Oral malodor associated with internal resorption

Area of Science:

• Dentistry
• Periodontology
• Oral Medicine

Background:

• Oral malodor (halitosis) is a common complaint with various etiologies.
• Persistent halitosis despite periodontal treatment necessitates investigation into less common causes.

Observation:

• A 39-year-old male presented with severe oral malodor and persistent periodontal issues around tooth 21.
• Diagnostic tests confirmed oral halitosis, with radiographic evidence of significant bone loss.
• Surgical inspection revealed a large perforating defect on the tooth's distal surface and granulation tissue.

Findings:

• The extracted tooth exhibited multiple perforating defects across all root surfaces, indicative of internal resorption.
• Internal resorption was identified as the primary cause of the tooth's defects and associated periodontal destruction.
• Extraction of the affected tooth led to a dramatic reduction in oral malodor.

Implications:

• This case highlights internal resorption as a potential, albeit rare, cause of severe oral malodor.
• Clinicians should consider internal resorption in refractory periodontal cases with unexplained halitosis.
• Early diagnosis and management of internal resorption are crucial for resolving persistent oral malodor.