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Halitosis, colloquially called bad breath, or fetor oris, is a symptom in which a noticeably unpleasant odor is present on the exhaled breath. Concern about halitosis is estimated to be the third most frequent reason for people to seek dental care, following tooth decay and gum disease; and about 20% of the general population are reported to suffer from it to some degree. Not all who think they have halitosis have a genuine problem. Of those who feel they have halitosis, significant percentages (5‑72%) have been reported to have no genuine halitosis when professionally examined. Of those who have genuine halitosis, often the odor is caused by bacteria present below the gumline and on the back of the tongue. The remaining 10% is accounted for by many different conditions, including disorders in the nasal cavity, sinuses, throat, lungs, esophagus, stomach or elsewhere. See the related article on tonsilloliths for another possible cause of halitosis. Very rarely, halitosis can be one of many symptoms of a serious underlying medical condition such as liver failure; but, in the vast majority of cases, the cause is minor and can often be reduced by adjustments to oral hygiene, including brushing or gently scraping the back of the tongue and improving the health of the gums by using dental floss. Occasionally, however, especially if the origin of the odor is not in the mouth, halitosis can be more difficult to diagnose and to manage successfully. Bad breath is a social taboo; and, as a result, perceived or genuine halitosis can sometimes trigger social anxiety and depression. == Classification == Two main classification schemes exist for halitosis, although none is universally accepted.〔 The Miyazaki ''et al.'' classification was originally described in 1999 in a Japanese scientific publication, and has since been adapted to reflect North American society, especially with regards halitophobia. The classification assumes three primary divisions of the halitosis symptom, namely genuine halitosis, pseudohalitosis and halitophobia. This classification has been suggested to be most widely used,〔 but it has been criticized because it is overly simplistic and is largely of use only to dentists rather than other specialties. * Genuine halitosis * *A. Physiologic halitosis * *B. Pathologic halitosis * * *''(i) Oral'' * * *''(ii) Extra-oral'' * Pseudohalitosis * Halitophobia The Tangerman and Winkel classification was suggested in Europe in 2002. This classification focuses only on those cases where there is genuine halitosis, and has therefore been criticized for being less clinically useful for dentistry when compared to the Miyazaki ''et al.'' classification. * Intra-oral halitosis * Extra-oral halitosis * * A. Blood borne halitosis * * * ''(i) Systemic diseases'' * * * ''(ii) Metabolic diseases'' * * * ''(iii) Food'' * * * ''(iv) Medication'' * * B. Non-blood borne halitosis * * * ''(i) Upper respiratory tract'' * * * ''(ii) Lower respiratory tract'' The same authors also suggested that halitosis can be divided according to the character of the odor into 3 groups:〔 * "Sulfurous or fecal" caused by volatile sulfur compounds (VSC), most notably methyl mercaptan, hydrogen sulfide and dimethyl sulfide. * "Fruity" caused by acetone, present in diabetes. * "Urine-like or ammoniacal" caused by ammonia, dimethyl amine and trimethylamine (TMA), present in trimethylaminuria and uremia. Based on the strengths and weaknesses of previous attempts at classification of halitosis, an etiologic classification has now been proposed: * Type 0 (physiologic) * Type 1 (oral) * Type 2 (airway) * Type 3 (gastroesophageal) * Type 4 (blood-borne) * Type 5 (subjective) Any halitosis symptom is potentially the sum of these types in any combination, superimposed on the physiologic odor present in all healthy individuals.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Halitosis」の詳細全文を読む スポンサード リンク
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