Bad Breath
Bad breath is a common condition, which usually originates in the mouth itself, and thus falls under the responsibility of the dental practitioner. In individuals with a healthy periodontium and good oral hygiene, bad breath usually comes from the posterior tongue dorsum, and can be treated by regular deep tongue cleaning. Nasal problems are an important secondary cause of bad breath, and are easy to detect by comparing the odour existing in the mouth and the nose.
Bad breath is a common condition, which usually originates in the mouth itself, and thus falls under the responsibility of the dental practitioner. In individuals with a healthy periodontium and good oral hygiene, bad breath usually comes from the posterior tongue dorsum, and can be treated by regular deep tongue cleaning. Nasal problems are an important secondary cause of bad breath, and are easy to detect by comparing the odour existing in the mouth and the nose.
Numerous other medical conditions can lead to bad breath, but are found very infrequently, as compared to the odour of oral and nasal etiologies. Contrary to popular belief, the gastrointestinal tract is rarely, if ever, responsible for chronic bad breath. Because people have trouble assessing their own oral malodour, many individuals develop greatly exaggerated concerns of suffering from bad breath ("halitophobia"), while millions of others remain ignorant of their own oral odours. In most cases, good professional oral care combined with a daily regimen of oral hygiene including inter dental cleaning, deep tongue cleaning and optional use of an efficacious mouth rinse, will lead to improvement.
Halitosis and its management are fast becoming a part of dental practice. One of the strong reasons to render this treatment service in a dental practice is the power of this concept as a marketing tool. Management of halitosis is an excellent way of attracting new patients, especially those who are not regular users of dental services.
Fear of pain is a major factor preventing people from seeking dental treatment. Since the management of halitosis is often viewed a "non dental" procedure by the public, it does not carry the psychological impact of other dental treatments. The idea of getting freedom from bad breath can be a strong motivator for the acceptance of dental treatment, particularly for periodontal disease, a major source of halitosis
Causes of Halitosis
Odour causing foods: Whatever food one consumes, affects the air exhaled and some of them like garlic and onion contribute to objectionable breath odour. After getting absorbed into the blood stream the food is transferred to the lungs, where it is expelled. The odour stops when the body eliminates it fully. Infrequent eating can also cause unpleasant breath.
Lack of Oral hygiene: If brushing and flossing is not done regularly, or if dentures are not cleaned properly, the food particles remain, collecting bacteria and causing bad breath. This appears to be due to the breakdown of proteins by a variety of bacteria. Several of the breakdown products are foul smelling gases. The posterior part of tongue is also an important source of bad breath. The postnasal drip can get stuck on the tongue, which is then broken down by bacteria on the tongue surface.
Dry Mouth (Xerostomia): Saliva is necessary to cleanse the mouth and remove particles that may cause odour. Dry mouth can be the result of continuous breathing through the mouth, salivary gland problems or various medications.
Tobacco products cause bad breath, stain teeth, reduce one’s ability to taste foods and irritate gum tissues, increasing the likelihood for periodontal disease.
Periodontal Disease: Persistent bad breath or a bad taste in the mouth is one of the warning signs of periodontal disease.
Sinus and respiratory infections: If bad breath appears suddenly in a child, it can mean the onset of a throat infection, bad breath will cease with the cure of throat infections.
The Tongue, teeth and gums are common sources of oral malodour, particularly sub gingival and proximal areas. Margins, overhangs, leaky crowns, and periodontal pockets are prime sites for anaerobic bacterial activity leading to putrefaction.
Halitosis is a very prevalent problem. It may simply be embarrassment to some, but it may also be the sign of potentially serious problems in others. After a professional cleaning and checkup if the patient thinks he has constant bad breath, ask him to keep a log of the foods he eats and to make a list of medications he takes. Referral to a physician may be necessary to rule out systemic involvement.
Halitophobia or the fear of bad breath is believed to exist in about 15% people. These persons believe they have bad breath but in reality they do not have it. It can cause unnecessary psychological problems for those affected.
Advice to People with Bad breath
Brush teeth after breakfast and dinner and get a professional cleaning done.
Floss the teeth to remove the food particles from inter dental areas.
Clean the tongue by brushing or using tongue scraper.
Drink plenty of liquids.
Chew sugar free gum for a minute or two to stimulate saliva flow especially if mouth feels dry.
Rinse mouth with water every time you drink or eat especially milk products and fish or meat.
Denture wearers may soak denture in antiseptic overnight.
Use a suitable mouthwash, or even better wash frequently with water.
Eat fresh fibrous vegetables such as carrots.
References
Brit. Dent. Assoc. News release Sept 1996
J. of Periodont. Res. 27:233-238,1992
JADA 127:475-482, 1996.
4. Internet.
Dr. Gyanendra Kumar
Astt. Professor
MAIDS NEWDEL
Astt. Professor
MAIDS NEWDEL
