Qual é a origem do mau hálito?
What causes bad breath?
Cali, C.M.; Tarzia, O.; Marcondes, F.K.
Rev. odontol. UNESP, vol.35, n3, p.185-190, 2006
Resumo
O termo "malodor oral" ou "halitose" é usado para descrever um odor desagradável que emana da cavidade bucal e é motivo, atrás somente da cárie e da doença periodontal, de visitas ao dentista. Surpreendentemente, um problema de tal magnitude, com tamanha prioridade para o público, tem sido tradicionalmente negligenciado pelos cirurgiões-dentistas. A maioria dos casos de halitose origina-se na boca como resultado do metabolismo microbiano, pelo qual compostos sulfurados voláteis são produzidos por bactérias gram-negativas anaeróbias. A halitose também tem sido relacionada à presença e à severidade da doença periodontal e à quantidade de saburra lingual além de desordens sistêmicas. Entretanto, a ocorrência de mau hálito na ausência de alterações bucais ou doenças sistêmicas tem representado um desafio para o profissional de saúde e, nesse contexto, sintomas psicopatológicos têm sido apontados como fatores indutores de halitose. Esse artigo discute os diferentes tipos de halitose e tem como objetivo auxiliar os cirurgiões-dentistas no manejo de pacientes sob essa condição, além de informar os profissionais de saúde em geral.
Palavras-chave
Halitose, saburra lingual, ansiedade, compostos sulfurados voláteis, doenças periodontais.
Abstract
The term “oral malodor” or “halitosis” is used to describe a foul or offensive odor emanating from the oral cavity and may rank only behind dental caries and periodontal disease as the cause of patient’s visit to the dentist. Surprisingly, a problem of this magnitude, with such high priority to the public has traditionally been neglected by the dental profession. Most oral malodor originates within the oral cavity itself, primarily as a result of microbial metabolism, in which volatile sulfur compounds (VSC) are produced by many oral bacteria, especially gram-negative anaerobic species. Halitosis has also been correlated with the presence and severity of periodontal disease and by the amount of coating on the tongue, in addition to systemic disorders. Since many patients complain about halitosis without clinical evidences, however, psychological symptoms have been pointed out as a factor inducing oral malodor. This article discusses the different types of halitosis and it is the authors’ goal to inform health professionals in general, and help dental clinicians achieve better management of patients with this condition.
Keywords
Halitosis, tongue coating, anxiety, volatile sulfur compounds, periodontal diseases
References
1. Tonzetich J, Ng SK. Reduction of malodor by oral cleansing procedures. Oral Surg Oral Med Oral Pathol. 1976; 42:172-81.
2. Rosenberg M, McCulloch CA. Measurement of oral malodor: current methods and future prospects. J Periodontol. 1992; 63:776-82.
3. Springfield J, Suarez FL, Majerus GJ, Lenton PA, Furne JK, Levitt MD. Spontaneous fluctuations in the concentrations of oral sulfur-containing gases. J Dent Res. 2001; 80: 1441-4.
4. Tarzia O. Halitose: um desafio que tem cura. São Paulo: Editora de Publicações Biomédicas; 2003.
5. Costa IM. Patologia das halitoses. Odontol Mod. 1987; 14(6):7-16.
6. Tonzetich J. Chromatographic separation of methionine, methionine sulphoxide, methionine sulphone, and their products of oral microbial metabolism. Anal Biochem. 1976; 73:290-300.
7. Attia EL, Marshal KG. Halitosis. Can Med Assoc J. 1882; 126:128-35.
8. Rosenberg M, Kulkarni GV, Bosy A, McCulloch CAG. Reproductibility and sensitivity of oral malodor measurements with a portable sulfide monitor. J Dent Res. 1991;70:1436-40.
9. Tonzetich J. Oral malodour an indicator of health status and oral cleanliness. Int Dent J. 1977; 28:309-19.
10. Tonzetich J. Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol. 1977; 48:13-20.
11. Shimura M, Watanabe S, Iwakura M, Oshikiri Y, Kusumoto M, Ikawa K, et al. Correlation between measurements using a new halitosis monitor and organoleptic assessment. J Periodontol. 1997; 68:1182-5.
12. Shaw M. Instruction manual – RH-17 series halimeter. California: Interscan Corporation; 1999.
13. Loesche WJ. Rationale for the use of antimicrobial agents in periodontal disease. Int J Technol Assess Health Care.1990; 6:403-17.
14. Eourdet PM. Soins faciles pour la propete de la bouche. Paris; 1771.
15. Geist H. Vom Foete ex ore in der Antique. Zahnarztliche Plaxis. 1956; 7:12-3.
16. Fukushima K. A fundamental and clinical study on the ingredients of bad breath in various oral conditions. J Oral Maxillofac Surg. 1986; 32:84-104.
