Halitosis as a key diagnostic factor to systemic diseases in the primary care
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20213268Keywords:
Halitosis, Family medicine, Systemic diseases, DiagnosisAbstract
Halitosis might be associated with reduced quality of life for the affected patients as a result of the personal and social embarrassments it might cause. The adequate identification and diagnosis of the underlying condition causing halitosis are important to achieve adequate treatment and prevention of many systemic diseases or even neoplasms. In this literature review study, we have discussed the potential role of halitosis in the diagnosis and identification of systemic diseases. We have discussed many diseases as diseases related to the gastrointestinal tract and liver, others related to metabolic and endocrinal disorders. Furthermore, psychological factors might attribute to pseudo-halitosis, while true halitosis comes secondary to oral and extraoral factors and physiological conditions. Poor oral hygiene might be the only reason for oral malodor, while many oral conditions might also contribute to the development of halitosis. Additionally, some conditions might have a characteristic bad smell, which might significantly enhance the diagnostic value and help clinicians. However, further examination and evaluation should also be conducted to prevent a potential overlap between the different conditions. On the other hand, some extra-oral disorders do not have a characteristic oral smell, which indicates that halitosis alone cannot adequately establish a proper diagnosis. Therefore, raising awareness about seeking medical attention when suffering from halitosis is recommended to achieve better outcomes and help clinicians draw efficacious prevention programs.
References
Outhouse TL, Al-Alawi R, Fedorowicz Z, Keenan JV. Tongue scraping for treating halitosis. The Cochrane database of systematic reviews. 2006(2):Cd005519.
Campisi G, Musciotto A, Di Fede O, Di Marco V, Craxì A. Halitosis: could it be more than mere bad breath? Internal and emergency medicine. 2011;6(4):315-9.
Silva MF, Leite FRM, Ferreira LB. Estimated prevalence of halitosis: a systematic review and meta-regression analysis. Clinical oral investigations. 2018;22(1):47-55.
van den Broek AM, Feenstra L, de Baat C. A review of the current literature on aetiology and measurement methods of halitosis. Journal of dentistry. 2007;35(8):627-35.
Scully C, Felix DH. Oral medicine--update for the dental practitioner: oral malodour. British dental journal. 2005;199(8):498-500.
Yaegaki K, Coil JM. Examination, classification, and treatment of halitosis; clinical perspectives. Journal (Canadian Dental Association). 2000;66(5):257-61.
Yaegaki K, Coil JM. Genuine halitosis, pseudo-halitosis, and halitophobia: classification, diagnosis, and treatment. Compend Contin Educ Dent. 2000;21(10a):880-6.
Coil JM, Yaegaki K, Matsuo T, Miyazaki H. Treatment needs (TN) and practical remedies for halitosis. International dental journal. 2002;52(3):187-91.
Marsicano JA, de Moura-Grec PG, Bonato RC, Sales-Peres Mde C, Sales-Peres A, Sales-Peres SH. Gastroesophageal reflux, dental erosion, and halitosis in epidemiological surveys: a systematic review. European journal of gastroenterology & hepatology. 2013;25(2):135-41.
Bollen CM, Beikler T. Halitosis: the multidisciplinary approach. International journal of oral science. 2012;4(2):55-63.
Hughes FJ, McNab R. Oral malodour--a review. Archives of oral biology. 2008;53(1):S1-7.
Suzuki N, Yoneda M, Naito T, Iwamoto T, Hirofuji T. Relationship between halitosis and psychologic status. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2008;106(4):542-7.
Gonçalves MLL, da Mota ACC, Deana AM. Photodynamic therapy with Bixa orellana extract and LED for the reduction of halitosis: study protocol for a randomized, microbiological and clinical trial. Trials. 2018;19(1):590.
Ghozy S, Tran L, Naveed S. Association of breastfeeding status with risk of autism spectrum disorder: A systematic review, dose-response analysis and meta-analysis. Asian J Psychiatr. 2020;48:101916.
Mahmoud AR, Dahy A, Dibas M, Abbas AS, Ghozy S, El-Qushayri AE. Association between sarcoidosis and cardiovascular comorbidity: A systematic review and meta-analysis. Heart Lung. 2020;49(5):512-7.
Ghozy S, Nam NH, Radwan I. Therapeutic efficacy of hepatitis B virus vaccine in treatment of chronic HBV infections: A systematic review and meta-analysis. Rev Med Virol. 2020;30(3):e2089.
Hashan MR, Ghozy S, El-Qushayri AE, Pial RH, Hossain MA, Al Kibria GM. Association of dengue disease severity and blood group: A systematic review and meta-analysis. Rev Med Virol. 2021;31(1):1-9.
Van den Broek AM, Feenstra L, de Baat C. A review of the current literature on aetiology and measurement methods of halitosis. Journal of dentistry. 2007;35(8):627-35.
Di Fede O, Di Liberto C, Occhipinti G. Oral manifestations in patients with gastro-oesophageal reflux disease: a single-center case-control study. Journal of oral pathology & medicine. 2008;37(6):336-40.
Rao A. Halitosis: A mirror of systemic and oral health. IOSR Journal of Dental and Medical Sciences. 2013;4:7-12.
Tangerman A. Halitosis in medicine: a review. International dental journal. 2002;52(3):201-6.
Tangerman A, Winkel EG. Intra- and extra-oral halitosis: finding of a new form of extra-oral blood-borne halitosis caused by dimethyl sulphide. Journal of clinical periodontology. 2007;34(9):748-55.
