Bad breath: causes and methods of solving the problem

Classification and diagnosis

The diagnosis of this disease should be carried out by a dentist; if no causes are found on this side, then it is necessary to undergo an examination by a therapist.

There are several types of halitosis:

• Physiological – in the absence of pathology, and the smell is the result of the accumulation of bacteria or plaque.
• Pathological, which is caused by diseases (diabetes, cirrhosis of the liver, internal bleeding, etc.).
• Pseudogynosis is a slight odor that is not perceived by others, but the patient often complains.
• Hapitophobia – occurs after treatment or examination. When no pathologies are found, there is no smell, but the patient continues to insist that there is an unpleasant odor.

The latter option refers to psychosomatic disorders and in this situation it is necessary to undergo a course of psychotherapy. It is also important to understand that the problem may be systemic and will require treatment from several specialists at once.

Why does there be an unpleasant odor?

The oral cavity is the beginning of the digestive tract. It contains many bacteria; saliva contains enzymes that can break down carbohydrates. Therefore, after waking up, all people have bad breath. But this condition is not considered a pathology; it is enough to brush your teeth for the smell to disappear.

A persistent unpleasant aroma appears after eating dishes with garlic, onions, and some spices. When alcohol is abused, the sour stench persists for a day or more, which is associated with the metabolism of ethyl alcohol in the liver and the release of its vapors through the lungs.

A large number of unpleasant aromas accompany diseases that affect metabolism. In patients with diabetes who do not follow a diet or use insulin incorrectly, when ketone bodies accumulate in the blood, the smell of acetone appears on their breath. People suffering from kidney failure will repel those around them with the unpleasant aroma of urea, which the kidneys cannot remove from the body.

Common causes in adults are pathologies of the digestive tract. Halitosis is caused by:

• gastritis with high acidity;
• stomach ulcer, duodenal ulcer;
• cardiac sphincter insufficiency;
• esophageal diverticula;
• malignant tumors of the stomach or esophagus.

Respiratory diseases can also cause an unpleasant odor. Air from the lungs passes through the oropharynx, so it can partially leave the body through the mouth. It smells unpleasant with purulent diseases of the sinuses, chronic runny nose or tonsillitis.

Causes

The causes of halitosis can be internal and external. Among them, the main ones include:

• Improper oral hygiene, especially when wearing braces and orthodontic structures;
• Presence of dental plaque and harder deposits;
• Caries of any depth of lesion;
• Constant or frequent dry mouth (due to stress or lack of fluid) leads to disruption of the microflora;
• Dental diseases of infectious, bacteriological and inflammatory nature;
• Poor nutrition: excessive consumption of sweets, spicy foods, alcohol, salty foods, protein diet and smoking;
• Complications of the dental field – pericoronitis, peri-implantitis, alveolitis;
• Diseases of the respiratory tract, digestive, genitourinary, endocrine systems;
• Taking medications that change the composition of saliva.

In a situation where there are no external dental causes, it is necessary to consult a therapist to identify the underlying disease that provokes a change in bad breath.

How is halitosis treated?

Dental treatment of halitosis involves:

• sanitization of the oral cavity (treatment of caries, removal of severely damaged teeth);
• removal of soft and hard plaque;
• removal of prosthetic systems (if any);
• gum treatment;
• taking antibacterial drugs;
• treatment of the oral cavity with antibacterial compounds;
• the use of special compositions that help neutralize odor (for example, bicarbonate soda solution, compositions with the addition of zinc, etc.). Such compositions release free oxygen, which prevents the proliferation of anaerobic bacteria.

The doctor recommends that the patient give up bad habits, adjust his diet, eliminating large amounts of protein foods, spices, marinades, etc.

And, of course, the main guarantee of successful treatment is the elimination of the root cause of halitosis, be it diseases of the teeth, soft tissues or internal organs.

