A Simple Guide to Halitosis

A Simple Guide to Halitosis(Bad Breath)
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What is Halitosis?
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Halitosis is the condition when a person suffers from chronic bad breath.

What are the causes of Halitosis?
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Halitosis is usually caused by the following:

Infections:
1.bacterial infection of the gums, dental cavities.(600 types of bacteria
present in mouth)

2.anaerobic infections of the mouth,

3.Infection of the tonsils, nose and sinuses(postnasal drip)

Gastric problems and indigestion:
1. Indigestion of food in the stomach can cause the undigested food in the stomach to emit an offensive smell through the mouth

2.gastroesophageal reflux of food can also cause the smell of acid and undigested food in the mouth

Certain food:
1.garlic and onions which has odious suphur compounds can give rise to foul smell from the mouth

2.fish

3.cheese

4.alcohol

Smoking:
Cigarettes smokes contains 40 over chemicals which cause bad mouth smell

Dry mouth:
1.Insufficient drinking of water

2.medications can cause dry mouth and produces a smell from the mouth

Systemic diseases:
1.liver failure.

2.Lower respiratory tract infections

3.Renal infections and renal failure.

4.Carcinoma.

5.Trimethylaminuria ("fish odor syndrome").

6.Diabetes mellitus.

What are the symptoms and signs of Halitosis?
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Persons who has Halitosis has the following
Symptoms:
1.Bad breath

2.Dry mouth

Signs:
1.discharge from nose or tonsils

2.furry tongue

How do you diagnose Halitosis?
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Diagnosis can usually be made by :
1.History of bad breath

2.lick the back of the wrist, let the saliva dry for a minute, and smell the dried saliva.

3.scrape the posterior back of the tongue with a plastic disposable spoon and smell the drying residue.

4. Halimeter: a portable sulfide monitor to test for levels of sulfur emissions (especially hydrogen sulfide) from the mouth.

5.BANA test: find the salivary levels of an enzyme which shows the presence of certain halitosis-related bacteria

5.ß-galactosidase test: the presence of this enzyme in the saliva indicates presence of bad breath

What is the treatment of Halitosis?
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1.Approprate Antibiotics, antifungal for infections of mouth

2.drinking several glasses of water a day prevents dryness of mouth

3.Eating a healthy breakfast helps clean the back of the tongue

4.Proper oral hygience after eating: brushing of teeth and flossing. Dentures should be removed at bedtime and soaked overnight in antibacterial solutions.

5.Avoid smoking

6.Gargle mouth after every meal.
Avoid the use of alcohol based mouth wahes.
Use instead oil based mouth washes.

7.Chewing sugarless gums helps to stimulate production of saliva and hence less bad breath

8.Treat underlying condition such as diabetes, liver, kidney and other conditions.

What is the prognosis of Halitosis?
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Prognosis is usually good with proper oral hygiene.

Recurrence is quite common.

A Simple Guide to Bacterial Vaginosis

A Simple Guide to Bacterial Vaginosis
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What is bacterial vaginosis?
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Bacterial Vaginosis (BV) is a condition in women where the normal balance of lactobacillus bacteria in the vagina is disrupted and replaced by an overgrowth of high concentrations of anaerobic bacteria (e.g., Prevotella sp. , Mobiluncus sp.), G. vaginalis, and Mycoplasma hominis.
The condition is characterised by vaginal discharge, odor, pain and itching.
Bacterial Vaginosis is the most common vaginal infection in women after puberty.

How is bacterial vaginosis spread?
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BV is associated with an imbalance in the lactobacillus bacteria in a woman's vagina. The cause of this imbalance is not known.
Some possible causes of this imbalance are:

1.Having multiple sex partners or a new sex partner

2.Vaginal Douching which alter the pH and bacterial flora of vagina

3.Using an intrauterine device for preventing pregnancy.

Women that have never had sexual intercourse are rarely affected.

What are the symptoms of bacterial vaginosis?
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Women with typical Bacterial Vaginosis symptoms have:

1.an abnormal vaginal discharge with an unpleasant fish-like odor especially after intercourse.
The discharge is usually greyish, semiadherent, homogeneous.
Sometimes it can be thin,cream to green in colour and frothy.

2.burning sensation during urination

3.itching around the outside of the vagina,

More than 50% women with BV report no symptoms at all.

What are the complications of bacterial vaginosis?
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In most cases, there are no complications.
Some serious complications from BV include:

1.pelvic inflammatory disease (PID) especially after surgery like hysterectomy
2.endometritis,

3.increased susceptibility to other STDs, such as chlamydia, gonorrhea and HIV.

4.increased risk for some complications of pregnancy such as ectopic pregnancy and premature births.

How is bacterial vaginosis diagnosed?
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1.vagina examination for homogeneous, thin, white discharge that smoothly coats the vaginal walls;

2.laboratory tests on a sample of vaginal fluid:

a.presence of clue cells on microscopic examination;

b.pH of vaginal fluid >4.5;

c.fishy odor of vaginal discharge before or after addition of 1% KOH (the whiff test).

d.Gram stain is used to detect the relative concentration of lactobacilli (long Gram-positive rods), Gram-negative and Gram-variable rods and cocci ( G. vaginalis, Prevotella, Porphyromonas, and peptostreptococci), and curved Gram-negative rods (Mobiluncus) characteristic of BV.

What is the treatment for bacterial vaginosis?
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All women suspected of BV should be treated to avoid such complications as Pelvic Inflammatory Disease.
Treatment is especially important for pregnant women.
All pregnant women who have symptoms of BV should be checked and treated.

BV is treatable with antibiotics :
metronidazole 500 mg orally twice a day for 7 days
OR
Metronidazole gel, 0.75%,5 g intravaginally, once a day for 5 days
OR
Clindamycin 300 mg orally twice a day for 7 days
OR
Clindamycin cream, 2%,5 g intravaginally at bedtime for 7 days

Either can be used with non-pregnant or pregnant women, but the recommended dosages differ.
Patients treated with metronidazole should be advised to avoid consuming alcohol for 24 hours.
BV can recur after treatment.

How can bacterial vaginosis be prevented?
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Since BV is seldom found in women who have never had intercourse.and is associated with having a new sex partner or having multiple sex partners, prevention measures are aimed at sexual transmission:

1. Abstain from sex

2.Do not have multiple sex partners.

3.Do not use vaginal douche.

4.Take all of the medicine prescribed for treatment of BV even if there are no more symptoms.