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Bad Breath

(Halitosis)

OVERVIEW

•  Offensive odor coming from the mouth; bad breath (halitosis)

Signalment/Description of Pet

•  Dogs
•  Cats
•  Small breeds and short-nosed, flat-faced breeds (known as “brachycephalic breeds”) are more prone to disease involving the mouth, because their teeth are closer together
•  Older pets are more likely to have bad breath (halitosis) than are young pets

Signs/Observed Changes in the Pet

•  Bad breath or halitosis is a sign itself
•  If due to oral disease, excessive salivation (known as “ptyalism”), with or without blood, may be seen; the pet may paw at the mouth; and lack of appetite (anorexia) may occur
•  In most cases, no clinical signs other than actual odor are observed

Causes

•  Metabolic—diabetes mellitus (“sugar diabetes”), uremia (excess levels of urea and other nitrogenous waste products in the blood)
•  Respiratory—inflammation of the nose or nasal passages (known as “rhinitis”); inflammation of the sinuses (known as “sinusitis”); cancer
•  Gastrointestinal—enlargement of the esophagus (the tube going from the throat to the stomach; condition known as “megaesophagus”); cancer; foreign body
•  Dermatologic—infection of the skin folds of the lips (known as “lip-fold pyoderma”)
•  Dietary—eating malodorous or offensive-smelling foodstuffs; eating feces or bowel movement (known as “coprophagy”)
•  Disease of the mouth—infection of the gums and supporting tissues of the teeth (known as “periodontal disease”) and/or ulceration of the tissues of the mouth; inflammation of the throat or pharynx (known as “pharyngitis”); inflammation of the tonsils (known as “tonsillitis”); cancer; foreign bodies
•  Trauma—electric-cord injury, open fractures, caustic agents
•  Infectious—bacterial, fungal, viral
•  Autoimmune diseases
•  Diseases characterized by one or more masses or nodular lesions in the mouth containing a type of white-blood cell, called an eosinophil (known as “eosinophilic granuloma complex”)

Risk Factors

•  Small breeds and short-nosed, flat-faced breeds (known as “brachycephalic breeds”) are more prone to disease involving the mouth, because their teeth are closer together; smaller pets live longer; and their owners tend to feed softer food

Treatment

Health Care

•  Outpatient
•  Once the specific cause of the bad breath (halitosis) is known, direct therapy at correcting the cause; it is possible that multiple causes may be involved (for example, the pet may have infection of the gums and supporting tissues of the teeth [periodontal disease] and have a foreign body or cancer present in the mouth)
•  Dental disease—assessment of the mouth, performed under general anesthesia, with x-rays of the mouth (known as “intraoral radiographs”) and treatment, including cleaning and polishing the teeth and extraction of teeth with greater than 50% loss of supporting tissues (gum and bone) around the teeth (often multiple teeth are extracted when advanced periodontal disease is the cause of the bad breath (halitosis)
•  Cancer of the mouth—surgical debulking (removing as much of the tumor as possible) or removal; radiation therapy; other cancer therapies, based on type of cancer
•  Foreign body—removal of foreign body (may require anesthesia)
•  Dermatologic causes—treatment for infection of the folds of the lips may include antibiotics, antibacterial shampoos, and possible surgery to remove some of the folded tissue
•  Dietary causes—prevent pet from eating malodorous foodstuffs (for example, keep pet away from garbage); prevent pet from eating bowel movement (for example, block off litter box so dog cannot get to cat feces; clean yard frequently)

Follow-Up Care

Patient Monitoring

•  Periodic examinations to monitor results of dental professional and home care

Preventions and Avoidance

•  Varies with underlying cause
•  Daily brushing or friction wipes to remove plaque (the thin, “sticky” film that builds up on the teeth) and control dental disease and odor
•  Prevent pet from eating malodorous foodstuffs (for example, keep pet away from garbage); prevent pet from eating bowel movement (for example, block off litter box so dog cannot get to cat feces; clean yard frequently)

 Key Points

•  Bad breath or halitosis is a sign; it is an offensive odor coming from the mouth
•  Bad breath (halitosis) generally indicates an unhealthy mouth
•  Once the specific cause of the bad breath (halitosis) is known, direct therapy at correcting the underlying cause
•  Ensure good oral health by professional and home dental care (such as brushing teeth) to decrease bad breath (halitosis)

 

 

Blackwell’s Five-Minute Veterinary Consult: Canine and Feline, Fifth Edition, Larry P. Tilley and Francis W.K. Smith, Jr. © 2011 John Wiley & Sons, Inc.