Bad breath bothering you?

The word ‘Halitosis’, is derived from the Latin word ‘halitus’ meaning breath. It is used to describe any disagreeable or unpleasant odour in the breath. While it has various synonyms such as fetor oris, fetor ex ore or oral malodour, the simplest way that it is described is bad breath!

bad breath

What is so dreaded about halitosis is that any of us may develop it at any point in our lives and easily as it appears, it is considerably hard to get rid of! Bad breath as we all well know is a social and psychological taboo and can be detrimental to one’s self-image and confidence.

However, there are various ways to tackle bad breath, but first, in order to do that we need to understand the causes of  bad breath.

Types of bad breath

There are two basic types based on which bad breath can be verified objectively

  1. Genuine or true halitosis
  2. Psychogenic halitosis.

Genuine halitosis is further subdivided into physiologic or transient halitosis and pathologic halitosis. Examples of physiologic halitosis include morning breath, dry mouth, smoking ,and drinking that disappear after simple oral hygiene measures such as brushing teeth. Pathologic halitosis is more persistent and requires medical intervention.

Psychogenic halitosis is subdivided into pseudo-halitosis and halitophobia. Pseudo-halitosis is when the patient thinks they have bad breath even if they don’t. Halitophobia is when the patient persists in believing they have halitosis despite the absence of any objective evidence.

Causes of bad breath

The causes of bad breath can be multifactorial, originating from either inside the oral cavity or various medical conditions. While systematic medical conditions and medications can contribute to the problem of bad breath, majority of bad breath originates in the mouth.

Contributing oral conditions include primarily poor oral hygiene followed by infections in the mouth, such as dental caries (tooth decay), periodontitis, gingivitis, oral thrush (a type of candidal infection of the oral cavity), unclean dentures ,and insufficient dental restorations.

The bacterial film called “plaque” that occurs naturally in the oral cavity can build up if not regularly removed through good oral hygiene practices. The bacteria in plaque or on the surfaces of the tongue, teeth ,and oral mucosa give off an odour that can affect one’s breath. Most of these factors have in common an increase in sulphur producing bacteria in the oral cavity. These anaerobic bacteria produce compounds like hydrogen sulfide, methyl mercaptan ,and dimethyl sulphide that also cause bad breath.

Certain types of foods and diet can cause malodour as well. The bi-products from ingested foods are absorbed, carried through the blood and excreted through the lungs. This explains why patients complain of garlic or onion breath long after they have eaten and even after they have brushed, flossed and rinsed. High protein diets also have been associated with bad breath as these cause ketosis and acetone that is excreted through the breath.

Extra-oral causes can be infections in the nose, throat or lungs, chronic sinusitis ,and bronchitis, or disturbances in the digestive system. Diabetes, liver ,and kidney disorders may contribute to offensive breath odour. This is also true of some medications, especially those that decrease salivary flow such as antidepressants, narcotics, decongestants, antihistamines or anti-hypertensives.

Diagnosis of bad breath

The most effective means of oral malodor identification is counterpart assessment. Family members, spouses ,and close friends can assist patients in identifying objectionable malodour.

However, there are certain medical tests that can be conducted to identify the precise cause of halitosis.

Management of bad breath

The basic foundation of good oral hygiene, regular brushing and flossing with proper technique is the first step. The toothpaste should be a fluoridated type to prevent caries. The tongue surface should be cleaned with a tongue scraper or a toothbrush.

Adequate saliva is the key to preventing bad breath. Saliva can be stimulated by the use of sugar-free gums, mints and candies. Chemotherapeutic products such as mouth rinses, toothpaste, and tongue gels are  becoming increasingly popular with patients.  These should be alcohol-free, sugar-free and contain an antibacterial agent such as chlorhexidine or triclosan.  Nature cures such as cinnamon, green tea, mint ,and parsley leaves can also be tried out.

If one has artificial dentures, these must be regularly cleaned. They should not be worn while sleeping at night. Instead, these ought to be soaked in water overnight. A dentist should regularly be visited at least once in every six months for professional cleaning and scaling for removal of plaque and calculus.

A thorough health history including a list of medications and supplements one is taking may be helpful in determining whether the cause of bad breath is localized to the mouth or might be a systemic condition, in which case a physician should be consulted.

Stay away from cigarettes, alcohol, eat right, and live healthy. With these regular and healthy habits, most bad breath problems can be easily resolved!







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