Veterinary Dentistry Q&A 14

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Halitosis is a very common complaint among pet owners.

Question	Answer		Article
What conditions may cause halitosis? What are their respective importance?	Halitosis may have extraoral and oral causes. Extraoral causes are related to diet (e.g. garlic in humans), metabolic diseases (diabetes, uremia), and infections (respiratory infections, e.g. pneumonia). Halitosis originating from the oral cavity is mostly due to bacterial activity in the mouth. It can be enhanced by oral tissue destruction during disease, by oral stagnation of food, and by stagnation of saliva in a specific area (e.g. lip fold) as well as by reduction of salivary flow. Halitosis is associated with oral causes in 85% of people affected. Periodontal disease is a very common cause of halitosis. Gastric conditions are not a common cause of halitosis as gas cannot come out from the stomach, except during the process of belching.		[[|Link to Article]]
How is halitosis produced?	Halitosis of extraoral origin is due to the presence of malodorous substances in the bloodstream which pass through the alveolar membrane of the lungs into the respired air. These substances may have a metabolic origin or a digestive origin (food). Halitosis originating from the mouth is due to the production of malodorous volatile gas by the putrefactive action of bacteria on exogenous and endogenous protein substrates such as exfoliated epithelium, salivary components, food debris, and blood. Anaerobes (especially Gram-negatives) associated with periodontal disease produce volatile sulfur compounds (VSCs), such as particularly hydrogen sulfide and mercaptan, which are responsible for bad breath.		[[|Link to Article]]
How can it be assessed?	Halitosis is commonly assessed by organoleptic methods. With subjective methods, it is generally accepted that three levels (weak, moderate, strong) can be recognized. However, this is not accurate, especially if assessment of the same dog over a period of time or comparison between dogs is necessary. The use of a panel of ‘blind’ examiners has been shown effective in halitosis research. Selection, calibration, and training of the examiners is necessary for optimal results. An objective method based on the measurement of VSCs with an electrochemical sensor has been shown accurate and reliable.		[[|Link to Article]]