Treatment of intra-oral halitosis

Intra-oral  halitosis  (bad  breath)  is reported  to affect  15-83 % of the adult population. Having intra-oral halitosis is a social and psycho-logical handicap, and may cause people in the  person’s social circle to increase the physical distance or to turn their faces in another direction to avoid the unpleasant smell from the exhaled air. Such behaviours may affect the individual’s self-confidence resulting in insecurity in social and intimate relations. The oral health-related quality of life status has also been reported to be lower in individuals with halitosis. Approximately 90% of what is considered as bad breath is the result of the degradation of organic substrates (proteins) by an- aerobic bacteria of the oral cavity. Intra-oral halitosis can be  assessed using both subjective and objective methods to evaluate the subject’s exhaled air. The most common one and the one often referred to as the ”gold standard”, is the organoleptic scoring system (OLS). OLS is a subjective method  evaluating  the  strength  of halitosis in exhaled air using a scale from 0-5. One objective  method to assess the presence of volatile sulphur compounds in exhaled air is to use a sulphide monitor measuring the total sum of the volatile sulphur  compounds  (T-VSC) in exhaled  air.  The three  gases  (hydrogensulphide (H2S), methyl mercaptan (MM) and dimethyl sulphide (DMS)) in exhaled air related to intra-oral halitosis can be assessed separately using a simplified gas chromatograph. Different treatment models such as periodontal treatment, tongue scraping and rinsing with Zn ion containing products have been used to reduce intra-oralhalitosis. The  present  thesis  has  evaluated  the  efficacy of  different treatment models in the treatment of intra-oral  halitosis.