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Parasitosis Possible Source of Paediatric Halitosis

Parasitosis should be considered when paediatric patients present with halitosis.

Turkish researchers found parasites in the stools of 35 percent of treated children and 33 percent of controls in a study of 162 children with parentally reported halitosis.

Investigators from Karaelmas University in Zonguldak treated 82 children with mebendazole and the other 80 children with placebo (controls).

Approximately 64 percent of children with parasitosis receiving mebendazole (18 of 28 patients) recovered from halitosis, compared with only 8 percent of those with parasitosis receiving placebo (two of 24 patients). Relative risk (RR) for recovery with mebendazole was 7.7.

Among participants who did not have stool parasites, halitosis improved in 14 of 52 taking mebendazole, compared with 10 of 48 given placebo (RR, 1.3).

"Mebendazole intake made a significant difference whether or not the children had parasites," the investigators say.

They suggest three possible explanations for parasitosis as the cause of halitosis.

Excess saliva secretion stimulated by parasitosis can lead to stasis, providing the environment for bacterial overgrowth. Parasitosis could cause the pulmonary migration of some parasites and larvae. Halitosis could also result from increased intestinal gases found in parasitosis.

Participants in the study ranged in age from 5 to 16 years. Parents had spontaneously reported bad breath in the children attending outpatient clinics for various non-pathologic reasons. These included well-child care, growth follow-up and lack of appetite.
Archives of Pediatrics & Adolescent Medicine, 2002; 156: 995-998. "A Randomized Placebo-Controlled Trial of Mebendazole for Halitosis"

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