Fetor Oris Research Articles

THE PROBLEM OF HALITOSIS WHEN USING REMOVABLE DENTURES (CLINICAL CASE)

Recently, more and more publications are appeared in the literature in relation to the occurrence of the problem of bad breath, which are based on the basis of scientific researches.
 Halitosis, or fetor oris chronic bad breath, according to one of the researchers in this field, belongs to the category of "social disability". Since, for a certain group of the population, halitosis is the reason for limited communication with people suffering from this disease.
 The purpose of our work is to highlight a clinical case of chronic halitosis in a patient who uses partial removable prostheses made of acrylates.
 Patient M., born in 1952, complained of chronic, unpleasant mouth odor, which is observed every day and cannot be eliminated with the help of toothpaste and a brush.
 From the anamnesis of the patient M., it became known that the patient has been using partially removable plate prostheses for about a year. The patient notes that the unpleasant smell from the oral cavity bothered her even before the manufacture of removable prostheses. However, since using them, halitosis has increased. According to the patient’s words, she takes care of the prostheses regularly, but sometimes, during night sleep, they remain in the oral cavity.
 Treatment of halitosis in patient M. was carried out in two directions. Firstly, it is motivation and training in proper oral hygiene, selection of hygienic care products, demonstration of the technique of cleaning lingual plaque, application of antiseptic rinses and mouth fresheners. Secondly, it is a careful individual selection of structural materials, proper care of the prosthesis and its timely replacement during the using.
 Remote results of the examination of the oral cavity of patient M. and determination of the IR index by the method of S. Ulitovskyi confirmed the absence of the slightest smell at a close distance and confirmed the correctness of the selected treatment.
 Conclusion. The clinical case of chronic halitosis in a patient who uses removable prostheses shows the need for diagnosis, treatment and the use of preventive measures in patients suffering from this pathological condition.

Fetor oris-A review on classification and management

Fetor oris or halitosis is an offensive or disagreeable odour that emanates from the mouth. Several etiological factors can contribute to this phenomenon with microbial factors being the most predominant entity. Microbial putrefaction of food debris, cells, saliva, blood leads to production of volatile sulfur compounds (VSCs) that cause bad breath. Understanding the different types and etiology of halitosis helps in providing better health care to patients burdened with bad breath. The treatment methods include mechanical and chemical reduction of microorganisms and other non-oral methods.

Quality and readability of internet-based information on halitosis

To evaluate quality and readability of Internet-based information on halitosis. An Internet search through 3 engines (Google, Yahoo, and Bing) was done with the terms ("bad breath," "halitosis," "oral malodor," "foul breath," "mouth malodor," "breath malodor," "fetor ex ore," "fetor oris," "ozostomia," and "stomatodysodia"). The first 50 websites from each engine resulting from each search term were screened. Included websites were evaluated using Health on the Net (HON) criteria, Journal of American Medical Association (JAMA) benchmarks, DISCERN, Ensuring Quality Information for Patients (EQIP), Flesch Reading Ease (FRE) score, and Flesch-Kincaid Grade level. A total of 101 websites were included. HON, DISCERN, EQIP, and FRE score were 42.9%, 37.6%, 37.4%, and 51.9% of the maximum score, respectively. Fewer than 50% of sites displayed attribution, disclosure, and currency according to JAMA benchmarks. HON score, DISCERN score, and EQIP score had significant correlation with each other and were significantly higher in sites displaying the HON seal. The current quality and readability of informative websites on halitosis are generally low and poorly organized. Clinicians should be able to assess the Internet-based information on halitosis, as well as give accurate advice and guide patients concerning this issue.

Clinical correlates of <i>helicobacter pylori</i> infection in children seen at a Tertiary Hospital in Uyo, Southern Nigeria

