What is Halitosis?

What is Halitosis?

Halitosis is the medical term used to describe the presence of an unpleasant odor in the breath, although it is commonly referred to as bad breath.

It is estimated that approximately 30% of the population suffers or has suffered from this problem frequently, regardless of gender, age, or social class.

Halitosis is a problematic condition that has a significant impact on social coexistence and repercussions on the self-esteem of those affected. While there is some concern from the population, there is still widespread misinformation on the subject.

Human breath is a gas of complex composition, which includes multiple volatile compounds.

The factors that determine the occurrence of these compounds are diverse, such as general health status, physical condition, presence of pathologies, eating habits, medication use, environmental factors, and lifestyle.

Thus, the presence of bad breath is an indicator of abnormal bacterial activity or altered physiological mechanisms.

It is estimated that more than 60% of halitosis cases originate from the mouth, while extra-oral causes (respiratory system, digestive tract, and systemic causes) are more complex to diagnose.

In some cases, there is no true halitosis but rather a condition that may induce an altered gustatory and/or olfactory sensation due to factors like reduced saliva secretion, digestive problems, stress, or anxiety, causing a person to believe they have halitosis.

Halitosis should be

Plaque, what is that?

The bacterial plaque is a film, initially invisible, full of bacteria that forms on the teeth, especially at the transition between the tooth and the gum.

The bacteria use the nutrients we ingest in our diet to develop and spread, forming increasingly larger bacterial complexes.

When the bacterial plaque is not properly removed, dental tartar can form, which will be discussed in the next article.

To prevent the formation of bacterial plaque, we should:

• Brush our teeth properly, at least twice a day;
• Use dental floss and/or interdental brushes daily to remove the bacterial plaque that accumulates between the teeth;
• Visit the dentist every 6 months.

Written by Raquel Brandão Carvalho

Bad Breath: How to Combat It?

Halitosis, or bad breath, is an abnormal and unpleasant alteration of the breath and is one of the oldest and most problematic conditions in our society.

It is estimated that between 22% and 50% of the global population suffer or have suffered from bad breath regularly, regardless of gender, age, or social class.

Since this condition has a high prevalence and negative social impact, and being a common complaint in medical-dental offices, it is considered the third most frequent reason for visiting a dentist, after dental caries and periodontal disease (Ren W. et al., 2016; Guedes C. et al., 2019).

According to a study conducted by Gameiro A., 2016, there are several psychosocial variables that mutually influence health and quality of life, as well as the well-being of society in general. Halitosis is pointed out as a real or imaginary change that manifests as a sign and/or symptom due to changes – physiological, adaptive, and pathological, which can be sensory, taste, and/or olfactory – occurring in the body.

However, despite the growing importance given to this issue on a social level, especially due to its significant impact on the quality of life of affected individuals, there is still widespread misinformation on the subject. Furthermore, halitosis continues to be a topic of misunderstanding and mockery in society, causing social, personal, and professional disruption.

The perception of this anomaly has significant psychological consequences, such as visible altered behavior manifestations – covering the mouth while speaking, maintaining greater interpersonal distance, or avoiding social relationships – and on the self-esteem of individuals.

Halitosis has a multifactorial etiology; more than 80 possible causes are identified. However, it is estimated that 90% of halitosis cases in adults and children are directly associated with oral conditions, such as the formation and accumulation of bacterial plaque – coated tongue, poor oral hygiene – salivary changes, dental caries, or periodontal disease; with the main phenomenon being the decomposition of organic matter by anaerobic bacteria present in the oral cavity.

Bad breath can also be associated with respiratory and otolaryngological disorders, such as tonsillitis and sinusitis, metabolic syndromes, as well as gastrointestinal, endocrine, hepatic, or renal pathologies, or even some habits, such as smoking and alcohol consumption, prolonged fasting, or the use of certain medications.

Halitosis has characteristics that make its treatment quite challenging due to its multifactorial etiology. One of the biggest obstacles in treatment approaches is the multiplicity and complexity of the causes, as they can originate from different parts of the body and, consequently, require the involvement of various medical specialties, thus requiring a multidisciplinary approach for effective treatment.

