Halitosis or bad breath is a major problem experienced by a large section of people. However, very few people are willing to discuss about it. Detection of halitosis is really difficult as it is not possible for an individual to smell his/her own breath. This problem often creates depressing and embarrassing moments for the afflicted individuals and also for the people around them. Bad breath problems can be eliminated more or less permanently by identifying and controlling / eliminating the root cause for the problem, rather than adopting temporary measures like use of mouth washes, mouth fresheners etc.
Causes for halitosis (bad breath) can be intra-oral and extra-oral.
Intra oral causes:
1. Dentures: Most removable denture wearers whether it be complete or partial, are found to have bad breath. Meticulous denture hygiene measures help control this problem to a certain extent.
2. Damaged dental fillings
3. Drifted or extruded teeth
4. Impacted teeth (esp. The lower impacted third molar allowing food entrapment in the area)
5. Oral tumors / cancer
6. Dry mouth (Xerostomia) – Please note: Most of medicines like antidepressants, antacids, antihypertensives etc causes dryness of mouth and this results in bad breath.
7. Tooth decay
8. Mouth ulcers
9. Gum diseases – gingivitis, periodontitis
10. Food entrapment in the mouth – between drifted teeth, ill-fitting bridgework, damaged fillings etc.
Bad breath can also be extra-oral in origin. Here are a few extra-oral causes:
11. Ear, Nose, Throat and Lung problems such as rhinitis, sinusitis, pharyngitis, tonsillitis, otitis, asthma, bronchitis, bronchiectasis etc.
12. Gastro Intestinal Conditions such as – Acid Peptic Disease (APD), Gastro-esophageal acid reflux disease (GERD), Constipation, Liver diseases etc.
13. Renal problems
14. Hormonal imbalances – esp. Diabetes Mellitus
15. Foods – foods containing large amount of garlic, onion etc. And frequent intake of coffee
Four different categories of food are found to increase the degree of bad breath problem by causing the increasing production of sulphide by anaerobic bacteria. They are:
a) Some dense protein foods like dairy products, fish, meat etc.
b) Drying agents like alcohol, cigarettes, alcohol based mouth washes etc.
c) Acids and sugars like juices of orange, pineapple, tomato, grapes etc.
d) coffee are the stimulators of anaerobic bacterial growth.
16. Smoking habit
In the mouth of a human being, there are about four hundred species of different types of bacteria. Among these, about 14 are anaerobic (thrive in an oxygen free environment) and the bad odours are mostly produced by these anaerobes, by producing sulphide gases. These anaerobes are normally present in the mouth and they also have certain beneficial effects. However, they create bad breath when they are present in large numbers, much more than the normal.
Bad breath is usually caused by volatile sulfur compounds that are released by the breaking down of proteins by the above said bacteria. These sulfur compounds generally have rotten egg smell and a lousy taste.
Bad odours generally emanate from the dorsum (surface) of the tongue… especially the backside because of the growth of anaerobic bacteria in that portion. It is a proven scientific fact that regular tongue cleaning (twice a day, after teeth brushing) will reduce the mouth odour by about 75 percent.
At TheSmileCentre, we employ special diagnostic measures as well as equipment to assess the bad breath problem.
Saliva is the main ingredient in our mouth that will eliminate the major concentration of odour by washing out the food particles and bacteria which are the primary causes for bad breath. While sleeping, salivary glands slow down its production and this in turn will result in the growth of bacteria in the mouth. To avoid the effect of “morning mouth”, the recommendation is to brush the teeth as soon as you are awake. Skipping breakfast will result in the reappearance of foul smell even after brushing the teeth. Remaining idle for a long time, with the restricted movement of tongue and jaws, for e.g., during travelling results in the development of bad breath. This is again because of the lack of saliva production.
Treatment for bad breath
Proper brushing of teeth and tongue cleaning at least twice a day and flossing will help us maintain a hygienic mouth and this in turn will help reduce the bad breath problem to a very great degree. Dental specialists at TheSmileCentre routinely recommend to our patients to use tongue scraper as part of the daily routine of dental hygiene which includes both flossing and brushing. This will definitely reduce bad breath. People with temporary dentures are advised to remove their dentures during night hours and they can use it in the morning only after brushing it properly.
Drinking plenty of water can help prevent bad breath to a great degree by preventing the growth and movement of bacteria in the mouth.
Chewing sugar-free gums and use of mouthwashes help to reduce foul smell. However, it is to be noted that these agents will give only short term benefits. Most of them work only for a few hours and after their effect is gone, bad breath recurs with, often with double intensity. One of the major ingredients of mouth fresheners is alcohol, which in turn can make mouth dry and initiate the speedy growth of bacteria.
Routine dental check-ups are necessary as it helps in the detection of oral problems well in advance. The regular check-ups will offer us opportunities to identify and treat dental plaque, bacterial infections etc.
If you come report to TheSmileCentre with the complaint of bad breath, dentists in the Smilecentre will help you identify the root cause of your problem. We will suggest you to consult a physician if your problem is extra-oral.
Importance of tongue cleaning is:
1. About 5- percent of the bacteria can be removed from the dorsum of the tongue by the daily tongue scraping.
2. Tongue cleaning helps us to reduce about 33 percent of dental plaque without making any considerable changes in the tongue.
3. Tongue scraping is very much important for chain smokers, mouth breathers and for those who are using dentures.
4. Tongue cleaning eliminates the source of bad breath, root caries, and also improves the taste buds and creates an interest in different variety of food during our old age.