Dimethylsulphidemia: the significance of dimethyl sulphide in extra-oral, blood borne halitosis

Abstract

Halitosis is a symptom and not a diagnosis. Rather, the topic represents a spectrum of disorders, including intra-oral, otorhinolaryngological, metabolic, systemic, pulmonary, psychological and neurological conditions. Halitosis may be the third most common trigger for patients to seek dental care and can cause significant impact on patient quality of life. About 10% of all genuine halitosis cases are attributed to extra-oral processes. Some authorities have reported that the nasal cavity and the oropharynx are the most common sites of origin of extra-oral halitosis. However, recent evidence appears to suggest that blood borne halitosis may be the most common subtype of extra-oral halitosis. Tangerman and Winkel report that dimethyl sulphide was the main volatile implicated in extra-oral blood borne halitosis. They proposed a hitherto unknown metabolic condition by way of explanation for this finding, resulting in systemic presence of dimethyl sulphide in blood and alveolar breath. This paper reviews the knowledge base regarding the behaviour of dimethyl sulphide in physiological systems and those disorders in which blood borne halitosis secondary to dimethylsulphidemia is thought to have an aetiopathological role.

Changes in salivary microbiota increase volatile sulfur compounds production in healthy male subjects with academic-related chronic stress

“…This condition is transient, disappearing following normal oral hygiene after awakening. However, pathological halitosis is more intense, persistent, and offensive, requiring treatment to eliminate its cause, and can be due to extra- or intra-oral factors [4]. Physiological halitosis can be persistent, but may not be offensive to others, while the pathological condition is offensive and can continue while its source exists [2].…”

Halitosis and helicobacter pylori infection

“…The basic pathophysiological process is microbial degradation of sulfur containing amino acid substrates, for example, methionine, cysteine, and cysteine. [5] Bacterial metabolism of these kinds of amino acids leads to metabolites including many compounds, such as volatile sulfur compounds (VSC), for example, hydrogen sulfide (H 2 S), methyl mercaptan (MM, CH 3 SH), dimethyl sulfide, and skatole, indole. [6] The main odorants implicated in intraoral halitosis are MM and H 2 S. [7] …”

“…About 10% to 20% of all genuine halitosis cases are attributed to extra-oral diseases, [5] including upper and lower respiratory tract disorders, gastrointestinal disorders, some systemic diseases, metabolic diseases, medications, and cancer. [4] Some authorities have reported that the ears, nose, and throat (ENT) are the most common sites of origin of extra-oral halitosis, [5] and it is well established that various ENT disorders and symptoms may be a manifestation of gastroesophageal reflux disease (GERD).…”

“…[4] Some authorities have reported that the ears, nose, and throat (ENT) are the most common sites of origin of extra-oral halitosis, [5] and it is well established that various ENT disorders and symptoms may be a manifestation of gastroesophageal reflux disease (GERD). Poelmans et al [8] showed that patients with suspected GERD-related ENT symptoms had a high prevalence of esophagitis and this was associated with better response to antisecretory therapy.…”

Behaviors and Management of the Dental Problems by the Residents of Madinah, Saudi Arabia

“…Many people think that they have halitosis, are not serious about problem. Only significant percentage of people feels that they have halitosis 12 and when professionally examined it is not. Some have genuine halitosis but on examination it is found that the odor is caused due to bacteria present in the plaque deposited on cervical region of tooth and on the back of the tongue.…”