Background : Helicobacter pylori (H pylori) infection is the commonest global chronic human bacterial infection. Data from developed countries show that acquisition occurs in childhood but manifestation of chronic gastroduodenal diseases occur more commonly in adulthood. H. pylori infection has however been associated with paediatric primary peptic ulcer disease, though data is rather scanty. There is virtually no data on the clinical correlates of the seropositive Nigerian paediatric subjects though the little data available shows higher prevalence rates compared to that of children from developed countries. Objectives : A prospective observational survey was carried out to determine the clinical correlates of H. pylori infection in ill children admitted in the emergency unit of our department. Methods : H. pylori Immunoglobulin G antibody was determined from serum samples stored at -200C using a commercial enzyme-linked immunosorbent assay kit, VicTorch. Data was analysed with using SPSS and correlates determined as appropriate. Results : The subjects were 132 (57.4%) males and 98(42.6%) females (male: female ratio= 1.3:1.0) with an age range of 0.5-15 years and a mean age of 5.0 (SD±4.0) years. The overall seroprevalence rate was 30.9%. Clinical features including abdominal pains, (p=0.001), fetor oris, (p=0.0001), diarrhoea (0.041) and family history of dyspepsia (p=0.002), showed significant association with seropositivity. Conclusion : Seroprevalence of H. pylori infection in Nigerian children is high and is associated with common gastroduodenal symptoms.

Three-Layer Oronasal Fistula Repair With Sandwiched Mastoid Fascia Graft

Oronasal fistula can cause speech problems, hearing loss, velopharyngeal insufficiency, and social problems related with fetor oris and oronasal fluid leakage. The purpose of this study was to achieve 3-layer closure with autogenous mastoid fascia graft in a group of patients with recalcitrant oronasal fistulas.Sixteen patients, aged between 2 and 56 years (mean, 13.9 y), with recalcitrant palatal fistula were operated on and included into the study in a tertiary clinic. Nine patients had previous fistula repairs. The patients' mean follow-up period was 6.8 months.Fistula closure was obtained in 14 of 16 patients. All 2 failures had type IV + V fistulas according to Pittsburgh Classification. A 3-layer technique for the closure of fistulas with autogenous mastoid fascia graft allows three-dimensional repair of the defect without tension. Using mastoid fascia via postauricular sulcus incision is a good alternative regarding hiding incision scars and not requiring intraoperative repositioning.

Diagnosis and treatment of diverticulums in laryngopharynx and cervical esophagus

To explore the clinical presentations, diagnosis and treatment of diverticulums in laryngopharynx and cervical esophagus. Nineteen cases of diverticulums in laryngopharynx and cervical esophagus with general clinical information available from 1985 to 2010 at Peking Union Medical College Hospital were reviewed retrospectively and analyzed with a literature review. One case of lateral hypopharyngeal pouch presented with fetor oris and pharyngalgia. Three cases of Killian-Jamieson diverticulums had fetor oris and dysphagia. Among 15 cases of Zenker diverticulums, 3 had fetor oris, sour regurgitation and dysphagia while another 12 cases were asymptomatic. Seven patients with subjective complaints underwent diverticulectomy through open surgeries or endoluminal approaches and their symptoms were resolved and no recurrences were found during a follow-up period of 6 months-18 years. In 12 cases of asymptomatic Zenker diverticulums, observation was adopted and there was no complaint during a follow-up period of 1 - 25 years. Lateral hypopharyngeal pouch, Killian-Jamieson diverticulum and Zenker's diverticulum are rare entities with different clinical presentations. For symptomatic diverticulum, the most common treatment is surgical resection of diverticulectom and the prognosis is satisfactory. But for asymptomatic diverticulum, observation suffices.