To prevent and/or combat bad breath, here are 10 tips you can follow:

1. Drink water – dry mouth is the ideal environment for the bacteria that cause bad breath; this is because they need low or no oxygen environments to multiply.
2. Reduce the consumption of certain foods – foods such as garlic, onions, and fried foods, for example, have high sulfur content.
3. Avoid acidic foods and sugar – besides dehydrating the body, anaerobic bacteria feed on these substrates.
4. Avoid prolonged fasting – the absence of food for an extended period causes accumulation of epithelial and food remnants on the back of the tongue.
5. Avoid smoking and alcohol – besides causing bad breath, they reduce saliva flow, xerostomia, and may trigger and/or worsen periodontal disease.
6. Chewing gum is not a solution – although it contributes to increased saliva production, it only temporarily freshens the breath and does not address the cause.
7. Brush your teeth and tongue well – inadequate oral hygiene leads to plaque formation, which can cause gingivitis or periodontitis. This, combined with bacteria that promote bad breath, is the recipe for unpleasant odor.
8. Avoid stress – stress increases the release of adrenaline into the bloodstream, which temporarily inhibits the salivary glands, resulting in reduced saliva flow.
9. Visit your general practitioner and have a general check-up – systemic diseases, such as Diabetes Mellitus, or taking certain medications can affect saliva production, causing dry mouth.
10. Consult your dentist periodically.

Schedule your evaluation appointment and find out how we can help!

Dr. Raquel Brandão Carvalho

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Bruxism, after all, what is it?

Bruxism is defined as an unconscious or involuntary action of grinding the teeth, typically during sleep.

It is, in fact, a disorder characterized by both grinding and clenching the teeth involuntarily, causing strain on the chewing muscles, which can lead to tooth wear, thereby compromising oral health.

The causes are not fully defined, although they are mainly associated with the following:

• Anxiety;
• Stress and/or frustration;
• Dental misalignment;
• Side effects of medications – (e.g., antidepressants);
• Complications of systemic diseases;
• Excessive alcohol or caffeine consumption;
• Smoking habits.

The main symptoms identified are:

• Headaches;
• Pain/discomfort in the temporomandibular joint (area in front of the ear);
• Pain in the chewing muscles (waking up with the sensation of having been chewing all night);
• Limited mouth opening;
• Stiffness in the shoulders and neck;
• Tooth wear (in later stages);
• Sleep disturbances.

The important thing is to find out if you suffer from this parafunction to stop its effects as early as possible. How is it diagnosed? If you sleep with a partner, ask if you grind your teeth (make noise). Additionally, during the consultation, the dentist can observe some characteristic signs of bruxism, which can be further confirmed with a sleep study.

The consequences of bruxism can be controlled with some behavioral changes and the use of a myorelaxant mouthguard, which protects the teeth from wear and reduces muscle activity. The mouthguard is a quick solution that minimizes pain, if any, and prevents permanent damage. However, the origin of the bruxism should always be investigated so that it can be treated.

Written by Raquel Brandão Carvalho

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So, what is Tartar?

Dental tartar is the calcification of bacterial plaque (described in the previous article) or dental biofilm that forms on the surface of the teeth. It can also form beneath the gums (subgingival tartar).

Since tartar is porous, it promotes a faster and greater spread of bacterial plaque (which adheres more easily), which, in turn, can facilitate the development of cavities, gingivitis, periodontitis, and bad breath.

The presence of tartar in the oral cavity not only harms dental and periodontal health but can also become an aesthetic problem. Unlike bacterial plaque, which can and should be removed daily by patients, tartar must be removed in the dental office by the dentist.

And how can we prevent the formation of dental tartar?
Simply by proper brushing – which will be described in the next article…

Written by Raquel Brandão Carvalho

What is Oral Cancer?

Oral and oropharyngeal cancer is the 6th most common cancer in the world and is classified as a group of malignant tumors that occur in the oral cavity, lips, and/or throat, including the tonsils and pharynx. The most frequent locations are the floor of the mouth (mucosa under the tongue), lateral border of the tongue, and soft palate.

Oral cancer most commonly occurs in men after the 4th decade of life, and tobacco consumption is the primary causal factor for oral cancer, especially when combined with excessive alcohol consumption.

Approximately 80% of patients diagnosed with oral cancer have a history of smoking. Therefore, smokers have a 5 to 7 times higher risk of developing this condition compared to non-smokers.