Symptoms

If an unpleasant odor appears only in the morning and goes away after hygiene procedures, then this is the physiological nature of the occurrence of halitosis. This condition is considered normal and does not require any intervention other than regular hygienic cleaning. Attention should be paid to the chronic nature of the odor, which is most often accompanied by the following symptoms:

• Increased sensitivity, looseness and bleeding of gums;
• Tooth mobility and the presence of gum pockets;
• Plaque on the mucous membranes of the mouth;
• Darkening of the enamel along the gum ;
• Pain and swelling of the mucous membranes of the tongue.

In the absence of these symptoms, we can talk about an atypical manifestation and it is necessary to exclude the presence of internal diseases.

Halitosis: treatment

The main treatment for halitosis comes down to professional teeth cleaning, when soft and hard plaque is removed. After this, the cause of the unpleasant odor is identified, and a treatment regimen is developed.

Halitosis involves treatment in adults by eliminating caries, inflammation of the mucous membranes, and removing teeth that cannot be restored. Drug treatment is carried out by an orthodontist; in situations where there are carious cavities or appointments for tooth , the person is redirected to another therapist. If halitosis is detected in a child , then the reason is most often due to improper hygiene, and accordingly it will be important to teach proper hygiene and treat possible caries. At any age, the mandatory stages of treatment will be:

• Correction of nutrition - avoidance of foods that can cause an unpleasant odor or contribute to the spread of bacteria;
• Oral hygiene : choosing a toothbrush and toothpaste, teaching hygiene using dental floss and brushes, and choosing a mouthwash.
• Antiseptic care to reduce bacteria if halitosis is associated with the development of pathogenic flora.
• Treatment of infectious gum diseases using applications of ointments and gels.

In situations where halitosis is caused by orthodontic and orthopedic structures, it is necessary, together with your doctor, to choose an alternative treatment method or select effective products . If the cause of bad breath is other systemic diseases of the body, then treatment should begin with them. For example, consult an endocrinologist or gastroenterologist, because Until the cause is eliminated, dental prophylaxis will be useless.

What is halitosis?

Approved by the Faculty of Columbia University College of Dentistry

What it is? One of the common dental problems is bad breath. It is also known as halitosis. This odor may occur intermittently or may be persistent, depending on its cause.

Millions of bacteria live in the oral cavity, including on the back of the tongue. For many people, they are the main source of bad breath. Consistent temperature and humidity in the mouth are ideal for the growth of these bacteria. In most cases, bad breath is caused by bacteria living in the oral cavity.

Some types of bad breath are considered generally normal. They are not usually considered health problems. One example is morning breath. It is associated with changes in the oral cavity during sleep. During the day, saliva washes away decaying food particles and eliminates odors. At night, the body produces less saliva. Your mouth dries out and dead cells accumulate on your tongue and inner cheeks. Bacteria that use these cells as a food source produce an unpleasant odor.

In addition, bad breath can be caused by the following reasons:

• Poor oral hygiene – Irregular or improper brushing or flossing causes food particles to become trapped between the teeth and disintegrate in the mouth. Poor oral hygiene usually leads to the development of periodontitis (gum disease), which also leads to bad breath.

• Infections in the mouth – these may be due to a cavity in the tooth or periodontitis (gum disease).

• Respiratory tract infections – infections of the larynx, sinuses or lungs.

• External source - eating garlic, onions, or coffee, smoking cigarettes, chewing tobacco. Smoking and drinking coffee, tea and/or red wine can also cause teeth discoloration.

• Dry mouth (xerostomia) – this may be due to salivary gland disorders, medications, or mouth breathing. A large number of prescription and over-the-counter medications can cause dry mouth.

• Diseases – diabetes, liver disease, kidney disease, lung disease, sinusitis, reflux disease and others.

• Psychiatric illness – some people may believe they have bad breath, but others may not notice it. This is called "pseudohalitosis".

Symptoms

You may not be aware that you have bad breath. This is because the olfactory cells in the nose become accustomed to the smell. People around you may notice the smell and move away when you speak, or even express displeasure through facial expressions.

