By: Alireza Talebian D.D.S Roghayeh Iranpoor D.D.S Addiction to cigarette smoking due to suffering from halitosis and the cessation following halitosis treatment. A case report By: Alireza Talebian D.D.S Roghayeh Iranpoor D.D.S

Introduction 200 visitors to a breath odor clinic employed various measures to reduce halitosis. The most frequently used measures was chewing gum. Only 1 sufferer used cigarette Odor as a masking agent

Case report Questionnaire potential Diagnosis: A combination of physiologic and extraoral pathologic halitosis with moderate psychologic condition

Measuring Oral malodor Portable GC OralChroma Organoleptic Rosenberg’s (0-5) scoring

Mouth air sampling

Chromatogram VSCs concentrations were below cognitive threshold

Organoleptic Assessment Left & Right Nostrils Odor Oral Odor LN Score:3 Oral Score:4 RN Score:3

Organoleptic Assessment Tonsil odor Tonsilar Score : 5

Organoleptic Assessment Odor of Posterior and anterior area of tongue Posterior Area Score :5 Anterior Area Score : 5 Gingival Sulcus Odor Gingival Sulcui Score : 3.3

To Make a Diagnosis “Mouthwash Test” Was performed The patient was asked to rinse his mouth with 5 ml of a zinc-containing commercial mouthwash. The chromatographic and organoleptic assessment was performed after 60 minutes. Since almost all parameters reduced , the diagnosis was made.

Confirmed Diagnosis Physiologic Halitosis + Tobacco induced halitosis Moderate psychologic Condition

Treatment The patient was instructed to 1- quite smoking 2- scrape anterior area of tongue 3- brush posterior area of tongue 4- rinse with a zinc-containing mouthwash

Follow-up visit Organoleptic scores were reduced VSCs concentrations were reduced Cigarette was quit

Conclusion It is proposed that attention to halitosis-caused tobacco addiction is necessary Integration this service into clinical practice is ethical and right thing to do Therefore a better practice is delivered to the patients