Halitosis

Dr. Amra Minhas Abid threw some light on Bad Breath problem.1
Bad breath, medically called halitosis, can result from poor dental health habits and may be a sign of other health problems. Bad breath can also be made worse by the types of foods you eat and other unhealthy lifestyle habits. So this week Social Diary consulted Dr. Amra Minhas Abid of KRL hospital Islamabad, here she shared some of the reasons of halitosis and suggested some treatments for this problem.

Question: Bad breath, also known as halitosis, is more common than many people realize these days. What are the main reasons of bad breath? What are the ways to prevent and banish bad breath?
Halitosis also known as “Bad Breath” is a common medical problem. It has both health and social implications. Halitosis affects about 50% of worlds population .It includes categories of, Genuine Halitosis, Pseudo Halitosis and Halitophobia. Almost 80% of the cases have their origin in the oral cavity (mouth).There are millions of bacteria residing in the mouth (particularly on the back of the tongue) which are the primary causes of bad breath. The mouth’s warm, moist conditions make an ideal environment for these bacteria to grow. The remaining 20% of cases are due to poor diet, alcohol abuse, smoking, drugs and diseases of the gastrointestinal tract and systemic conditions. Treatment of halitosis requires a multidisciplinary approach. Some types of bad breath, such as “morning mouth,” are considered to be fairly normal, and they usually are not health concerns. The “morning mouth” type of bad breath occurs because the saliva which regularly washes away decaying food and odors during the daytime diminishes at night, while you sleep. Your mouth becomes dry, and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor. Studies have showed that halitosis is usually caused by putrefactive process triggered by gram, ve anaerobic bacteria, which produce large amounts of volatile sulphur compounds (VSC) due to breakdown of proteins. VSC is the cause of malodourous smell. These bacteria reside in saliva dental plaque and gingival pockets etc.

Bad breath can be caused by the following reasons:bad-breath

  • Poor dental hygiene: Infrequent or improper brushing and flossing leave food particles to decay inside the mouth which cause accumulation of plaque with heavy bacterial growth.
  • Infections in the mouth: Gum and periodontal diseases cause areas of pocketing and harbor bacteria. Gingivitis, Periodontitis and abscess may develop around the teeth, open sores and ulcers may develop on the tongue or gums.
  • Respiratory tract infections: Throat infections, sinus infections, lung infections, swollen lymph nodes (“swollen glands”) in the neck, fever, stuffy nose, a greenish or yellowish nasal discharge, a mucus-producing cough may contribute to bad odor.
  • Crash dieting: Fasting and living on low carbohydrates can cause the body to break down fats which produces chemicals called Ketones that may be smelt in the breath.
  • Medication: Nitrates to treat angina (chest pain), tranquillizers (phenothiazine) can cause bad breath. You may request your doctor to change the drugs.
  • Xerostomia: Dry mouth: Is caused due to lack of saliva production (usually because of salivary gland disease or mouth breathing). As a result of decreased salivary flow, bacteria grow rapidly and produce foul breath.
  • Digestive system: Presence of H-pylori bacterial infection and gastro esophageal Reflux disease (GORD) may be a cause.
  • External factors: Garlic, onions, coffee, cigarette smoking, and chewing tobacco.
  • Systemic illnesses: Diabetes, liver disease, kidney disease, lung disease, sinus disease.
  • Halitobhobia: Is a Psychological condition in which the person is paranoid about smell of his or her own breath. Cognitive behavioral therapy (CBT) can treat paranoia and fixation on smell.
  • Orthodontic braces and halitosis: Patients undergoing orthodontic treatment usually encounter foul mouth odor .This is due to the fact that brackets and wires accumulate food particles easily. The retentive sites require meticulous cleaning, using specially designed orthodontic brushes advised by your orthodontist.

Diagnosis
Your dentist should review your medical history for any medical conditions and medications that could cause dry mouth. Your dentist should also inquire about your diet, personal habits (smoking, chewing tobacco) and any associated symptom as when the bad breath was noticed? And by whom?

Expected Duration of treatment: Depends on the cause of halitosis.
Bad breath may results from a systemic illness which may require a long-term treatment with proper medical care.

Does daily flossing help prevent Halitosis?
Bad breath caused by dental problems can be prevented easily. Daily maintenance calls for brushing your teeth, tongue and gums after meals, flossing thoroughly, and rinsing with mouthwashes (containing chlorine dioxide) approved by the American Dental Association (ADA). Regular visits to the dentist (at least twice a year) should be made. Bad breath can also be combated by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles. Other products that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, high fiber diet like raw carrots etc.

When to call for Professional help?
Visit your dentist promptly if you have bad breath with symptoms of painful, swollen gums that bleed easily and when you feel loosening of teeth along with increasing interdental space. Also, visit your doctor if you have bad breath along with a fever, sore throat, a postnasal drip, a discolored nasal discharge or a mucus-producing cough. Even if you have none of these associated symptoms, call your dentist or physician if your bad breath continues despite a good diet and proper dental hygiene.
Once bad breath has been diagnosed, the outlook for fresh breath is usually excellent as long as you stick to your dentist’s or physician’s treatment plan.

“Bad breath may results from a systemic illness which may require a long-term treatment with proper medical care.”