Types of Oral Odour (Halitosis)
1. Morning Breath
Oral malodour is common on awakening usually as a consequence of reduced salivary flow and stagnation during sleep. It may be exacerbated by mouth breathing during sleep. Morning breath rarely has special significance, and can be rectified by eating, tongue brushing, toothbrushing and rinsing the mouth with fresh water.
2. Exogenous Malodour (External Cause)
This is often the consequence of eating foods that contain strong aroma or smell, such as garlic, onion, spices, durians, or habits such as smoking or drinking. The cause is straightforward and avoidance of these foods and habits is the best means of prevention. No specific treatment is necessary.
3. True Oral Malodour (Internal Cause)
Halitosis that is not due to (1) or (2) is most often a consequence of oral bacterial activity, typically from anaerobic organism arising from a few sources, namely;
• Poor oral hygiene
• Periodontal (gum) disease
• Infected extraction sockets / wound
• Post-operative blood clots
• Food stuck / trapped under dentures or bridge
• Dry mouth due to low saliva production
The bacteria (mostly Gram negative Anaerobes) produce volatile compounds that cause the malodour.
4. Systemic Causes
In the absence of oral infections, the oral malodour may be due to the following:
• Medication (Taken orally. Examples include those that cause a dry mouth)
• Nasal infection or lower respiratory tract infection (Foreign body in nasal cavity)
• Diabetic ketosis (Breath may smell of acetone)
• Gastrointestinal disease (Gastroesophageal reflux disease)
• Hepatic / Renal Failure (Uremic Smell)
• Dry Mouth Syndrome
• Psychogenic Malodour