Bad Breath or Halitosis can be a source of embarrassment and shame. Some people with bad breath aren’t even aware there’s a problem. Bad breath (Halitosis) is a widespread condition affecting about a quarter of population. The most common cause of bad breath is decaying food debris between the teeth and gum (poor oral hygiene).
What are the causes Bad Breath
Anything that decreases the flow of saliva or stimulates the growth of anaerobic bacteria.Saliva irrigates the mouth, stimulates swallowing thereby flushing away debris. As saliva contains oxygen, the dryer your mouth and the thicker your saliva, the less the washing action and the lower the oxygen level creating a more anaerobic environment for bacteria to produce sulfur compounds. This oral stagnation is more pronounced in mouth breathers and those who snore. Certain medications for high blood pressure, antihistamines and depression can decrease saliva flow. Dehydration and stress also reduces the flow of saliva. Morning breath occurs due to decreased salivary flow during sleep.
These anaerobic bacteria breakdown proteins as the start to digestion, and produce these sulfur compounds as a by-product. These proteins come from oral cellular debris dead bacteria, saliva, food debris, mucous, post nasal drip and phlegm.
An important factor in bacterial growth is the pH of the mouth. Bacteria reproduce faster in a more acid environment. Coffee and acidic foods increase acidity. Hormonal changes have even been implicated with bad breath. During menstruation, estrogen causes sloughing of body lining tissue including that of the mouth. This gives additional nutrition for anaerobic bacteria.
Other causes of bad breath include:
and tonsil or throat infection -Chronic pharyngitis, Tonsillolith
and dry mouth
and smoking
and alcohol and certain foods e.g. Garlic
and inflammation of the oesophagus, (Oesophagitis), reflux GERD
and inflammation of the sinuses – Chronic Sinusitis and Postnasal drip
and build up of bacteria on the tongue-Stomatitis
and crash dieting – when energy producing food such as Carbohydrates are with held from the body, stored body fat is broken down instead. The waste product from this type of energy break down are ‘Ketones’, which give a sweet and sickly smell
Sinusitis and bad breath
Chronic sinus infections are among the most common form of upper respiratory infection in children and adults.
The most common symptoms of chronic sinus infection include:
1. Purulent postnasal discharge.
2. “Fullness” or congestion around the sinus areas
3. Chronic coughing, frequently at night.
4. Chronic sore throat.
5. Bad Breath.
Recognize the symptoms of chronic sinus infection and to prevent the causes of sinus infection, including removing the irritants from the environment or treating the allergies.
Postnasal Drip
Post nasal drip refers to the sensation of thick phlegm in the throat, which can become infected.This is part of the mucous – nasal cilia system that defends us from disease. When the amount of liquid secreted by the nose and sinus is reduced, and the cilia of the nose and sinus slow down, the fluid thickens and you become aware of its presence. This also gives bad taste and smel in mouth.
Gingivitis
Bacteria play an important role in many dental problems such as bad breath (halitosis), gum disease, plaque and possibly sensitive teeth. Plaque also starts out with a sticky film of live bacteria. If it is not removed at this stage, it starts growing on the sugar and minerals and hardens to become calculus which may lead to gum irritation, gingivitis and eventually to periodontal disease causing halitosis
Chronic Tonsillitis
Chronic tonsillitis and chronic pharyngitis is a common cause of Halitosis.
Tonsil Stones (tonsilloliths) are caused by an accumulation of sulfur-producing bacteria and debris that become lodged in the tonsils. This debris (which can include mucous from post nasal drip) putrefies in the back of your throat, and collects in the tonsil crypts (small divots or pockets which appear on the surface of the tonsils).
When this debris combines with the Volatile Sulfur Compounds produced by the anaerobic bacteria beneath the surface of your tongue, along with the tonsil stones it can also create chronic Halitosis.
How is Bad Breath treated?
and Improving oral hygiene – correct brushing technique and regular flossing of teeth
and avoiding smoking, drinking alcohol and eating spicy foods
and using an antiseptic mouth wash -Betadine gargle
and chewing sugar free gum to increase the flow in saliva
and using a tongue cleaner to brush and clean the tongue
Medications
If all the above self help remedies fail, go to a dentist and ENT surgeon, he may be able to help you. A course of Ciprofloxacin with metronidazole or Tinidazole may help to curb the anaerobic infections.
Migratory Glossitis
(Geographic Tongue)
Geographic tongue is a map-like appearance of your tongue due to irregular patches on its surface.
Causes
The specific cause of geographic tongue is unknown, although vitamin B deficiency may be involved. Other causes may include irritation from hot or spicy foods, or alcohol. The condition appears to be less common in those who smoke.
The pattern on the surface of the tongue may change very rapidly. This pattern changes occur when there is a loss of the tiny finger-like projections, called papillae, on the tongue’s surface. This makes areas of the tongue flat. These areas are said to be “denuded.” Denuded areas may persist for more than a month.
Symptoms
- Map-like appearance to the surface of the tongue
- Smooth, beefy red patches and lesions on the tongue
- Patches that change location from day to day
- Soreness and burning pain
No treatment is usually necessary for benign migratory glossitis and stomatitis. Symptomatic lesions can be treated with topical prednisolone and a topical or systemic antifungal medication (Flucanazole) can be tried if a secondary candidiasis is suspected. Occasional symptomatic cases respond well to topical tetracycline or systemic, broad-spectrum antibiotics, but this should not be expected.
Try avoiding causative factors.
Apthous ulcers
Some people seem to be prone to develop repeated aphthous ulcers, while others may have similar damage to the cheek but without having an ulcer developing from it. This may depend on the general resistance of the body and on the type of bacteria normally in the mouth. Stress appears to lower the resistance of the mouth to such ulcer formation.
Treatment
If subject to repeated ulcers, it is worth discussing the problem with a dentist or oral hygienist. Identifying food allergies can be difficult but the type of food known to bring about an ulcer may become obvious to you after some time.
The aim of treatment is to reduce the pain and inflammation. Local anaesthetic lozenges or gel can be used as often as necessary to reduce discomfort. people benefit from the anti-inflammation effects of hydrocortisone. This can be administered in the form of pellets which are sucked.
Tetracycline is sometimes very effective. A capsule containing 250 mg of this antibiotic is prized open. Half the yellow powder content is put into a tumbler which is approximately one-third filled with warm salt water. Rinse your mouth with this solution, on each occasion keeping the liquid in contact with the ulcer for 5 minutes at a time. This method often reduces the period of pain to 1 or 2 days.
Gargle warm salt water with turmeric powder is also good.
Steroid paste is applied to the ulcer help healing fast. Steroid (cortisone-like) drugs and tetracycline can both cause an infection by yeast organisms (thrush) in the mouth if used for an excessively long period.
Cauterising with silver nitrate helps healing and reduce pain.
Most aphthous ulcers improve after 6 or 7 days and have disappeared within 2 weeks. Large ulcers may take up to 30 days to heal, especially if there is continued irritation.
All ulcers eventually heal, although the period of pain is often longer if nothing is done to reduce the inflammation.
Regular antiseptic mouthwashes have not been shown to be of real benefit.
Tetracycline can stain growing teeth, and therefore should not be used in children under age 12.
Biopsy of the ulcer should be considered if it is not healed in 2 weeks.