17. Yaegaki K, Sanada K. Volatile sulfur compounds in mouth air from clinically healthy subjects with and without periodontal disease. J Periodontal Res. 1992;21:434-9.
18. Kozlovsky A, Gordon D, Galernter I, Loesche WJ, Rosenberg M. Correlation between the BANA test and oral malodor parameters. J Dent Res. 1994;73:1:1036-42.
19. De Boever EH, De Uzeda M, Loesche WJ. Relantionship between Volatile Sulfur Compounds, BANA-Hidrolysing bacteria and gingival health in patients with and without complaints of oral malodor. J Clin Dent.1994;4:114-9.
20. Bosy A, Kulkarni GV, Rosenberg M, McCulloch CA. Relantionship of oral malodor to periodontitis: evidence of independence in discrete subpopulations. J Periodontol. 1994; 6:37-46.
21. Coli JM, Tonzetich J. Characterization of volatile sulphur compounds production at individual gingival crevicular sites in humans. J Clin Dent. 1992;3:97-103.
22. Calil, CM. Influência da doença periodontal e dos níveis de saburra lingual na halitose [Monografia de Especialização]. Piracicaba: Faculdade de Odontologia da Unicamp; 2005.
23. Quirynen M, Avontroodt P, Soers C, Zhao H, Pauwels M, van Steenberghe D. Impact of tongue cleansers on microbial load and taste. J Clin Periodontol. 2004;31:506-10.
24. De Boever EH, Loesche WJ. Assessing the contribution of anaerobic microflora of the tongue to oral malodor. J Am Dent Microbiol. 1996; 34:537-42.
25. Tonzetich J, Yaegaki K, Coil JM. Collagen metabolism by fibroblasts cultures in presence of methyl mercaptan. J Dent Res. 1986; 64:786.
26. Ng W, Tonzetich J. Effect of hydrogen sulfide and metil mercaptan on the permeability of oral mucosa. J Dent Res. 1984; 63:994-7.
27. Kleinberg G, Westbay G. Salivary and metabolic factors involved in oral malodor formation. J Periodontal Res. 1992; 63:768-75.
28. Bogdasarian RS. Halitosis. Otolaryngol Clin North Am. 1986; 19:111-7.
29. Grein NJ. Estomatologia para o clínico – halitose: diagnóstico e tratamento. Odontol Mod. 1982; 9(6):40-5.
30. Shinjiro K, Shuji A, Kenjiro G, Kurihara E, Toshihiro A, Tadamichi T. Low salivary flow and volatile sulfur com pounds in mouth air. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:38-41.
31. Messadi DV. Oral and nonoral sources of halitosis. J Calif Dent Assoc. 1997; 25:127-31.
32. Loe H, Silness J. Periodontal disease in pregnancy. Acta Odontol Scand. 1963; 21:533.
33. Egelberg J. Gingival exudate measurements for evaluation of inflammatory changes of the gingivae. Odontol Revy. 1964; 15:381.
34. Lindhe J, Attstrom R. Gingival exudation during the menstrual cycle. J Periodontal Res. 1967; 2:194.
35. Main DMG, Ritchie GM. Cyclic changes in oral smears from young menstruating women. Br J Dermatol. 1967;79:20-30.
36. Lindhe J, Attstrom R, Bjorn AS. The influence of progesterone on gingival exudation during menstrual cycle. J Periodontal Res. 1969; 4:97.
37. Queiroz CS, Hayacibara MF, Tabchoury CPM, Marcondes FK, Cury JA. Relationship among stressful situations, salivary flow rate and oral volatile sulfur-containing compounds. Eur J Oral Sci. 2002; 110:337-40.
38. Eli I, Bath R, Kozlowsky A, Rosenberg M. The complaint of oral malodor: possible psychopathological aspects. Psychosom Med. 1996; 58:156-9.
39. Kurihara E, Marcondes FK. Oral concentration of sulfur compounds in stressed rats. Stress. 2002; 5:295-8.
40. Calil MC, Marcondes FK. Influence of anxiety on the production of oral volatile compounds. Life Sci. 2006; 79:660-4.
41. Silva FT, Prado GB, Ribeiro LCG, Leite JR. The anxiogenic video-recorded Stroop color-word test: psychological and physiological alterations and effects of diazepam. Physiol Behav. 2004; 82:215–30.
42. Bosch JA, De Geus EE, Ring C, Nieuw Amerongen AV, Stowell JR. Academic examinations and immunity: academic stress or examination stress? Psychosom Med. 2004; 66:625–6.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email