The most common cause of halitosis is periodontal disease, and the smell results from the bacterial populations associated with plaque, calculus, unhealthy tissues and decomposing food retained within the oral cavity.
As plaque ages and becomes ingrained, the bacterial flora changes to a more motile, gram-negative anaerobic population such as Porphyromonas, Bacteroides, Fusobacterium and Actinomyces species. As periodontitis progressed to pocket formation, food debris and bacterial breakdown products accumulate within the pocket and result in halitosis.
The bacteria generate volatile sulfur compounds such as hydrogen sulfide, methyl mercaptan and volatile fatty acids.
Many other causes for halitosis also exist:
Respiratory: sinusitis, rhinitis, neoplasia
Gastrointestinal: megaoesophagus, foreign body, neoplasia
Dermatological: lip fold dermatitis
Dietary: eating malodorous food, coprophagy
Oral disease: periodontal disease, pharyngitis, neoplasia, foreign bodies
Trauma: electric cord injuries, open fractures caustic agents
Autoimmune diseases
Eosinophilic Granuloma Complex
Small breeds of dogs, cats, and older animals in general are more predisposed to developing halitosis.
Diagnosis
Subjective methods of assessing halitosis may involve grading the condition into three levels: weak, moderate and strong.
An objective and accurate method of assessing odour release is by measuring sulfide concentration using an industrial sulfide monitor.
Other diagnostic procedures should include a full and thorough history and physical and oral examination.
Further tests such as radiography, cytology and biopsies may be indicated depending on the findings.
Treatment
Treatment and prognosis will depend on the pathology found.
For periodontal pathogens, clindamycin is a useful antibiotic which can be used as pulse therapy, for 5 days at the beginning of each month, to reduce halitosis.
Oral care products and tooth brushing also help control plaque and therefore the bacterial load.
The treatment of periodontal disease should be referred to.
References
Vertstraete, F. (1999) Veterinary Dentistry: self-assessment colour review Manson Publishing
Lobprise, H. (2007) Blackwell's Five Minute Consult Clinical Companion: Small Animal Dentistry Wiley-Blackwell