BAD BREATH

Bad breath or Halitosis is a term used to describe noticeably unpleasant odors exhaled in breathing—whether the smell is from an oral source due to bacteria or otherwise..

Causes

Tongue

The is the most common location for mouth-related halitosis.

Tongue bacteria produce malodorous compounds and fatty acids, and account for 80 to 90 percent of all cases of mouth-related bad breath.

Large quantities of naturally-occurring bacteria are often found on the posterior dorsum  of the tongue, where they are relatively undisturbed by normal activity. This part of the tongue is relatively dry and poorly cleansed, and bacterial populations can thrive on remnants of food deposits.

Mouth

There are over 600 types of bacteria found in the average mouth. Several dozen of these can produce high levels of foul odors when incubated in the  laboratory.

The odors are produced mainly due to the breakdown of proteins into individual amino acids, followed by the further breakdown of certain amino acids to produce detectable foul gases.

Other parts of the mouth may also contribute to the overall odor, but are not as common as the back of the tongue. These locations are, in order of descending prevalence: inter-dental and sub-gingival niches, faulty dental work, food-impaction areas in-between the teeth, abscesses,  and unclean dentures.

Oral based lesions caused by viral infections like Herpes Simplex and HPV may also contribute to bad breath.

Gum disease

There is some controversy over the role of periodontal diseases in causing bad breath. Whereas bacteria growing below the gum line (subgingival dental plaque) have a foul smell upon removal, several studies reported no statistical correlation between malodor and periodontal parameters.

Nose

The second major source of bad breath is the nose.

In this occurrence, the air exiting the nostrils has a pungent odor that differs from the oral odor.

Nasal odor may be due to sinus infections or foreign bodies.

Tonsils

In general, putrefaction from the tonsils is considered a minor cause of bad breath, contributing to some 3–5% of cases. Approximately 7% of the population suffers from small bits of calcified matter in tonsillar crypts called tonsilloliths that smell extremely foul when released and can cause bad breath.

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Stomach

The stomach is considered by most researchers as a very uncommon source of bad breath.

The esophagus is a closed and collapsed tube, and continuous flow of gas or putrid substances from the stomach indicates a health problem—such as reflux serious enough to be bringing up stomach contents or a fistula between the stomach and the esophagus which will demonstrate more serious manifestations than just foul odor.

Systemic diseases

There are a few systemic (non-oral) medical conditions that may cause foul breath odor, but these are extremely infrequent in the general population. Such conditions are

  1. Fetor hepaticus: an example of a rare type of bad breath caused by chronic liver disease.
  2. Lower respiratory tract infections (bronchial and lung infections).
  3. Renal infections and renal failure.
  4. Carcinoma.
  5. Trimethylsminuria (“fish odor syndrome”).
  6. Diabetes mellitus.
  7. Metabolic dysfunction.

Treatment

The following are the mode of treatment of bad breath;

  1. Gently cleaning the tongue surface.
  2. Chewing gum
  3. Gargling
  4. Maintaining proper oral hygiene.

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