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:
• tonsil or throat infection -Chronic pharyngitis, Tonsillolith
• dry mouth
• smoking
• alcohol and certain foods e.g. Garlic
• inflammation of the oesophagus, (Oesophagitis), reflux GERD
• inflammation of the sinuses - Chronic Sinusitis and Postnasal drip
• build up of bacteria on the tongue-Stomatitis
• 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?
• Improving oral hygiene - correct brushing technique and regular flossing of teeth
• avoiding smoking, drinking alcohol and eating spicy foods
• using an antiseptic mouth wash -Betadine gargle
• chewing sugar free gum to increase the flow in saliva
• 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.
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