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halitosis (bad breath, fetor oris, ozostomia)
Etiology:
1) respiratory tract infection
a) bronchiectasis
b) lung abscess
2) oral infection
a) acute primary herpetic gingivostomatitis
b) acute necrotizing ulcerative gingivitis
c) periodontal disease
d) dental caries
3) smoking
4) hepatic failure (fishy odor)
5) azotemia (ammoniacal or urinary odor)
6) diabetic ketoacidosis (sweet, fruity odor)
7) Zenker's diverticulum
Clinical manifestations:
- dysphagia for liquids & solids suggests Zenker's diverticulum
Special laboratory:
- barium esophagraphy for Zenker's diverticulum
- follow with upper GI endoscopy
Management:
oral hygiene
1) mouth wash
2) dental floss
3) toothpaste/brushing
4) hard candy & other items that stimulate salivation help to diminish breath odor
5) professional cleaning
6) removal of tongue plaque [4]
General
sign/symptom
References
- Stedman's Medical Dictionary 26th ed, Williams &
Wilkins, Baltimore, 1995
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY,
1994, pg 205
- Medical Knowledge Self Assessment Program (MKSAP) 15,
American College of Physicians, Philadelphia 2009
- Messadi DV, Younai FS.
Halitosis.
Dermatol Clin. 2003 Jan;21(1):147-55, viii. Review.
PMID: 12622277