Halitosis

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:

Metabolic: diabetes, uraemia

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

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