What are the types of Halitosis ? 

Type 1 Halitosis :

The malodour is normal when you wake up only in the morning. Every individual has absolutely more or less. Not treated. It will reappear even if it is treated.

Type 2 Halitosis:

The lingual surface is indented and protruding. Bacteria that settled deep in the tonsillar crypts, spoil proteins from foods and feeds into volatile sulphur compounds .

The reason for the odour is volatile sulphur compounds. There are dozens of VSB gases that cause bad breath. The most common ones are described here. Be sure !  You do not want to smell any of these.

Type 3 Halitosis :

This type halitosis is derived from dorsum of the tongue , but the source of bacteria is not in the mouth, it is rather in sinuses, tonsils, throat and peripheral tissues . It is the cause of halitosis astonishingly large people in society. 

Type 4 Halitosis:

When digestion enzymes and organs do not digest food properly, It means , food will be broken down by the bacteria. Gases released in digestive tract reach the mouth out of  the person’s will and knowledge. The individual does not need to belch. These gases ramp to the mouth in 0.68 mL/min while sitting and 0.12 mL/min while supine . The person is not aware of this . In this type halitosis, if gastroesophageal flap valve between the stomach and oesophagus gets languished, more bad breath will fill the mouth. Particularly in proportion to the advancing age, the appearance of such halitosis increases. 

Type 5 Halitosis:

Arises from the lungs. It is not malodour , it is  BREATH ODOUR. It happens in two ways.  First: if there is an infection in lung parenchyma or lower respiratory tract (pneumonia, pleuritis, adenitis, bronchitis etc…), unpleasant odoured gases released  directly interfuse into the expiration.The second way is that chemically changed blood gases transform into aromatic compounds in expiration. The most vivid example of this is the malodour  seen in diabetic or gouty patients , dialysis patients , immediately after anaesthesia ,  pregnancy . This type of halitosis never responds to malodour  treatment , what ever do ,  it shows no improvement .Because neither the fragrance source is in the mouth nor the reason is in the mouth. 

Type 6 Halitosis:

Suppose that they have a bad breath . Actually there is no measurable pathological bad breath . Dominant thought is “ I think my mouth smells , they are away from me “ They usually soulful, delicate, carry disciplined and introverted personality.They are very difficult to diagnose and treat. It should be treated with the cooperation of a psychiatrist. Never say “ your mouth smells “ to these patients .

Why mouth smell ?

If there is dryness of mouth , there is Type 1 halitosis ( sleeping with open mouth , lack of saliva , after radiotherapy , alcohol use , etc.). 

If there is a source of microbes that hosts bacteria in mouth , there is Type 1 halitosis .These microbes  resources may be based on the order of frequency :

- Under the bridge 

- Gingivitis

- Decay cavity 

- wisdom tooth capuchon 

- All retentive surfaces in the mouth and uncleaned prostheses

Patients  with pharyngitis, tonsillitis, sinusitis may have Type 2 halitosis. Patient may not be aware of this disease .

Allergic patient with postnasal drip may have Type 2 halitosis . Patient may not be aware of this drip . 

Patient with In gastro oesophageal sphincter dilatations, reflux and gastritis may have type 3 halitosis. 

There is Type 3 halitosis cause by Digestion enzymes deficiency. Individuals may be accustomed to the disease with  simple complaints (heartburn, indigestion, gas).

Type 4 halitosis  is present in all metabolic diseases (including diabetics , gout, nephropathy) that may change blood gases and blood biochemistry, which may be the cause of acidosis , alkalosis.

Patients who eat same food everyday may have type 3 halitosis .  Such patients can only be identified by anamnesis

Pregnant patients have type 4 halitosis .

Patients who use drugs regularly may have type 4 halitosis . 

Fasting patients may have type 4 halitosis . 

Patients with pulmonary infection may have type 4 halitosis .

How is Halitosis Treated ?

Increase the oral hygiene of your patient . 

Smooth all rough surfaces that may hold bacteria . Al surfaces in the mouth should be clean from bacteria and polished . The most common problem is the bridge . 

Give tongue brush training . Inform your patients to brush their tongues everyday without making it bleed or hurt . 

Prevent your patients from using alcohol or  quit the halitosis treatment . Because alcohol alone is the cause for halitosis.

Give tongue brush training . Inform your patients to brush their tongues everyday without making it bleed or hurt .

Countless halitosis case disappear only when the bridges in the mouth are removed !

Teeth must be brushed every night before going to bed and everyday after breakfast . 

Toothbrush must be 

1-Rarely Bristle 

2-Medium soft 

3-Small 

Patients with halitosis must use toothpaste with zinc. There are four  toothpastes with zinc on the market . 

After the brushing of the tongue , antiseptic mouthwash can be used for no longer than a week . 

Tongue must be brushed after every brushing of the teeth . It must brushed from end of the tongue to the front without pressure . 

The antiseptic mouthwash must be alcohol-free . 

The antiseptic mouthwash formula must be without anti inflammatory . 

Only 1 (one)  brand of mouthwash is available at the pharmacies with this prescription . Other types of mouthwash are not suitable for the treatment of halitosis .  

Salted water can be used instead of antiseptic mouthwash . Don't prescribe salted water to the patients who has blood pressure and kidney diseases . 

You can prescribe to your patient to use chewing gums containing zinc for 1-8 weeks period . There are 2 gums with zinc on the market .  

The above-mentioned treatment cures Type 1 cases completely. In Type 2 cases there will be partial treatment. Other types of halitosis cannot be cured with this treatment.