Late diagnosis is largely responsible for the high mortality rate. About 6 in every 10 patients die within 5 years of their diagnosis. However, with early detection and timely and appropriate treatment, the 5-year survival rate can increase.

It is important to be aware and know that oral cancer can manifest in different forms, such as white or red patches, hardened masses, ulcers, or persistent nodules, dental mobility, pain, paresthesia (loss of sensitivity), difficulty or pain when chewing and/or swallowing, bad breath, speech problems, tissue growth areas, enlarged lymph nodes (lymphadenopathy), among other signs and symptoms. Most lesions are painless initially, becoming progressively painful.

The treatment for oral cancer is carried out with surgery and/or radiotherapy, and the earlier it is detected, the simpler and quicker the recovery will be. Therefore, it is crucial to conduct an appropriate diagnosis through a visual examination and palpation of the oral and adjacent (perioral) structures, along with complementary exams such as radiographs, CT scans, among others. In inconclusive cases, a biopsy of the lesion is recommended to confirm the diagnosis.

Many of the signs and symptoms of oral cancer are common to other diseases, so it is essential to report them to your family doctor and/or dentist.

The key to treatment is early diagnosis, so screen for and prevent oral cancer. And how to do it? Visit your dentist at least twice a year.

Written by Raquel Brandão Carvalho

Christmas – Take Care of Your Oral Health: 5 Tips to Save Your Teeth

December is the season of sweets and excesses.

Therefore, we should take some precautions during this month to take good care of our teeth and oral health!

• Eat sweets during meals, preferably after lunch, and avoid chocolates before going to bed;

• Stay well-hydrated;

• Do not cut/tear gift ribbons with your teeth;

• Stick to your oral hygiene routine – brush your teeth at least twice a day for 2 minutes. Don’t forget the dental floss and/or interdental brush;

• Schedule a routine appointment with your Dentist for the beginning of next year.

Dr. Raquel Brandão de Carvalho

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How to Clean Prostheses on Dental Implants

Clínica Zenha Blog

Oral Hygiene

A safe solution for replacing one or more lost teeth is the placement of dental implants and, later, rehabilitation on dental implants.

The oral hygiene care we take with rehabilitations over dental implants should be as strict or even more demanding than with our natural teeth, in order to avoid the accumulation of bacterial plaque and, thus, prevent the development of surrounding diseases such as peri-implant mucositis or peri-implantitis.

The variety of oral hygiene tools is vast, and therefore it is necessary to know the available instruments and understand how to use them in order to clean as efficiently as possible.

Toothbrush

The toothbrush can be manual or electric. It contributes to the mechanical control of bacterial plaque, but it is not sufficiently effective in completely removing bacterial plaque, for which complementary instruments are needed.

A frequent question is whether electric toothbrushes are as or more effective than manual ones. The fact that they have a smaller head makes it easier to clean hard-to-reach areas, such as the back faces of the last molars. Therefore, it can be a more advantageous alternative.

Never forget, brushing should be done at least 2 times a day.

Complementary Instruments

There is a wide variety of instruments that complement brushing. They should be used twice a day, and their use should be adapted to the type of rehabilitation and the manual dexterity of each user.

1. Dental Floss

Dental floss is essential for interdental cleaning. There are specific flosses for dental implants that allow cleaning around the dental implant. It should be inserted on both sides, covering the entire surface area, sliding gently towards the gum.

2. Interdental Brushes

Like dental floss, interdental brushes clean between the teeth. The great advantage of using interdental brushes is that they allow easier removal of bacterial plaque in narrow areas or hard-to-reach spaces, as they require less manual dexterity compared to dental floss.

There are various sizes available. The goal is for the interdental brush to fit well in the existing space. Therefore, different sizes may be necessary depending on the various interdental spaces.

If you have any doubts about the most suitable choice, speak to your dentist.

3. Irrigation System (Water Jet)

Irrigation systems help remove bacterial plaque and can be used with either water or antiseptic solutions. They are very useful for cleaning hard-to-reach areas where other tools cannot reach on their own.

They are easy and safe to use, but they do not replace brushing and other complementary instruments.

The maintenance of rehabilitations on dental implants largely depends on plaque control, making it essential to use and combine various oral hygiene tools. However, to ensure safe and effective use, proper instruction and motivation from patients are necessary.

If you still have any questions about this topic, schedule an appointment today.

