It is known that almost one-third of patients who seeks treatment for bad breath do not have genuine halitosis. Halitosis can occur even in cases when the malodor is not perceived by those around the patient and can neither be confirmed by organoleptic tests, nor by sulfur portable monitor readings. In such cases, these patients have been considered as halitophobic or have pseudo-halitosis. The complaint might signal the existence of a chemosensory dysfunction. Factors associated with taste and smell perception can be potentially connected to the occurrence of oral malodor. The threshold values of volatile sulfur compounds that have been used to establish the diagnosis of genuine halitosis do not take into account that the patient may perceive low levels of these and of other volatile compounds through retronasal olfaction. The current concept of halitosis requires the presence of a signal that has been based on equipment results, from the olfactory perception of the examiners and of those who interact with the patient. Nevertheless, the concept does not encompass the symptoms of halitosis. This paper addresses some of the possible causes of chemosensory dysfunction and proposes a new definition for halitosis.

Resumo A Saúde Bucal Pública no âmbito da SESDF inseria-se no contexto de fragmentação, do qual toda rede padecia. Não havia integração entre as equipes de saúde bucal e os demais profissionais na Atenção Primária e os outros níveis atuavam de forma errática e insular, impedindo o efetivo estabelecimento da Rede de Atenção. Em 2017, a gestão à frente da pasta optou por converter o sistema organicamente com base na estratégia saúde da família e na lógica das redes de atenção. O presente estudo tem por objetivo relatar quais as principais ações postas em prática para que a saúde bucal pudesse acompanhar a conversão, evoluindo para construção da Linha de Cuidado específica da área, permitindo a ampliação do acesso e a qualificação da Atenção .

Objectives. To establish referential values ranges of hyposalivation and normosalivation for the salivary flow rate (SFR) of upper labial (LS) and palatal (PS) mucosa using Schirmer's test strips paper and as a second goal to determine the values ranges of the SFR of palatal (PS) and upper labial (LS) mucosa in subjects with and without xerostomia. Methods. A cross-sectional study was conducted among subjects distributed in three groups according to their unstimulated and stimulated whole saliva. Results. 144 subjects were enrolled in groups as follows: severe hyposalivation (n = 24), mild hyposalivation (n = 78), and normosalivation (n = 42). The mean and the 95% confidence interval for the LS flow rate (μL/cm2/min) were 3.2 (2.46 to 3.94), 5.86 (4.96 to 6.75), and 9.08 (7.63 to 10.53) (P < 0.001) for each group, respectively. The PS results were 1.01 (0.68 to 1.34), 1.72 (1.31 to 2.13), and 2.44 (1.66 to 3.22) (P = 0.014). Xerostomia complainers presented lower rates of LS (5.17 (4.06 to 6.23)) than non-complainers (7.33 (6.4 to 8.27)) (P = 0.003). Conclusions. The test was reliable to provide referential values ranges for LS flow rate measurement and was shown to be valid to distinguish normosalivation from severe and mild hyposalivation and also to predict xerostomia.

Halitosis is the term used to define the unpleasant odor exhaled through exhaled air, which may be signaling a pathological, physiological or adaptive condition. Most individuals who present this alteration experience personal discomfort, social embarrassment and emotional anguish, which can cause serious disturbances of coexistence, especially in the school environment. The etiology of halitosis is multifactorial, but its main cause comes from the formation of volatile sulfur compounds (VSC) resulting from the proteolytic bacterial action on stagnant organic matter in the oral cavity. The use of orthodontic appliances may be an agent related to the development of this alteration, since it favors the accumulation of organic residues, epithelial desquamation, gingival inflammation, in addition to making local hygiene difficult. Therefore, the present study aims to evaluate the breath of patients with orthodontic appliances and also the possible presence of bullying related to such an event, in young adults aged between 18 and 24 years, students at Universidade Paulista de Brasília. Breath assessment was performed using an organoleptic test (gold standard), which is performed by the examiner’s sense of smell, and a Halimeter® portable monitor, and saliva assessment was performed using a sialometry test, in which the amount of saliva was evaluated. The possible relationship with bullying was assessed through a specific questionnaire. Of the twelve students included in the study, seven presented halitosis when evaluated through the organoleptic test, however, of these seven only two presented parameters compatible with halitosis, when evaluated by the Halimeter®. In relation to bullying, this study showed that it was present in the lives of many respondents, but not necessarily because of breath.