English Paper

HALITOSIS
(Oral Malodour)

Arranged by :

1.
2.
3.
4.
5.

Izzati Aqmar D W
Maydina Izzatul Y
Nabilah
Sarah Azhar U
Siti Khairiah

1611111320019
1611111120014
1611111220022
1611111120025
1611111120027

Lecturer :
Drs. Ronny Ralin, M.Kes

FACULTY OF DENTISTRY
LAMBUNG MANGKURAT UNIVERSITY
2016
PREFACE
1

First

at

all,

give

thanks

for

Gods

love

and

grace

for

us.

Thanks to God for helping us and gives us chance to finish this assignment timely.
And I would like to say thank you to Mr. Drs. Ronny Ralin, M.Kes as the lecturer
that always teaches us and give much knowledge about how to practice English
well.
This assignment is a groups assignment to create a paper based on the
theme of dental health. We took the theme about Dental disease. Specifically, we
raised the theme about Halitosis or so-called Bad Oral Breath.
These papers are very far from perfect. Therefore, we expect critism and
good advice in order to create a better papers in the future.
Last word, we apologize if there are mistakes in our English writing. We
hope this paper may be useful for readers. Thank you.

Banjarmasin, October 24th, 2016.

Writer

TABLE OF CONTENTS
2

Chapter 1. Background......................................................................................1
Chapter 2. Problems..........................................................................................2
Chapter 3. Analysis...........................................................................................3
References.........................................................................................................5

CHAPTER 1
BACKGROUND

Patients with halitosis may seek treatment from dentists for the oral
malodour they feel. In this article, an examination protocol, classification system
and treatment needs for such patients will be explained as well as simple treatment
measures such as instruction in oral hygiene, tongue cleaning and mouth rinsing.
In the world of dentistry, there are physiologic halitosis, oral pathologic halitosis and

pseudo-halitosis. This classification system can be used to identify patients with

halitophobia. For example, patients with psychosomatic halitosis. They usually
undergo some hallitosis treatments for genuine halitosis, even though they do not
have it. It is more difficult to diagnose and manage. We can use a questionnaire to
assess the psychological condition of patients who claimed themselves have a
halitosis. The dental clinicians can be better in manage their patients with
understanding this different types of halitosis and the corresponding treatment
needs.

CHAPTER 2
PROBLEMS
Examination for Halitosis
The three main methods of analyzing oral malodour are organoleptic
measurement,

gas

chromatography

(GC)

and

sulphide

monitoring.

Organoleptic measurement is a sensory test scored on the basis of the

examiners perception of a subjects oral malodour. GC, performed with
apparatus equipped with a flame photometric detector, is specific for detecting
sulphur in mouth air. GC is considered the gold standard for measuring oral
malodour because it is specific for volatile sulphur compounds (VSC), the
main cause of oral malodour.However, the GC equipment is not compact, and
the procedure requires a skillful operator; therefore, it is impractical for
practitioners to equip their offices for GC. Sulphide monitors analyze for total
sulphur content of the subjects mouth air. Although compact sulphide
monitors are portable and easy to use, most are not specific for VSC. For
example, the Halimeter (Interscan Co., Chatsworth, CA) has high sensitivity
for hydrogen sulphide, but low sensitivity for methyl mercaptan, which is a
significant contributor to halitosis caused by periodontal disease. Thus, the
most reliable and practical procedure for evaluating a patients level of oral
malodour is organoleptic measurement.
Conditions for Organoleptic Measurement
The recommended examination procedures are described below. Patients are
instructed to abstain from taking antibiotics for three weeks before the
assessment, to abstain from eating garlic, onion and spicy foods for 48 hours
before the assessment and to avoid using scented cosmetics for 24 hours
before the assessment. Patients are instructed to abstain from ingesting any
food or drink, to omit their usual oral hygiene practices, to abstain from using
oral rinse and breath fresheners, and to abstain from smoking for 12 hours
before the assessment. The oral malodour examiner, who should have a

normal sense of smell, is required to refrain from drinking coffee, tea or juice,
and to refrain from smoking and using scented cosmetics before the
assessment.
Classification of halitosis
The classification of halitosis includes categories of genuine halitosis, pseudohalitosis and halitophobia. Genuine halitosis is subclassified as physiologic
halitosis or pathologic halitosis. If oral malodour does not exist but the patient
believes that he or she has oral malodour, the diagnosis would be pseudohalitosis.
If, after treatment for either genuine halitosis or pseudo halitosis, the patient still
believes that he or she has halitosis, the diagnosis would be halitophobia.
1. Genuine halitosis
a. Physiologic halitosis
halitosis ini terjadi hanya sementara yang disebabkan Cactor makanan,
misalnya, bawang putih and dont cause damage to the mouth. This halitosis
usually occur on the tongue.

b. Pathologic halitosis
The pathologic of halitosis includes categories of oral and extraoral
halitosis. The oral halitosis caused by disease, pathologic condition or
malfunction of oral tissues and it is derived from tongue coating. The
extraoral halitosis is originated from disorders anywhere in the body
whereby the odour is bloodborne and emitted via the lungs
2. Pseudo-halitosis
Obvious malodour is not perceived by others, although the patient

stubbornly complains of its existence.

Condition is improved by counselling (using literature support, education

and explanation of examination results) and simple oral hygiene measures.

3. Halitophobia
After treatment for genuine halitosis or pseudo-halitosis, the patient

persists in believing that he/she has halitosis.

No physical or social evidence exists to suggest that halitosis is present.

Treatment needs (TN) for breath malodour

Category
TN 1

Explanation
Explanation of halitosis and instructions for oral hygiene
(support and reinforcement of a patients own self-care

TN 2

for further improvement of their oral hygiene).

Oral prophylaxis, professional cleaning and treatment

TN 3
TN 4

for oral diseases, especially periodontal diseases.

Referral to a physician or medical specialist.
Explanation of examination data, further professional

TN 5

instruction, education and reassurance.

Referral to a clinical psychologist, psychiatrist or other
psychological specialist.

Types of Treatment For Halitosis

Treatment Needs

Classificasion

Physiologic halitosis
Genuine halitosis

TN-1 and
Pathologic
halitosis

Pseudo-halitosis
Halitophobia

TN-1

Oral
Extraora

TN-2
TN-1 and

l
TN-3
TN-1 and TN-4
TN-1 and TN-5

CHAPTER 3
ANALYSIS
The prevalence of halitosis has been reported to be as high as 50%. However,
only a few patients visit dental clinicians to seek help for halitosis. This fact
suggest that the patiens who do visit clinicians may have different

psychological characteristics or values concerning their own breath than other

individuals. The classification of halitosis includes categories of genuine
halitosis, pseudo-halitosis and halitophobia. Therefore, it is important for the
general practitioner to distinguish between patiens with real halitosis and those
with psychological halitosis. Treatment needs (TN) for halitosis in dental
practice have been categorized into five classes to provide guidelines for
clinicians in treating halitosis patiens. Treatment of halitosis physiologic
halitosis (TN-1), oral pathologic halitosis (TN-1 and TN-2) and pseudohalitosis (TN-1 and TN-4) would be the responsibility of dental practitioners.
Treatment of extraoral pathologic halitosis (TN-3) would be managed bya
physician or medical specialist. Treatment of halitophobia (TN-5) would be
managed by a physician, psychiatrist or psychological specialist.

REFERENCE
Yaegaki, Ken and Jeffrey M. Coil. 2000. Journal of the Canadian Dental
Association Examination, Classification, and Treatment of Halitosis;
Clinical Perspectives. May 2000, Vol. 66, No. 5