Lawson LD, Wang ZJ. Allicin and allicin-derived garlic compounds increase breath acetone through allyl methyl sulfide: use in measuring allicin bioavailability. Journal of agricultural and food chemistry. 2005;53(6):1974-83.
Suzuki N, Yoneda M, Naito T. Detection of Helicobacter pylori DNA in the saliva of patients complaining of halitosis. Journal of medical microbiology. 2008;57(Pt 12):1553-9.
Gall-Troselj K, Mravak-Stipetić M, Jurak I, Ragland WL, Pavelić J. Helicobacter pylori colonization of tongue mucosa--increased incidence in atrophic glossitis and burning mouth syndrome (BMS). Journal of oral pathology & medicine. 2001;30(9):560-3.
Adler I, Denninghoff VC, Alvarez MI, Avagnina A, Yoshida R, Elsner B. Helicobacter pylori associated with glossitis and halitosis. Helicobacter. 2005;10(4):312-7.
Serin E, Gumurdulu Y, Kayaselcuk F, Ozer B, Yilmaz U, Boyacioglu S. Halitosis in patients with Helicobacter pylori-positive non-ulcer dyspepsia: an indication for eradication therapy? European journal of internal medicine. 2003;14(1):45-8.
Katsinelos P, Tziomalos K, Chatzimavroudis G. Eradication therapy in Helicobacter pylori-positive patients with halitosis: long-term outcome. Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2007;16(2):119-23.
Dou W, Li J, Xu L. Halitosis and helicobacter pylori infection: A meta-analysis. Medicine (Baltimore). 2016;95(39):e4223.
Suzuki N, Beppu R, Yoneda M. Effects of eradication of Helicobacter pylori on oral malodor and the oral environment: a single-center observational study. BMC research notes. 2020;13(1):406.
Türkay C, Soykan I, Kir M, Ozden A. The effect of Helicobacter pylori eradication on symptoms and gastric emptying in patients with nonulcer dyspepsia. The Turkish journal of gastroenterology. 2002;13(3):146-53.
Zaric S, Bojic B, Popovic B, Milasin J. Eradication of gastric Helicobacter pylori ameliorates halitosis and tongue coating. J Contemp Dent Pract. 2015;16(3):205-9.
Thieu H, Bach Dat B, Nam NH. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva medica. 2020;111(5):498-501.
Miekisch W, Schubert JK, Noeldge-Schomburg GF. Diagnostic potential of breath analysis--focus on volatile organic compounds. Clinica chimica acta; international journal of clinical chemistry. 2004;347(1-2):25-39.
Mitchell S, Ayesh R, Barrett T, Smith R. Trimethylamine and foetor hepaticus. Scand J Gastroenterol. 1999;34(5):524-8.
Minamide T, Mitsubayashi K, Jaffrezic-Renault N, Hibi K, Endo H, Saito H. Bioelectronic detector with monoamine oxidase for halitosis monitoring. The Analyst. 2005;130(11):1490-4.
Aylıkcı BU, Colak H. Halitosis: From diagnosis to management. Journal of natural science, biology, and medicine. 2013;4(1):14-23.
Li ZH, Guedri H, Viguier B, Sun SG, Marty JL. Optimization of hydrogen peroxide detection for a methyl mercaptan biosensor. Sensors (Basel, Switzerland). 2013;13(4):5028-39.
Carmona TI, Posse LJ, Dios DP, Feijoo FJ, García VE. Extraoral etiology of halitosis. Medicina oral. 2001;6(1):40-7.
Mitchell SC. Trimethylaminuria (fish-odour syndrome) and oral malodour. Oral diseases. 2005;11 Suppl 1:10-3.
Schmidt AC, Hebels ER, Weitzel C. Engineered Polymersomes for the Treatment of Fish Odor Syndrome: A First Randomized Double Blind Olfactory Study. Advanced science (Weinheim, Baden-Wurttemberg, Germany). 2020;7(8):1903697.
Mogilnicka I, Bogucki P, Ufnal M. Microbiota and Malodor-Etiology and Management. International journal of molecular sciences. 2020;21(8).
Sabir N, Jones EA, Padmakumar B. Trimethylaminuria. BMJ case reports. 2016;2016.
Whittle CL, Fakharzadeh S, Eades J, Preti G. Human breath odors and their use in diagnosis. Annals of the New York Academy of Sciences. 2007;1098:252-66.
Nakhleh MK, Quatredeniers M, Haick H. Detection of halitosis in breath: Between the past, present, and future. Oral diseases. 2018;24(5):685-695.
Tanigawa T, Yamashita J, Shibata R, Shinohara A. A tonsillolith: possible cause of halitosis. The American journal of the medical sciences. 2013;346(1):64.
Myers NE, Compliment JM, Post JC, Buchinsky FD. Tonsilloliths a common finding in pediatric patients. The Nurse practitioner. 2006;31(7):53-4.
Tsuneishi M, Yamamoto T, Kokeguchi S, Tamaki N, Fukui K, Watanabe T. Composition of the bacterial flora in tonsilloliths. Microbes and infection. 2006;8(9-10):2384-9.
Ansai T, Takehara T. Tonsillolith as a halitosis-inducing factor. British dental journal. 2005;198(5):263-4.
Veeresha KL, Bansal M, Bansal V. Halitosis: A frequently ignored social condition. Journal of International Society of Preventive & Community Dentistry. 2011;1(1):9-13.