Self diagnosis Scientists have long thought that smelling one's own breath odour is often difficult due to acclimatization, although many people with bad breath are able to detect it in others. Research has suggested that self-evaluation of halitosis is not easy because of preconceived notions of how bad we think it should be. Some people assume that they have bad breath because of bad taste (metallic, sour, fecal, etc.), however bad taste is considered a poor indicator. Patients often self-diagnose by asking a close friend. One popular home method to determine the presence of bad breath is to lick the back of the wrist, let the saliva dry for a minute or two, and smell the result. This test results in overestimation, as concluded from research, and should be avoided. A better way would be to lightly scrape the posterior back of the tongue with a plastic disposable spoon and to smell the drying residue. Home tests that use a chemical reaction to test for the presence of polyamines and sulfur compounds on tongue swabs are now available, but there are few studies showing how well they actually detect the odour. Furthermore, since breath odour changes in intensity throughout the day depending on many factors, multiple testing sessions may be necessary. Testing If bad breath is persistent, and all other medical and dental factors have been ruled out, specialized testing and treatment is required. Hundreds of dental offices and commercial breath clinics now claim to diagnose and treat bad breath. They often use some of several laboratory methods for diagnosis of bad breath: * Halimeter: a portable sulfide monitor used to test for levels of sulfur emissions (to be specific, hydrogen sulfide) in the mouth air. When used properly, this device can be very effective at determining levels of certain VSC-producing bacteria. However, it has drawbacks in clinical applications. For example, other common sulfides (such as mercaptan) are not recorded as easily and can be misrepresented in test results. Certain foods such as garlic and onions produce sulfur in the breath for as long as 48 hours and can result in false readings. The Halimeter is also very sensitive to alcohol, so one should avoid drinking alcohol or using alcohol-containing mouthwashes for at least 12 hours prior to being tested. This analog machine loses sensitivity over time and requires periodic recalibration to remain accurate. * Gas chromatography: portable machines are being studied. This technology is designed to digitally measure molecular levels of major VSCs in a sample of mouth air (such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide). It is accurate in measuring the sulfur components of the breath and produces visual results in graph form via computer interface. * BANA test: this test is directed to find the salivary levels of an enzyme indicating the presence of certain halitosis-related bacteria. * β-galactosidase test: salivary levels of this enzyme were found to be correlated with oral malodour. Although such instrumentation and examinations are widely used in breath clinics, the most important measurement of bad breath (the gold standard) is the actual sniffing and scoring of the level and type of the odour carried out by trained experts ("organoleptic measurements"). The level of odour is usually assessed on a six-point intensity scale. Classification Two main classification schemes exist for bad breath, although neither are universally accepted. The Miyazaki et al. classification was originally described in 1999 in a Japanese scientific publication, and has since been adapted to reflect North American society, especially with regards halitophobia. The classification assumes three primary divisions of the halitosis<unk> , namely genuine halitosis, pseudohalitosis and halitophobia. This classification has been suggested to be most widely used, but it has been criticized because it is overly simplistic and is largely of use only to dentists rather than other specialties. * Genuine halitosis *A. Physiologic halitosis *B. Pathologic halitosis *(i) Oral *(ii) Extra-oral * Pseudohalitosis * Halitophobia The Tangerman and Winkel classification was suggested in Europe in 2002. This classification focuses only on those cases where there is genuine halitosis, and has therefore been criticized for being less clinically useful for dentistry when compared to the Miyazaki et al. classification. * Intra-oral halitosis * Extra-oral halitosis * A. Blood borne halitosis * (i) Systemic diseases * (ii) Metabolic diseases * (iii) Food * (iv) Medication * B. Non-blood borne halitosis * (i) Upper respiratory tract * (ii) Lower respiratory tract The same authors also suggested that halitosis can be divided according to the character of the odour into 3 groups: * "Sulfurous or fecal" caused by volatile sulfur compounds (VSC), most notably methyl mercaptan, hydrogen sulfide and dimethyl sulfide. * "Fruity" caused by acetone, present in diabetes. * "Urine-like or ammoniacal" caused by ammonia, dimethyl amine and trimethylamine (TMA), present in trimethylaminuria and uremia. Based on the strengths and weaknesses of previous attempts at classification, a cause based classification has been proposed: * Type 0 (physiologic) * Type 1 (oral) * Type 2 (airway) * Type 3<unk>  * Type 4 (blood-borne) * Type 5 (subjective) Any halitosis<unk>  is potentially the sum of these types in any combination, superimposed on the physiologic odour present in all healthy individuals.
symptom of Gastroesophageal reflux disease
symptom of Peptic ulcer disease
symptom of Stomach cancer
symptom of Helicobacter pylori
symptoms of Helicobacter pylori
symptom of Peanut allergy
symptoms of Peptic ulcer disease
symptom of Gastritis