Oral malodor refers to an unpleasant smell formed by a gram-negative anaerobic microorganism that produces volatile sulfur compounds (VSCs). It is also called bad breath. Dental patients have been facing the challenge of bad breath or malodor since putting on masks began. The causes of malodor vary from non-pathologic to pathologic, affecting more than half of the population. The dental hygienist plays a major role in figuring out the cause and the treatment of malodor.
Oral Malodor Chemistry
Volatile sulfur compounds are the primary cause of malodor. These compounds include dimethyl sulfide, hydrogen sulfide, sulfur dioxide, and methyl mercaptan. VSCs usually come from proteinaceous substances, including salivary corpuscles, oral epithelium, food debris accumulation, blood, and saliva. Generally, bad breath causes may vary, but the greatest percentage originates in your oral cavity.
Gram-positive and gram-negative bacteria also take part in causing malodor. Some VSCs form sulfur-producing anaerobic bacteria, which causes malodor. For instance, the odor that comes from the amino acids is created by gram-negative bacteria. Even though gram-positive bacteria are present, they play a dormant role if malodor is present.
Sources of Odor Malodor
The tongue is the source of malodor. It acts as a habitat for VSC because of the anatomy of the surface of the tongue. It comprises various papillae, which permit food remains to get trapped in the crevices.
Additionally, other intrinsic sources of malodor include faulty restorations, periodontal pockets, blood from gum disease probing, and abscesses.
Non-Pathologic Causes
Non-pathologic causes of bad odor are temporary and are caused by receptors that are easily altered. Smoking is one major example of a non-pathologic cause. Smoking causes periodontal disease, malodor, and poor oral hygiene. This is because smokers tend to have a higher level of hydrogen sulfide, which is the main constituent of malodor. Their saliva also has gram-negative bacteria components, which include Campylobacter rectus and Fusobacterium.
Prescription drugs are another non-pathological cause. Prescription drugs have xerostomia which increases the bad breathe or odor. Sympatholytic medicines taken to control blood pressure interferes with the production of saliva. Examples of these drugs include a-2 blockers, a-blockers, and beta-blockers.
Sedatives and muscle relaxers are other examples of non-pathologic sources, but they have a temporary effect. Finally, other malodor causes include food debris accumulation, consumption of certain foods such as garlic, onions, and other spices, reducing saliva flow when sleeping, and metabolic functions.
Pathologic Causes
These causes are more common and chronic. Examples of these causes include periodontal disease, poor dental home care, food impaction, xerostomia, mucositis, oral infection, and wearing dentures while sleeping.
Malodor gotten from foodstuff impaction is due to sub-gingival pockets and defective restoration formed from inflammation, periodontal disease, and tooth crowding.
Malodor might also get linked with non-dental extrinsic circumstances like cancer, renal failure, diabetic ketosis, and acidosis. Bad odor has also been linked with gastrointestinal conditions.
Treatment of Oral Malodor
To evaluate the odor malodor of a dental patient, begin with reviewing their medical history. The dental hygienist should access the indication of non-pathological and pathological indicators. They also ought to access the dental home care routine and medication list of the dental patient.
For instance, if you have a bacterial infection like gingivitis, periodontal disease, abscess, or mucositis, an antibacterial agent might be the best treatment option. This is because it might reduce the gram-positive and gram-negative bacterial flora.
Educate the Patient and Implement Dental Home Care Routine
Implementing a dental home care routine and educating the patient should include interdental cleaning, tooth brushing, mouth rinse, and tongue scraping. All these practices reduce the bacteria that cause odor malodor.
Patients should also address any alterations in dental home care because of dexterity conditions caused by arthritis, stroke, dementia, and neurologic. You can use an ergonomic or electric toothbrush if you are suffering from diseases like arthritis.
Use Antimicrobial Products
Antimicrobial products function as oxidizing agents, and they minimize VSC concentrations. These products include cetylpyridinium chloride, chlorhexidine, quaternary ammonium compounds, hydrogen peroxide, sodium bicarbonate, and benzalkonium chloride.
Use Probiotics
Probiotics are used in instances where acid reflux and gastrointestinal disease are the cause. Increased water consumption and nutritional counseling may be effective in the treatment of odor malodor.
Probiotics refer to living bacteria or food ingredients that have living microorganisms that, when used adequately, benefit the patient’s health. They also promote oral health and a healthy gut. Nutritional guidance might include increased water consumption and reduced intake of spicy food. This is to minimize the production of acid linked to the presence of odor malodor.
Conclusion
The predominance of odor malodor is a great concern with patients with dental issues. The treatment and cause of this condition is not a single fit for all model, which means that the dental hygienist has to perform thorough evaluations and examinations of the individual’s medical and dental history. This information is very important, particularly during treatment.
