Bad breath in the context of "Periodontal disease"

Sulfur (American spelling and the preferred IUPAC name) or sulphur (Commonwealth spelling) is a chemical element; it has symbol S and atomic number 16. It is abundant, multivalent and nonmetallic. Under normal conditions, sulfur atoms form cyclic octatomic molecules with the chemical formula S₈. Elemental sulfur is a bright yellow, crystalline solid at room temperature.

Sulfur is the tenth most abundant element by mass in the universe and the fifth most common on Earth. Though sometimes found in pure, native form, sulfur on Earth usually occurs as sulfide and sulfate minerals. Being abundant in native form, sulfur was known in ancient times, being mentioned for its uses in ancient India, ancient Greece, China, and ancient Egypt. Historically and in literature sulfur is also called brimstone, which means "burning stone". Almost all elemental sulfur is produced as a byproduct of removing sulfur-containing contaminants from natural gas and petroleum. The greatest commercial use of the element is the production of sulfuric acid for sulfate and phosphate fertilizers, and other chemical processes. Sulfur is used in matches, insecticides, and fungicides. Many sulfur compounds are odoriferous, and the smells of odorized natural gas, skunk scent, bad breath, grapefruit, and garlic are due to organosulfur compounds. Hydrogen sulfide gives the characteristic odor to rotting eggs and other biological processes.

A tongue cleaner (also called a tongue scraper or tongue brush) is an oral hygiene device designed to clean the coating on the upper surface of the tongue. While there is tentative benefit from the use of a tongue cleaner it is insufficient to draw clear conclusions regarding bad breath.

The large surface area and lingual papilla are anatomical features of the tongue that promote tongue coating by retaining microorganisms and oral debris consisting of food, saliva and dead epithelial cells. Tongue cleaning is done less often than tooth brushing, flossing, and using mouthwash.

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Halitosis (bad breath) may also occur.

Periodontal disease typically arises from the development of plaque biofilm, which harbors harmful bacteria such as Porphyromonas gingivalis and Treponema denticola. These bacteria infect the gum tissue surrounding the teeth, leading to inflammation and, if left untreated, progressive damage to the teeth and gum tissue. Recent meta-analysis have shown that the composition of the oral microbiota and its response to periodontal disease differ between men and women. These differences are particularly notable in the advanced stages of periodontitis, suggesting that sex-specific factors may influence susceptibility and progression. Factors that increase the risk of disease include smoking, diabetes, HIV/AIDS, family history, high levels of homocysteine in the blood and certain medications. Diagnosis is by inspecting the gum tissue around the teeth both visually and with a probe and X-rays looking for bone loss around the teeth.