Diagnosis and Treatment of Oral Halitosis. Summary of the Doctoral Thesis

Abstract

Many scientists have acquired extensive interest in this oftentimes concealed subject in the last century. Up until the end of the 20th century, halitosis and bad breath was an uncommon subject not only in Latvia, but also in Europe. Bad breath studies carried out over several centuries indicate that halitosis has oral origins. The research of this study is important, because it affects a wide array of population and various age groups. The aim is to study the diagnosis and treatment opportunities of oral halitosis. The responses to the questionnaire given by halitosis patients clearly indicate that most patients who are aware of the problem have taken no action, even though they know that communication with others has become difficult. This suggests that patients do not regularly visit a dentist, perhaps only when a visit cannot be avoided, which is also suggested by association of bad breath with other dental problems (bleeding gums and extracted teeth). Most of the patients do not know the reason for malodour, and have not taken any actions. The level of halitosis, estimated by halimeter readings, was clearly associated with bacterial amounts. The main bacteria contributing to malodour was Porphyromonas gingivalis which explained 52% of the variability in halimeter readings (r=0.72). Further 20% of the residual variation was explained by Tannerella forsythietensis and Treponema denticola. The results show that bacterial testing should focus on Porphyromonas gingivalis, but noncovariable variation in malodour was also explained by Tannerella forsythietensis and Treponema denticola. That corresponds with experimental studies, where VSC were produced by oral anaerobic bacteria. The main cause of halitosis is oral pathology – increased amounts of oral anaerobic bacteria: Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, and Prevotella intermedia. There were few differences between genders, risk factors, and age with regard to bacterial amounts in periodontal pockets. The concentration of bacteria in the oral cavity is significantly higher in halitosis patients than in the studied control group, who do not complain about halitosis. The PCR examinations correspond with halimetric examinations.