Bad breath: causes and treatment

Health Tips

Well, let’s say they said … What’s next? It often takes years to find the cause and eliminate it! And this entails already emotional suffering and social failure. The prevalence of this trouble, which we will continue to call the medical term halitosis, is extremely high. I don’t have data for Russia, but in the USA, in one or another period of life, every fifth person suffered from halitosis.

How to find your scent

As already mentioned, halitosis is not always obvious to the patient himself. The best diagnosis is a trusting relationship in the family, when a loved one tells you about the problem. But if a loved one has a chronic runny nose or he doesn’t want to upset you for anything in the world, what should you do? There are a few simple tricks to make sure you have or don’t have halitosis yourself:

  • if there is plaque on the tongue, the probability of halitosis is already high, the plaque should be brushed off without paste and smelled;
  • clean the interdental spaces with dental floss or a toothpick and evaluate the smell from them;
  • in the morning on an empty stomach, exhale slowly into a glass, and then smell it;
  • press a spoon on the tonsils, evaluate the smell from them;
  • if there is a removable denture, put it in a plastic bag for a few minutes, and then evaluate the purity of the smell in it.

How to calculate the reason

In reputable foreign journals, most of the articles on halitosis are devoted to dental problems. In second place – inflammatory processes in the nose, sinuses and tonsils. The esophagus and stomach, other organs as sources of halitosis are rarely named. Is that really how things are? I don’t think it’s more likely that these articles were written by dentists, and the patient first of all goes to them with such a problem. This, of course, is correct – you should start the search from top to bottom and from simple to complex.

Dentists have studied in great detail the immediate cause of bad breath – the smell is created by anaerobic (oxygen-free) bacteria living in the folds of the tongue, especially its root, in the tongue, in the gum pockets, less often in the lacunae of the tonsils. The most important provocateur of halitosis are dentures. An independent source of halitosis can be chronic inflammation in the nose and its sinuses (nasohalitosis). These causes account for 99% of cases of bad breath. The remaining percentage will go to rare today, advanced forms of diabetes and liver failure (they are easily diagnosed by a blood test).

How to get rid of the smell

The mechanism associated with the multiplication of bacteria in the mouth is not synonymous with specific diseases. The true causes of halitosis may lie far beyond the mouth. In order for anaerobic bacteria to begin to multiply, a nutrient medium without oxygen is needed. Such conditions are created with periodontal disease, periodontitis, caries, pulpitis and other dental diseases. Therefore, the first task in the fight against halitosis is the sanitation of the oral cavity. And if the elimination of fetid cavities in the teeth is usually achieved in a short time, then the treatment of periodontal disease may take time. The teeth were cured, there is no periodontal disease, but the smell remains. We begin to sin on the liver or some mythical “slags”. But in vain! You need to remember what your dentist told you about oral hygiene.

We clean the language

Sanitation is not only healthy teeth and gums, but also clean, free from plaque pharynx, tonsils and tongue. Cleaning the tongue, especially its far part, is a necessary condition for combating halitosis, regardless of its cause. For this, special scrapers and brushes are produced, but an ordinary toothbrush has proven itself to be excellent, which should be brushed daily not only teeth, but also the tongue – just like teeth, with paste! If this is not enough, the dentist may prescribe antiseptic solutions and gels with an antibacterial component, such as metronidazole. Finally, you have achieved perfect cleanliness in your mouth and the dentist is ready to fasten a “mouth of exemplary content” sign to your teeth. But the smell is still there. What to do now?

We turn to the ENT doctor

The dentist will look deeper into the mouth and find post-nasal drip – mucus and, possibly, pus flows down the wall of the pharynx from the nose. This is already a job for an otorhinolaryngologist. The ENT will perform a rhinoscopy (examine the nasal cavity with a video camera), a tomography of the sinuses, find the cause of the inflammation, treat it, and perhaps even need an operation. You have been cured. And the smell … This smell has not gone anywhere! No, someone was lucky both at the first stage and at the second, but often the plot develops according to the most bizarre scenarios.

For example, I was approached by a patient who went through all the stages described above many years ago, and his dentist decided that it was in the gum pockets, the microbes live there. This non-poor patient bought and installed dental equipment at home for a total of 30,000 euros. The doctor performed procedures on her once a week for 5 years. And the patient, meanwhile, had complaints of belching and heartburn. Gastroscopy showed inflammation of the esophagus, and an ENT on the occasion found reflux-related pharyngitis (inflammation of the throat).

Contacting a gastroenterologist

What is reflux disease? This is a condition when the contents of the stomach are thrown back into the esophagus and even the pharynx, gastric acid burns them, they respond with abundant mucus formation, creating conditions for the development of halitosis. That is, with reflux, the source of the smell is also not in the stomach – in the inflamed throat, tonsils, at the root of the tongue. But the cause of suffering is a violation of the relationship between the esophagus and the stomach. It should be said that this patient had the classic clues typical of reflux disease: belching and heartburn. But this is not always the case. The only manifestation of reflux disease may be halitosis. Sometimes it is accompanied by signs of chronic inflammation of the pharynx and larynx – pain when swallowing, hoarseness, the need to cough up mucus accumulated in the throat. After treating the reflux disease, the odor problem was resolved and our patient was able to free his home from medical equipment. Fortunately, more and more ENT doctors are now able to diagnose reflux pharyngitis and laryngitis and refer such patients to a gastroenterologist.

We observe hygiene

As you can see, almost always the cause of the smell is anaerobic bacteria in the mouth and throat, but the conditions for them create diseases not only of the oral cavity, but also of the nose, sinuses, pharynx, esophagus and stomach.

However, the basis of the fight against halitosis, regardless of its origin, is oral hygiene. Clean your tongue every day and especially its root, carefully floss the interdental spaces, keep removable dentures clean – and you will be happy.

Photo: shutterstock

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