Andrea Loving

Public Health Research Abstract

DHY258

7/29/20
 Something that is frequently discussed between patient and clinician is how to reduce bad

breath. Oral malodor, also known as halitosis, can be a cause of insecurity for many of our

patients. Not only that, it can be a symptom of a more systemic issue going on. It is important

for us to educate our patients on how to eliminate this widespread problem using evidence-based

practices. In this paper I will be discussing some basic information about halitosis as well as an

article I found on PubMed that investigated some diagnostic and therapeutic approaches to

reducing halitosis in patients over the age of fifteen.

According to information found on Mayo Clinic, halitosis can have several different

etiologies including certain foods, tobacco use, dry mouth, medications, and of course, poor oral

hygiene (Mayo Clinic, 2018). Of all patients experiencing halitosis, it is thought that

approximately 80-90% of those cases are caused by gingival conditions including caries and

poor oral hygiene (PubMed, 2012). Typically using regular home cleaning measures, including

brushing and flossing, will improve the condition with consistency (Mayo Clinic, 2018).

Occasionally there are underlying diseases that will exacerbate this problem and regular home

hygiene will not be the remedy. Objective and subjective assessments must be taken when

halitosis is caused by an extraoral or systemic factor (PubMed, 2012).

The microbiological findings have shown that the bacteria found in the mouths of those

experiencing halitosis is not necessarily of different variety than those not experiencing this

condition. Most common species found in biofilm of the tongue base are Veillonella, Prevotella,

Actinomyces, Fuscobacterium, and Peptostreptococcus (PubMed, 2012). Although these

bacteria can be found in those who do not have bad breath, those with halitosis tend to have

higher numbers of these bacteria (PubMed, 2012). The oral cavity can be colonized by up to 700
different bacteria, so the presence of halitosis is not necessarily related to specific bacterium, but

the increase in the number of pathogens.

Another study I chose to review was conducted over a period of one year. There were 35

patients involved in the study and the mean age of participants was 31.9 years old. Among the

patients, it was shown that those experiencing sinusitis were also experiencing halitosis

(PubMed, 2018). This could be related to the sinus drainage that occurs during this infection.

One other common etiology was Helicobacter pylori infection and gastrointestinal ulcers

(PubMed, 2018).

Following treatment, most of the participants saw resolution of halitosis. Treatments

chosen for each patient were related to the etiology of the condition, and 71.8% of participants

saw improvement (PubMed, 2018). Although many patients saw positive results, there are few

studies done regarding this common problem that is experienced by many.

In conclusion, halitosis is a common condition experienced by approximately 25-30% of

the population (PubMed, 2012). There is not a lot of reliable information found surrounding this

topic. Halitosis is most often eliminated using proper home care practices, but educating our

patients using evidence-based studies is the best way to eradicate this problem.
Bad breath. (2018, March 10). Retrieved July 29, 2020, from

https://www.mayoclinic.org/diseases-conditions/bad-breath/symptoms-causes/syc-

20350922

Zalewska A;Zatoński M;Jabłonka-Strom A;Paradowska A;Kawala B;Litwin A;. (2012).

Halitosis--a common medical and social problem. A review on pathology, diagnosis and

treatment. Retrieved July 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/23082699/

Sombié R;Tiendrébéogo AJF;Guiguimdé WPL;Guingané A;Tiendrébéogo S;Ouoba

K;Bougouma A;. (2018). [Halitosis: Multidisciplinary diagnostic and therapeutic

approaches]. Retrieved July 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/30574220/