Medical preparation
Before seeing a doctor, don't use any drugs and fresheners, such as mouthwash, spray, or chewing gum, mint tablets and other things that can cover up bad breath.
Don't eat durian, garlic, leek and other foods with strong smell. Before seeing a doctor.
Medical department
According to the patient's personal situation and medical history, the departments that often see a doctor are stomatology, otolaryngology, gastroenterology, respiration, psychology, endocrinology and nephrology.
Related inspection
Sensory evaluation method
The clinical examination or evaluation of halitosis usually adopts subjective examination, that is, "sensory evaluation", which is regarded as the "gold standard".
Smell directly
Check the bad breath in the mouth, and the examiner (usually a doctor) directly smells the breath exhaled by the patient to make an evaluation.
The inspection method is: when the examiner puts his nose at a distance of 10cm from the patient's mouth, avoid breathing, so as to better check the patient's oral odor. The patient counts from 1 to 10, and the examiner continuously smells the air exhaled by the patient and scores it.
Check the bad breath: let the patient breathe with his mouth closed and let the examiner evaluate his senses.
Saliva odor test (same as wrist licking test)
The patient licks his wrist, leaving saliva and letting it dry 10 second. After the examiner smells the wrist, he makes an evaluation.
Tongue coating odor test
Scrape the tongue coating off the back of the tongue with a tasteless spoon and smell it.
Paper bag collection method
Generally speaking, both the examiner and the patient may feel embarrassed to directly evaluate the exhaled gas in the mouth and nasal cavity, or they may ask the patient to exhale into the paper bag, and then the examiner will check the smell in the bag.
The advantage of sensory evaluation is that no equipment is needed, and various smells can be found through the inspector's sense of smell; Experienced examiners can also find related diseases that may exist in patients through different smells.
The disadvantage is that the whole exam is subjective and lacks quantitative standards. Different nose sensitivities of examiners will lead to different test results and poor repeatability of test results.
Objective measurement method
gas chromatography
It can analyze any volatile components in air, cultured saliva, tongue coating fragments or oral saliva, and it is highly specific to sulfide, the main component of halitosis, and can be detected even at low concentration.
The advantages are objective, repeatable and reliable results. However, the machines needed for testing are expensive, bulky and require well-trained operators, so they cannot be used in daily life and are currently limited to research.
Portable volatile sulfide monitor
Simple operation and good repeatability, but it is only sensitive to sulfur compounds, and there are many other substances besides sulfide in halitosis, so it is impossible to accurately evaluate halitosis.
In addition, there are other objective methods to measure halitosis, such as saliva incubation test and tongue sulfide probe, but they are rarely used in routine clinic because they are expensive and time-consuming.
diagnose
Under normal circumstances, the doctor will first judge whether the patient really has bad breath, and then ask the patient about the history of bad breath, including the time and frequency of bad breath, duration, accompanying symptoms, eating habits, medication history, past medical history and so on. Make a preliminary judgment first.
For pathological halitosis, the causes of halitosis are preliminarily judged by combining the medical history and accompanying symptoms, and the patients are instructed to go to a suitable specialist to treat the primary disease related to halitosis.
disease diagnosis
The most common causes of halitosis are oral periodontal disease, nose and throat diseases, respiratory diseases, gastrointestinal diseases, systemic diseases and so on. Combined with the patient's medical history, accompanying symptoms, signs and examination results, the corresponding diagnosis can be made.
differential diagnosis
It is worth noting that the causes of halitosis are very complicated, and patients' halitosis is often not caused by a single factor. Physiological halitosis caused by food, tobacco and alcohol and bad oral hygiene habits often coexists with disease factors. In clinical diagnosis, the patient's medical history, medication history, living habits, etc. A comprehensive inquiry should be made in order to find out the possible diseases that cause bad breath in time.
treat cordially
For patients with non-physiological halitosis, it is necessary to remove the cause of halitosis through clinical treatment. Including pathological halitosis and "false" halitosis caused by psychological factors.
Family handling
Scraping and washing the tongue coating: research shows that cleaning the tongue coating can remove 45%~75% sulfide, thus reducing bad breath.
Flossing: Not flossing often leads to dental plaque, which leads to a high probability of bad breath.
Masking odor: Antibacterial mouthwash, oral awake spray, chewing gum and mint tablets can temporarily mask bad breath.
Professional therapy
For oral diseases, oral specialist treatment should be carried out; For nasopharynx and larynx diseases, choose corresponding treatment methods according to different diseases; Patients with gastrointestinal diseases associated with Helicobacter pylori infection can be treated with drugs. If the patient has endocrine or other systemic diseases, these potential diseases should be treated; For mental patients who consciously have bad breath, it is recommended to have psychological counseling or related drug treatment.