HalitosisIsolation

Caring for those who can’t

A dental hygienist is a state

licensed professional dedicated

to education and providing oral

care.

Halitosis

Halitosis

Where does it come

from?

Stomach

Teeth

Tongue

Sinuses

Loneliness

Isolated by a

wall of stink

Quality of LifeOut of place

New surroundings

Isolated by breath

Protect yourself

Yeah, right

Bad breath

Isn’t funny

No dignity

Not Healthful

Caustic chemistry

Bacteria

Small amount from stomach

Tongue

Teeth

Bacteria break down tissue

Bacteria

Cadaverine

Hydrogen sulfide

Methyl mercaptan

Volatile Sulfur Compounds

Cadaverine

Hydrogen sulfide

Methalmercaptan

VSC

Toxic gas

CNA

QoL

VSC

Toxic gas

Other residents

QoL

Perio infections

• Subgingival biofilm

Coated tongue

• Harbors micro-organisms

Unclean dentures

• Odor causing biofilm

Oral pathology

• Oral cancer

Throat infection

• Strep throat or yeast

Non-oral origins

Renal or hepatic failure

Carcinomas DiabetesUpper

respiratoryinfections

Foods

Lack of saliva

Polypharmacy

Polypharmacy

Nearly all medications

reduce saliva

Average number of

medications per

resident is 8

Polypharmacy

The combination of

drugs that all cause

dry mouth contribute

to halitosis

Saliva’s job

Buffer acids created

by bacteria

Dilute bacterial

byproducts

Overgrowth of bacteria

Produce gases

Gases are exhaled into the

atmosphere

Volatile Sulfur Compounds

Dangerous gasses

Destroy tissues

Harmful if inhaled

VSCHydrogen sulfide

• Significant H2S poisoning

usually occurs by inhalation.

• Local irritant effects, along

with arrest of cellular

respiration, may follow.

• Effects similar to cyanide

toxicity.

• Easily penetrates biologic

membranes.

Cadaverine

Hydrogen sulfide

Methalmercaptan

VSCHydrogen

sulfide

• As a cellular poison, H2S

affects all organs, particularly

the CNS and pulmonary

system.

• The spectrum of illness

depends on the concentration

and duration of exposure.

Cadaverine

Hydrogen sulfide

Methalmercaptan

VSCMethyl

mercaptan • Methyl mercaptan is a natural

substance released from decaying

matter.

• Little is known about the health

effects of this compound.

• This chemical has been found in at

least 2 of the 1,300 National

Priorities List sites identified by the

environmental Protection Agency

(EPA).

Cadaverine

Hydrogen sulfide

Methalmercaptan

VSC

Cadaverinen a foul-smelling diamine

formed by bacterial

decarboxylation of lysine.

Cadaverine is poisonous

and irritating to the skin.See also ptomaine

Cadaverine

Hydrogen sulfide

Methalmercaptan

VSC

Cadaverine • n a foul-smelling

diamine formed by

bacterial

decarboxylation of

lysine. Cadaverine is

poisonous and

irritating to the skin.• See also ptomaine

Cadaverine

Hydrogen sulfide

Methalmercaptan

Cures

Mouthwash

Difficult to use

Expensive

Alcohol

Cures

Xylitol

Stops biofilm from growing

Not enough bacteria to cause

damage

Many forms

Cures

Xylitol

Safe for use with diabetes

Fewer calories than sugar

Cures

Removing biofilm

Between teeth

Every dayAt least

the front of teeth

From tongue

Cures

Diet Changes

Raw foods

Avoid smoking

Low carbs - diabetes

Less simple sugar

Cures

Hydration

Foods with high water

content

Chew gum Drink water

Simplify bathroom

Professional Oral Care

These results suggest that POHC by dental hygienists is effective in preventing respiratory infections in elderly persons requiring nursing care.

Cumulative Effects

Cumulative effects of

inhaling halitosis have

not been studied.

It’s up to all of us

Ask how to provide

better oral care.

Dental hygienists

are here to help.

Conclusion

Bad breath is not inert

Poisonous gases are

emitted from decaying

food and gum tissue in

the mouth

Dependent adults are at

risk for inhaling those

gases.

Find out the laws restricting dental hygienists in your state!

Mandating a dental hygienist on the staff of all Medicaid funded care facilities can save millions of dollars a year just in people with diabetes.

Credits

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ScriptShirley Gutkowski, RDH, BSDH, FACE

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Copyright 2011 Exploring Transitions, LLC