Bad taste in your mouth, comments about bad breath and somebody advising you to use a mouthwash, all refer to the fact that you are suffering from ‘HALITOSIS’.
Halitosis is an experience for all at one time or another, but some of us have to counter the problem more often than others.
The reasons behind the problem can be several;
Oral (mouth): Accumulation of bacteria and plague causes soft gingiva’s ulceration, resulting in periodontal pockets, an ideal place for bacteria’s nourishment. Anaerobic bacteria and bad smelling sulphur (H2 S) are the major contributors to a bad breath. The reasons for this can be inadequate oral hygiene, advanced tooth decay or periodontal diseases.
In case of no caries or gum diseases, the most common cause of a bad breath is the tongue. The bacteria make home in ridges of the tongue, especially in its posterior one-third part. The posterior end of the tongue receives saliva from a nearby gland and anaerobic bacteria break down amino acids (present in the saliva), producing gases that cause bad breath. Some of the diseases related to bad breath are oral candidiasis (a fungal infection), acute necrotizing ulcerative gingivitis (ANUG) or French mouth, apthous ulceration, dental abcess, herpese infection and oral carcinomas.
Non Oral:
a) Xerostomia (dry mouth): A disease caused by inadequate production of saliva, which dampens the oral tissues, leaving behind particles in the oral cavity that cause bad breath. The production of saliva can be affected by certain medicines that cause dryness, antidepressants, anticholinergics, narcotics, antihistamines, antihypertensive, salivary gland dysfunctions and sjogren’s syndrome (a hereditary disease).
b) Smoking (nicotine) destroys ascorbic acid (vitamin C), an essential for immunity.
c) Diet: A high protein diet is always ideal for anaerobic bacteria. Garlic, raw onions, cabbages, eggs, fish, red meat, peppers, coffee and tea get absorbed into blood stream and are transferred to the lungs, which are expelled while you exhale.
Systematic diseases: Systemic diseases that can cause bad breath include diabetes mellitus, sinus infection (mucous accumulation), pharynx/tonsil infection, pulmonary (bronchitis, pulmonary emphysema), diabetic ketoaudosis, cirrhosis (liver dysfunction), gall bladder infection, uremia, post nasal drip (PND) and GIT diseases.
Psychiatric problems: Psychiatric problems, which can affect breath include schizophrenia and depression/anxiety.
Halitosis is common in tense situations like interviews, speech, etc.
Some of the characteristic smells accompanied by various diseases include acetone (a fruity smell) caused by diabetic ketoacidosis, sweaty smell caused by liver dysfunction and and extremely foul smell caused by diphtheria.
It must be kept in mind that bad breath under the following circumstances is normal:
Morning breath because the function of salivary glands slows down over night and saliva thickens, which stops it from bathing mouth tissues properly, therefore mouth breathers face the problem more often, but it disappears when you eat or drink.
Hunger breath accompanies morning breath and arises from putrefaction of pancreatic juice, which pours into the stomach when nothing is eaten or drunk. Hunger breath is more apparent even after brushing, if morning meals are omitted.
Menstrual breath is caused because of hormonal disturbances, which trigger sloughing of the body’s lining tissues and oral tissues and creates more ridges for bacteria, leading to halitosis.
MYTHS: Certain myths are associated with halitosis, but morning, menstrual and hunger breaths are normal and can be treated. A mouth wash can be of no help in case of halitosis and it only masks the situation. A mouth wash that contains alcohol can even worsen the situation. Brushing more often cannot help because it only damages enamel and gums
Evaluation: We cannot know about halitosis, unless our friends, family or colleagues inform us, so the only way to find is to ask others.
Treatment: Halitosis can be treated by proper oral hygiene, filling, scaling, etc. In case of Xerostamic, try getting rid of artificial saliva sugarless candies and increase your fluid intake (at least 18-20 glasses per day), suck on sugarless lozenges. Keeping the mouth moist stops accumulation of bacteria and eating citrus fruits, rich in vitamin C can help. A cationic mouthwash like chlorehexatidine gluconate (CHG) in 0.2% helps a lot it and it has the ability to bind oral tissues. Odour neutralising substace like cetylpyridinium chloride (CPC) and Zince chloride can also be used. A hydrogen peroxide mouthwash releases free oxygen, which is harmful to bacteria, zinc salts and ionone (an ingredient of tomato juice) also help. The posterior one-third of the tongue should always be scrapped properly and teeth should be brushed regularly, not often.
For enquires & queries, rananadeem8@hotmail.com.
