Treatment of Oral and Nonoral Sources of Halitosis in Elderly Patients

Summary

The increasing number of older patients being seen in medical and dental offices in the industrialised world emphasises the need for a thorough understanding of the normal aging process. Additionally, close attention must be paid to the disease processes that affect this special needs population. Although there are many positive psychosocial issues associated with the aging patient, many diseases and disabilities associated with the aging process place an increased burden on the elderly patient. The relationship between general and oral health must be understood by the practitioner if therapies are to be effective.

Although it is not the objective of this article to provide a comprehensive review of oral healthcare, an attempt will be made to provide general information on the diagnosis and treatment planning for oral malodours often associated with poor oral and/or systemic health. Every healthcare provider treating the elderly patient for oral malodours must recognise that there is potentially a direct relationship between the oral and systemic health of the patient. While most oral malodours have a simple cause, no single therapy is always effective. For best results, a team approach to diagnosing and treating oral malodours involves the dentist, physician, dietician and pharmacist. This multidisciplinary approach should be arranged before the onset of any complex therapy. When indicated, supportive, responsible family members should be additionally involved to assure patient compliance.

The mouth and teeth can be a source of great pride and pleasure. A beautiful smile is one of the most pleasant greetings a human can offer. Enjoying a meal of fine food and drink is truly gratifying. Unfortunately, the oral hard and soft tissues can also be a source of pain, social discomfort and disease. Additionally, the mouth can be a valuable diagnostic tool. In fact, the oral environment has long been recognised as a potential early indicator of systemic disease. Unfortunately, in the presence of systemic or oral disease, the mouth and surrounding structures can be a source of a significant social problem — disagreeable breath odours. In severe cases, oral malodours can lead to social isolation and ostracism.