Bad breath — or halitosis — comes with a lot of embarrassment and social ridicule. In fact, bad breath is somewhat of a taboo topic, and people who have it may be scared to talk about getting treatment, even with their doctor. Seeking medical advice can be crucial and the only thing that solves your problem, however. Halitosis can be caused by numerous different underlying conditions, and surprisingly, not all of them are related to the oral cavity!
What Causes Bad Breath? Broadly speaking, the causes of bad breath can be divided into intra-oral and systemic factors.
Poor Oral Hygiene
Unsurprisingly, poor oral hygiene continues to be the number one cause of bad breath. Most people try and brush once a day, with a small minority brushing twice a day. If you're currently a once-a-day brusher, just keep this in mind: even if you brush twice a day, in the morning and the evening, some amount of plaque gets left behind. This eventually contributes to the formation of tartar, which harbors bad breath-causing bacteria. Start brushing twice a day now if you weren't doing so already.
What else do you need to do?
You also need to take care of your tongue. The tongue's surface, which has a rough feel, is actually made up of microscopic ridges and troughs. This makes it ideal for the colonization of halitosis-causing micro-organisms, which won't go away unless you actually clean your tongue. Yes, tongue cleaning should be a regular part of the daily oral hygiene routine!
You can clean your tongue with your regular tooth brush by gently brushing the surface of the tongue. A lot of tooth brush manufacturers now also add a rough surface to the back of the brush — this is a tongue cleaner. You can also buy separate tongue cleaners from pharmacies.
Decaying Teeth
The presence of one or more decaying teeth in the mouth also causes halitosis. This is particularly true for teeth that are so rotten that they've been destroyed to a great extent: unwelcome bacteria have taken up permanent residence there. The destruction of the normal morphology of the teeth also makes the accumulation of debris a lot easier.
Gum Disease
Gum disease or periodontal disease results in the formation of "pockets" around the necks of the teeth. These pockets develop over time due to the destruction of supporting fibers, and serve as ideal niches for halitosis-causing bacteria. The micro-organisms that produce bad breath grow in conditions that are low in oxygen, which are found at the base of these pockets. Their metabolic products include volatile sulfur compounds which result in the appearance of a foul odor.
READ Bad Breath and Your Health: Are They Connected?
Your doctor will begin with non-surgical treatment therapies and the re-evaluate before progressing to surgical options.
What Else Causes Bad Breath?
A Dry Mouth
Saliva plays a vital role in keeping the oral cavity healthy. Its normal flow is essential for the lubrication of the teeth, and physically clears away accumulated bacteria. Saliva also contains a number of protective enzymes that help prevent the growth of micro-organisms involved in the production of volatile sulfur compounds.
A number of reasons, genetic and acquired, can lead to a dry mouth. However, all of those are associated with a difficulty in maintaining oral hygiene, increased incidence of diseases, and halitosis.
The key to fighting the effects of a dry mouth is to keep the mouth lubricated. Sugar-free chewing gums stimulate salivary flow, drinking small sips of water frequently is also helps, and keeping yourself well-hydrated is essential for numerous reasons.
Systemic Causes Of Bad Breath
In some cases, halitosis indicates the presence of a deeper underlying disorder that could even be life-threatening. Let's take a look at their nature and symptoms.
ENT Problems
The most common extra-oral cause of bad breath would be an infection of the sinuses, leading to a constant drainage of mucos into the oral cavity. The patient will exhibit other symptoms like heaviness of the head, a stuffy nose and pain on sudden position changes which should point the doctor on the right direction.
GERD
People with persistent reflux will also suffer from halitosis, since the acid contents of the stomach reach the esophagus and the gases released will eventually make their way into the oral cavity. The underlying cause is a malfunction of the esophageal sphincter that is supposed to prevent the contents of the stomach from moving back up.
Liver And Kidney Failure
Liver and kidney failure are very rarely diagnosed by a dentist after a patient seeks help for bad breath, but it can happen. The accompanying symptoms are usually much much more severe and require immediate attention. Theoretically, however, these conditions can lead to a characteristic smell of ammonia or a fish-like smell.
Upper Respiratory Disorders
If there does not seem to be an obvious cause of halitosis and the patient does not show any improvement after intra-oral measures were taken, then the possibility of upper respiratory tract infections should be looked at. The management of all the systemic disorders involves specific treatment that should be aimed at treating the chief disorder. Patients should be referred to specialists, who will then order the necessary investigations and make their own clinical judgements.
READ Bad Breath (Halitosis), Treatment and Prevention
Conclusion
It is important to remember that the vast majority of complaints of bad breath can be resolved by taking adequate intra-oral measures and through the continuous adherence to high levels of hygiene. Systemic disorders as a cause for halitosis, while rare need to be kept in the mind while examining the patients. As they, the eyes cannot see (or in this case the nose cannot smell) what the mid does not know.
Sources & Links
- Photo courtesy of Instant Vantage via Flickr: www.flickr.com/photos/instantvantage/8847401331
- Photo courtesy of JeepersMedia via Flickr: www.flickr.com/photos/jeepersmedia/15213721515
- 1. http://www.webmd.com/oral-health/guide/bad-breath
- 2. SADJ. 2005 Feb
- 60(1):17-9. Halitosis: a review.