Halitosis: new insight into a millennial old problem

The problem of halitosis has been reported since ancienttimes. References have been found in papyrus manuscriptsdating back to 1550 BC. Hippocrates advised that any girlshould have pleasant breath, making sure always to washher mouth with wine, anise and dill seeds [1].More than50 years ago, Blackburn [2] investigated halitosis in a case-series of 73 patients affected by leukemia. He found apeculiar odor of the breath resembling that of a freshlyopened corpse. This characteristic smell is not associatedwith clinical involvement of the gum, mouth, or upperrespiratory or alimentary tract. He associated this particularsmell with the hematologic disease. Nearly 15 years ago,the role of cadaverine was pointed out as a putative com-ponent of halitosis [3]. On the contrary, putrescine, that issimilar to cadaverine, is not involved as component ofhalitosis. Cadaverine, together with putrescine, was firstdescribed in 1885 [4] by the German physician LudwigBrieger (1849–1919). Cadaverine is a toxic diamine usu-ally produced by protein hydrolysis during putrefaction ofanimal tissue. Cadaverine is also known as 1,5-pentanedi-amine and pentamethylenediamine, and represents one ofthe substances possibly implicated in establishing halitosis.Particularly, isolates of Klebsiella and Enterobacter havebeen found to emit foul odors in vitro that resemble badbreath, with concomitant production of volatile sulfides andcadaverine [5].When incubated on a sterile denture,enterobacterial isolates produce typical denture foul odor.Moreover, isolates exhibit cell-surface hydrophobic prop-erties when tested for adhesion to acryl and aggregationwith ammonium sulphate. The results, taken together,suggest that Klebsiella and related Enterobacteriaceae mayplay a role in denture malodor. However, cadaverine maybe produced by other mechanisms as well as oral bacterialgrowth.From a conventional point of view, halitosis, fetor oris,oral malodor or bad breath are the general terms used todescribe unpleasant breath emitted from a person’s mouthregardless of whether the odorous substances in the breathoriginate from oral or non-oral sources. There are fewstudies evaluating the prevalence of oral malodor in thegeneral population, with reported rates ranging from 22 tomore than 50%. In addition, approximately 50% of adultsand elderly individuals emit socially unacceptable breath,related to physiologic causes, upon arising in the morning[6]. Moreover, there are no universally accepted standardcriteria, objective or subjective that define a halitosispatient [7].Thus, this is a clinical problem as common asundervalued by clinicians who have to remember theimportance of physical examination as from the mouth’ssmell for an all-inclusive clinical decision-making. In thisissue of Internal and Emergency Medicine, Campisi et al.[8] have carried out an excellent and complete guide forapproaching the halitosis symptom. Each of us can learnfrom this interesting and in-depth review. As the authorsstate, despite its frequency, this problem is often unac-cepted and declared as taboo. However, even if nearly 90%of patients suffering from halitosis have oral causes, animportant percentage of oral malodor cases have an extra-oral etiology. They may often be referred to the category of‘‘blood-borne halitosis’’. According to the Tangerman [9]classification, this is one of the three major categoriestogether with upper respiratory tract and lower respiratorytract causes. Many organ or systemic diseases may beresponsible for ‘‘blood-borne halitosis’’ even though some

Comparison on the effect of oral nursing by tooth-brushing and cotton scrubbing for the patients with orotracheal intubation

Objective To explore the oral care effects of tooth-brushing with 0.05% iodophor and oral cotton scrubbing with 0.05% iodophor for the patients with orotracheal intubation. Methods 86 patients with orotracheal intubation were randomly divided into cotton scrubbing group(control group,42 cases)and toothbrushing group(experimental group,44 cases). Oral PH values,the incidence of fetor otis and stomatitis 10min and 4 hours after care were compared. Results In the control group,oral PH value of 66.6% patients maintained 6.6 ～7.1 10min after care and the proportion was 40. 4% after 4 hours; the incidence of fetor oris and stomatitis were 42.8% and 38.0% respectively. In the experimental group,oral PH value of 86.3% patients maintained 6.6 ～ 7.1 10min after care and 77.2% after 4 hours; the incidence of fetor oris and stomatitis were 22.7% and 13.6% respectively. The differences of all the four indicators between the two groups has reached statistical significance(P ＜ 0. 05). Conclusions The oral care effects of tooth-brushing with 0.05% iodophor were much better than oral cotton scrubbing with 0.05% iodophor for the patients with orotracheal intubation. Key words: Orotracheal intubation; Oral nursing; Tooth-brushing; Cotton scrubbing

An unusual tonsillolithiasis in a patient with chronic obstructive sialoadenitis

Concretions in the tonsil or peritonsillar area are an infrequent entity in clinical practice. Some patients have no symptoms or they can present with fetor oris or odynophagia. The lesions are often detected incidentally during radiographic examination. This pathology can be related to lithiasis in other regions of body. The authors describe a tonsillolith accidentally detected in a patient with a lithiasis of left submandibular gland. We review published cases of tonsilloliths and analyse the causes of stone formation in peritonsillar and tonsil regions.