Dr Raquel Brandão Carvalho

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Do you have bad breath? Here’s how to get rid of it

Bad breath, also known as Halitosis, affects the quality of life of individuals as it has a significant impact on social, personal, and professional interactions, resulting in a reduction in self-esteem.

The causes of bad breath are diverse:

• General health condition;
• Physical condition;
• Presence of oral and/or systemic diseases;
• Dietary habits;
• Medications;
• Environmental factors;
• Lifestyle.

So, how can we treat and/or reduce bad breath?

Drink water

A dry mouth is the ideal environment for the bacteria that cause bad breath. This is because they are anaerobic, meaning they thrive in environments with little to no oxygen.

For this reason, it is important to drink at least 8 glasses of water a day.

Avoid acidic foods and sugar

Avoid acidic and sugary drinks like sodas and coffee, as bacteria feed on these substrates. Additionally, they dehydrate the body.

Maintain good oral hygiene

Inadequate oral hygiene leads to plaque formation, and as we discussed earlier, it can lead to gingivitis or periodontitis.

This situation, combined with the presence of bacteria that promote bad breath, is the recipe for unpleasant odor. Don’t forget to brush your tongue.

Get a check-up

S systemic diseases, such as Diabetes Mellitus, or taking certain medications, can affect saliva production, causing dry mouth. Visit your family doctor and get a general check-up.

Avoid smoking and alcohol

Besides causing bad breath directly, they reduce saliva flow and can induce and/or worsen periodontal disease.

Dr. Raquel Brandão Carvalho

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4 Tips for an Envious Smile

Our smile is essential for ensuring our well-being. And to make sure nothing goes wrong and you have even more reasons to smile, here are four simple tips you should follow to have a healthy and enviable smile.

1. Care with your diet

• Be cautious with soft drinks and ice creams – these sugary foods are increasingly consumed during this season.

These foods stimulate the proliferation of oral bacteria, forming the biofilm (plaque) more easily and quickly, which can result in future problems.

• Enrich your diet with fruits and vegetables – fruits like apples and pears help with the mechanical cleaning of teeth.

Citrus fruits like oranges are rich in vitamin C, which helps in the formation of collagen and, consequently, the proper maintenance of gum tissue, but be cautious as consuming them in excess can contribute to acid erosion, leading to the loss of structure and increased tooth sensitivity.

• Moderate the consumption of coffee, tea, soft drinks, and any other highly pigmented food – these can lead to tooth discoloration.

• Don’t overconsume alcohol – the presence of alcohol in the mouth reduces saliva production, leading to more plaque buildup, increasing the risk of cavities and other oral issues, such as bad breath.

2. Don’t neglect oral hygiene

• It’s never too much to remind that the success of oral hygiene lies in two factors: technique and brushing frequency.

No matter how often you brush your teeth, if you don’t do it properly, meaning if you don’t use a good technique, plaque removal may not be effective, increasing the probability of oral issues.

• Don’t forget about cleaning between the teeth, and this can only be done with dental floss and/or interdental brushes.

This procedure should be applied in all interdental spaces as a complement to brushing, at least once a day.

• Brushing your tongue should be part of your daily routine. That’s where many bacteria and food residues accumulate.

Did you know that the tongue could be the cause of that persistent bad breath?

What to do when you don’t have time to brush your teeth? As a solution, you can chew a sugar-free gum or one containing xylitol (a natural sweetener). This will increase saliva production and provide an instant cleaning effect.

3. Whiter teeth

We all desire a beautiful smile and white teeth, as they are considered a symbol of beauty, health, and even youth.

Anyone with good oral hygiene and healthy teeth can undergo teeth whitening, achieving a whiter, more uniform smile in a fast, effective, and safe manner.

4. A new smile

Sometimes, the smile we desire cannot be achieved with just teeth whitening, as some correction of minor imperfections, such as position, alignment, shape, or even color, is needed.

However, there are several solutions, such as the placement of dental veneers.

Dental veneers work as thin “covers” that are applied and bonded to natural teeth, thus transforming your smile.

It’s important to emphasize that you should never neglect your oral health, as all the care you take should not change, no matter the season.

Therefore, don’t forget to have regular check-ups with your dentist, at least every 6 months, to detect any problems early. And always remember, smiling is the best remedy.

Got questions? Then talk to us, we’re here to help!

Dr. Raquel Brandão Carvalho

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