Other symptoms depend on the underlying cause of bad breath:

Oral infections – symptoms vary depending on the type of infection. These may include: • Red or swollen gums, with possible slight bleeding, especially after brushing or flossing • Pus between teeth or a collection of pus (abscess) at the base of a tooth • Loss of teeth or changes in the fit of dentures • Painful open sores or sores on the tongue or gums

Respiratory tract infections – symptoms may include: • Sore throat, red and/or swollen tonsils • Enlarged cervical lymph nodes • Fever • Stuffy nose • Greenish or yellowish nasal discharge • Cough with phlegm

Dry mouth – symptoms may include: • Difficulty swallowing dry foods • Difficulty talking for long periods due to dry mouth • Burning mouth • Unusually high number of cavities • Sjögren's syndrome

Diseases – symptoms of diabetes, lung disease, kidney disease or liver disease.

Diagnostics

Your dentist or therapist may look for bad breath during your appointment. Sometimes a patient's odor can indicate the likely cause of the problem. For example, a “fruity” smell may be a sign of uncontrolled diabetes. A urine-like odor, especially from a person at increased risk of kidney disease, can sometimes indicate kidney failure.

The dentist will review your medical history to determine medical conditions that may cause bad breath and medications that may cause dry mouth. The dentist will also ask you about your diet, personal habits (smoking, chewing tobacco) and any symptoms. He will also ask who noticed the bad breath and when.

The dentist will examine your teeth, gums, mouth, and salivary glands. He will also palpate your head and neck and evaluate your breathing as you exhale from your nose and mouth.

If the most likely cause is medical condition, your dentist may refer you to a GP. In severe cases of gum disease, your dentist may recommend seeing a periodontist (a dentist who specializes in gum problems).

If your doctor suspects you have a lung infection, diabetes, kidney disease, liver disease, or Sjögren's syndrome, you will need diagnostic tests. The type of tests depends on the suspected disease. You may be required to have blood tests, urine tests, chest x-rays or sinus x-rays, or other tests.

Estimated duration

The duration of elimination of bad breath depends on its cause. For example, if the problem is poor oral hygiene, proper dental care will immediately provide fresh breath. After a few days of regular brushing and flossing, even better results will be achieved. Periodontitis and tooth abscess also respond quickly to proper dental treatment. Bad breath associated with chronic sinusitis may return, especially if it is caused by a structural problem in the sinuses.

Bad breath caused by the disease can persist for quite a long time. It often resolves with proper treatment of the underlying condition.

Prevention

Prevention of bad breath caused by dental problems is easily achieved through proper home and professional care.

• Brush your teeth, tongue and gums after meals and floss once a day. This is the most important thing if bad breath is caused by dental problems

• If recommended by your dentist, rinse with a mouthwash approved by your local dental association.

• Visit your dentist regularly (at least twice a year) for examinations and professional oral hygiene.

To combat bad breath, you can also drink plenty of water throughout the day to help your body produce saliva. Periodically rinsing your mouth with water helps remove food particles. Chewing sugar-free gum or sugar-free breath mints can help keep your breath fresh and prevent plaque buildup. However, be aware that consuming sugar-free gum and/or candies that contain sorbitol may have side effects. These include diarrhea and flatulence.

Treatment Treatment for bad breath depends on the cause.

When to see a specialist

Contact your dentist immediately if your bad breath is due to loose teeth or painfully swollen or bleeding gums. Also see your doctor if your bad breath is associated with any of the following symptoms:

• Fever • Sore throat • Postnasal drip • Colorless nasal discharge • Cough with phlegm

If you do not have all of these symptoms, but bad breath persists despite proper nutrition and oral hygiene, contact your dentist or physician.

Sometimes, bad breath can be a sign of a medical condition that needs urgent attention. If you have diabetes, gastroesophageal reflux disease (GERD), or chronic liver or kidney failure, ask your doctor what bad breath may mean for your condition.

Forecast

The prognosis for fresh breath is usually good if you follow your dentist's or physician's treatment plan.

Halitosis: treatment at home

Halitosis can be treated with traditional methods at home, but all procedures should be carried out after consultation with a doctor , and in the absence of serious health pathologies. The main direction of treatment is to remove pathogenic microflora. To do this, use herbal rinses:

• Chamomile;
• Oak bark;
• Sage.

