Protocolos terapéuticos para el manejo de la halitosis oral: productos de higiene oral utilizados y nuevas estrategias terapéuticas

Resum

The main goals of oral halitosis treatment are: to lower the total numbers of odour producing bacteria that are mainly harboured in the posterior part of the tongue dorsum and at a lower extent, in the gingival sulci and periodontal pockets; to reduce the amount of proteic substrates available and to neutralise the volatilisation of the generated odoriferaus components. In order to achieve these three goals we normally apply different mechanical and chemical control measures. When applying mechanical control measures on tongue and dental biofilms we are reducing the total load of bacteria and the amount of proteic substrates. Even though, mechanical removal of the tongue coating is a necessary step in the treatment of oral halitosis, it is not sufficient by itself due to some limitations. And the coadjuvant use of chemical control measures are needed. The chemical agents most commonly used in the treatment of oral halitosis combine and antimicrobial agent such as chlorhexidine or cetylpiridinium chloride, with zinc salts, that precipitate volatile sulphur compounds (VSC). When managing oral pathological halitosis, besides the previously mentioned measures, we will need to treat the oral diseases related to oral halitosis occurrence (periodontal diseases, caries...). At present, new alternative therapeutical approaches are under study, as it is the case of probiotics. Although the preliminary results are promising, more evidence is needed before its use can be recommended.