Halitosis (Fetor oris) in patients seen at the periodontology clinic of the University College Hospital, Ibadan - a subjective evaluation

The aim of this study was to assess the prevalence of halitosis among periodontal patients and to evaluate the association between this condition and increasing age, social class, gender and oral hygiene status. The subjects comprised two hundred and fifty five consecutive patients who attended the periodontology clinic of the University College Hospital from November 1996 and March 1997. The patients were matched for sex and their ages ranged from 16 years to 74 years and made up of 128 males and 127 females. Cases of halitosis were cross-validated by two examiners to rule out a biased diagnosis. One hundred and twenty eight patients were males while 127 were females. A total of 37 patients presented with halitosis representing 14.5% . There was no statistically significant difference in relation to gender, p > 0.05. In the different age groups, only 7% of the subjects in the 31 - 40 years age group had halitosis while 36% of the subjects in the over 60 years age group were affected, (chi(2) - 13.01, df = 5, p < 0.05). There was also a statistically significant difference in the prevalence of halitosis according to oral hygiene status and social class. The results showed a low prevalence of halitosis as erroneously claimed but showed an association between the condition and increasing age, social class and oral hygiene status.

Sinusitis in Saudi Children

Sinusitis is considered one of the most common diseases in childhood, though no actual figures are quoted in the medical literature. This study, which was conducted in an ambulatory care facility a...

Tonsil Concretions and Tonsilloliths

Although infrequently seen in many clinical practices, tonsillar concretions can be the source of both fetor oris and physical and social concern for the patient. Though stones rarely form in the tonsil or peritonsillar area, the findings of calcified objects or stones anywhere within the body has long been a subject of interest. The salient features of these entities and their relevance to clinical practice are discussed in this article.

Management of Radionecrosis

The resultant damage to bone following radiation for carcinoma is a severe complication 24 and difficult to treat. The primary pathological process is necrosis of bone, but infection and residual cancer often complicate the picture. The patient suffers severe unremitting pain and may have a draining wound, fetor oris, and trismus. In the head and neck, the mandible is most frequently involved. The essentials of treatment are wide removal of the affected bone plus coverage by adequate soft tissue with good blood supply. Pathogenesis.— Late change in arteries (obliterative endoarteritis) gradually shuts off the blood supply provided by osseous nutrient vessels and periosteum. 25 As long as there is viable soft tissue coverage, these changes, although progressive and inexorable, 26 remain unnoticed. Should the skin or mucosal covering be broken, however, infection from the surface bacteria can spread rapidly through the fibrotic, nearly bloodless, soft tissue where defensive mechanisms have

PALLIATION OF ADVANCED CARCINOMA OF THE PHARYNX.

Introduction THE SYMPTOMS of advanced carcinoma of the oropharynx and base of the tongue are familiar to the otolaryngologist. They include pain radiating to the ears, dysphagia, odynophagia, trismus, fetor oris, and excessive salivation. In past years, the management of this type of patient devolved on the use of analgesics and narcotics, attention to oral hygiene and diet, and tracheostomies and gastrostomies. The patient often lingered on in a state of misery, until he succumbed from a hemorrhage, inhalation pneumonia, or general inanition. The administration of cancer chemotherapeutic agents has to some extent altered the picture and has improved both the local disease and general condition of the patient. The patient with incurable carcinoma of the oropharynx and base of the tongue, who responds to these drugs, will lose his pain, trismus, and fetororis, and will note improvement in swallowing. Objectively, the lesion is smaller, cleaner, and less offensive. The

Case report no. 25. Acute monocytic leucemia: Report of a case with oral manifestations

In this case symptoms appeared in the mouth as one of the first signs of acute monocytic leucemia, and the patient's chief complaint while in the hospital was the swollen and ulcerated gums and the marked fetor oris which increased with the progress of the disease.

ARSENIC POISONING CAUSED BY A MOUTHWASH CONTAINING SOLUTION OF POTASSIUM ARSENITE

D. G., a white girl, aged 10 years, was admitted, July 20, 1932, with Vincent's infection of the mouth of eleven days' duration. Symptoms of note prior to admission included anorexia, fetor oris, fever and anuria. Bitter complaint of vomiting and gagging, continuous nausea and inability to retain anything, even water, was made by the mother. The patient had received an injection of Thio-Bismol (sodium bismuth thioglycollate) into the buttock, a local application of neoarsphenamine (0.4 Gm. in aqueous solution), and the following mouthwash: On admission the temperature, pulse and respiration were 98.6, 100 and 25, respectively. The blood pressure was 106 systolic, 70 diastolic. The prominent features on examination were a shallow lingual ulcer, moderate cervical lymphadenopathy and right-sided abdominal tenderness. The heart and lungs presented no abnormalities. There was no edema, and the eye-grounds were normal. The admission diagnoses were: (1) Vincent's infection and (2) anuria (of unknown