Infusions should be warm, because... hot broth can burn your mouth and provoke the development of the disease. If fresh breath disappears due to hygiene or nutrition, then it is recommended to eat apples, carrots and pears, which gently remove plaque and massage the gums. Fresh herbs (parsley, mint, rosemary, basil) freshen your breath. Ginger root, which is finely chopped and consumed after meals, also helps well. It is important to make sure that you are not allergic to them before consuming any food.

Preventive actions

Prevention of halitosis is the main and most effective way, because Periodic treatment of this problem does not solve it comprehensively. To avoid bad breath, you must do the following:

• Choose a toothbrush with the appropriate degree of hardness. If you have periodontal disease, then the bristles should be soft; for those who have a tendency to form plaque, it is better to choose harder bristles.
• Use pastes and powders without abrasives to avoid deformation of the enamel.
• Regularly after meals, use brushes or floss to clean your teeth, and a mouthwash with an antibacterial effect.
• Drink plenty of water to prevent dry mouth.
• Reduce the amount of coffee and tea that form plaque, and also stop smoking.

Timely undergo preventive examination not only from the dentist, but also from other specialists. This is necessary for the prevention and treatment of other diseases in which halitosis is only a symptom. Contact us for professional oral hygiene in the clinic.

Causes of bad breath

A slight bad breath in the morning is a completely normal phenomenon that almost everyone experiences. This happens due to a decrease in saliva production, mild dehydration and the accumulation of desquamated epithelium in the mouth. After a morning glass of water and brushing my teeth, everything returns to normal. But if the symptoms do not disappear throughout the day, we are talking about a disease - halitosis.

There are two main categories of causes of halitosis: oral (associated with diseases of the teeth, gums, tonsils, nasopharynx) and systemic - due to disturbances in the functioning of internal organs. In the vast majority of cases, we are dealing with the first reason.

Oral form

The specific putrid odor from the mouth is a product of the activity of anaerobic bacteria. They accumulate where there is no air: under dental plaque, under the gums, in carious cavities, on the tongue. By breaking down amino acids, bacteria release substances with a specific aroma (for example, hydrogen sulfide).

• Caries (including under dentures), gingivitis, pulpitis, periodontitis, stomatitis, dental cysts, pericoronitis. A rotten smell may indicate the beginning of necrotic processes.
• Diseases of the ENT organs: inflammation of the tonsils, adenoids, sinuses, nasal mucosa, especially if there is purulent discharge. Excessive mucus production leads to foul odor.
• Excessive dry mouth (xerostomia). Due to decreased salivation, the mouth is less cleaned and, accordingly, the likelihood of dental odor increases.

Bad smell as a symptom

Bad breath may also have other causes. The state of our breathing is affected by the functioning of the liver, kidneys, lungs, gastrointestinal tract, endocrine system, taking certain medications, smoking and addiction to alcohol. Only a doctor can determine the cause of halitosis, but the smell itself will help you get some idea of ​​the disorder.

• The smell of acetone or rotting apples indicates the growth of ketone bodies in the blood plasma. In children, it can be a syndrome of type I diabetes, infectious diseases or dietary disorders. In adults, talk about the development of type II diabetes or poor nutrition due to alcohol dependence. When acetone appears in your breath, you first need to take a blood test to check the sugar content.
• The smell of urine (ammonia) raises suspicions about the development of kidney failure.
• The smell of fish is a syndrome of trimethylaminuria, a genetic disease in which the substance trimethylamine accumulates in the body.
• The smell of rotten eggs indicates another genetic disorder - cystinosis.
• A sweet smell may indicate decreased liver function and even cirrhosis.
• Sour smell - about bronchial asthma.
• The smell of iron is a likely symptom of diseases of the blood, pancreas or stomach. But it can also be caused by wearing metal prostheses or drinking water with a high iron content, so there is no need to worry ahead of time.
• The smell of vomit or excrement sometimes accompanies intestinal obstruction.