Halitosis: A Clinical Review

~ Exam ~

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1. Some of the earliest sound studies on bad breath indicated that the ________ is the source of most halitosis.

  a. gastrointestinal tract

  b. sinus

  c. circulatory system

  d. oral cavity

2. Organoleptic sampling means:

  a. measurement of odor using a sophisticated commercially available machine.

  b. measurement of bleeding and inflammation in the gingival sulcus using a periodontal probe.

  c. relying on the self-report of the patient for estimation of the degree of malodor.

  d. smelling the expired air or other sample of the subject for presence or lack of odor.

3. The currently accepted conclusion is that volatile sulphur compounds (VSC) are the main component of oral malodor.

  a. true

  b. false

4. The advantages of the gas chromatograph include:

  a. individual gasses can be quantified.

  b. gasses are measured even if there are very low concentrations.

  c. it is portable.

  d. a and b

5. Disadvantages of a gas chromatograph include:

  a. (relatively) expensive

  b. personnel need to be trained to use machine

  c. significant amount of time required for measurement

  d. all of the above

6. Industrial sulfide monitor measurements have been shown to be more reproducible and recognized reduction of malodor following mouthrinsing better than organoleptic scores.

  a. true

  b. false

7. Advantages of the sulfide monitor over the gas chromatograph include:

  a. less expensive,

  b. no training required for operation,

  c. portable,

  d. measures quickly so several measurements can be taken consecutively.

  e. all of the above

8. Disadvantages of the sulfide monitor include:

  a. does not separate the gases to measure each sulfide individually,

  b. ethanol or essential oils interfere with the machine’s ability to measure the gasses, so it is not appropriate for studies on mouthwash efficacy,

  c. may need periodic recalibration.

  d. all of the above

9. In most cases, bad breath can be reduced or eliminated by:

  a. proper dental care, oral hygiene, deep tongue cleaning and, if necessary, rinsing with an effective mouthwash.

  b. sinus surgery.

  c. antacid use.

  d. antibiotics.

10. Persistent uncontrollable halitosis may have:

  a. Gastrointestinal ulcers

  b. Internal bleeding

  c. Hiatal hernia

  d. Diabetes mellitus

  e. Any of the above

11. The microorganisms on the tongue and in dental plaque putrefy proteins, mucins, and peptides to release volatile sulfur compounds which are released as gas in the breath.

  a. true

  b. false

12. Malodor is produced in saliva that has a neutral or alkaline pH but is inhibited by an acidic pH. Fermentation of sugars inhibit malodor generation but is the basis of caries formation.

  a. true

  b. false

13. In the study about diamines by Drs. Goldberg, Kozlovsky, and Rosenberg, cadaverine levels were:

  a. associated with odor judge organoleptic scores, plaque index scores, and gingival index scores.

  b. relative to the BANA scores and mean probing depth.

  c. not associated with VSC levels.

  d. all of the above.

14. The following conditions present malodor that is not associated with the bacterial load of the dorsum of the tongue:

  a. Traumatic ulceration

  b. Dental Abscess

  c. Herpetic Infections

  d. Apthous Ulcers

  e. All of the above

15. Medications that can contribute to xerostomia include:

  a. Antihistamines

  b. Anxiolytics

  c. Antipshychotics

  d. Anticholinergics

  e. All of the above

16. Conditions that can contribute to xerostomia include:

  a. Diabetes

  b. Anemia

  c. Vitamin Deficiency

  d. Radiation Treatment

  e. All of the above

17. The following systemic sources can contribute to halitosis:

  a. Pharyngitis

  b. Cirrhosis of the liver

  c. Renal failure

  d. Ulcers

  e. All of the above

18. If halitosis persists after debridement of the tongue and proper dental care (including periodontal treatment if indicated and proper oral hygiene), the patient should be referred to their physician for further investigation of a systemic cause.

  a. true

  b. false

19. A complete medical history does not need to be taken if the patient complains of bad breath.

  a. true

  b. false

20. In a normal examination, five main types of odors can be found emanating from the mouth. Which of these is not one of them?

  a. periodontal-type odor

  b. odor from the posterior tongue dorsum

  c. denture odor

  d. athlete’s mouth odor

  e. characteristic nasal odor

21. Patients who have oral malodor related to dry mouth should be instructed to:

  a. drink extra water.

  b. use a mouthwash containing alcohol.

  c. breathe through their mouths.

  d. all of the above

22. Toothbrush filaments should be made of:

  a. straw

  b. wood

  c. brick

  d. synthetic nylon

  e. natural materials

23. Toothbrush filaments should have filaments:

  a. rounded

  b. straight

  c. square

  d. uneven

24. The Bass Technique or the Modified Bass should be directed apically to the tooth at an angle to the long axis of the tooth.

  a. 60°

  b. 80°

  c. 45°

  d. 35°

25. The tongue’s papillae create an uneven surface.

  a. filiform and fungiform

  b. villiform and williform

  c. rugae and raphae

  d. hydrogen dioxide and methyl mercaptan