| Causes of bad breath ? | | | | Some times the salivary duct is obstructed by |
| Bad breath is a common health problem which | | | | stones or tumors.Cancer of the salivary gland is |
| greately affects the daytoday activities of | | | | associated with offenssive odor. In suppurative |
| somany people. The offenssive odor from the | | | | parotitis purulant dischrge in to the mouth causes |
| mouth is unpleasent to those who come in close | | | | bad breath. |
| contact with bad breathers. The problem will be | | | | 10) Tonsillitis: |
| doubled by psychological trauma leading to | | | | Tonsils are a pair of lymphoid tissue situated in |
| depression. The sufferers from this problem wil | | | | the lateral wall of oropharynx. Inflammation of the |
| be isolated from the society. This can even lead | | | | tonsil is called tonsillitis. Bad breath is seen in both |
| to marital disharmony. | | | | acute and chronic tonsillitis. Quinsy or peritonsillar |
| Literally speaking all humanbeings are | | | | abscess can also produce bad breath. |
| badbreathres. Oral cavity contains millions of | | | | 11) Tonsillar plaques & tonsillar fluid: |
| anaerobic bacteria like fusobacterium and | | | | If bad breath persists even after maintaining |
| actinomyces which acts on the protein of food | | | | proper oral hygeine there is possibility of this |
| materials and putrifies them. This process results | | | | condition. Serous fluid secreated from the folds of |
| in the formation of offenssive gases like | | | | tonsil is very offenssive. Some patients complain |
| hydrogen sulphide,methyl | | | | that they hawk some cheesy materials from the |
| mescaptan,cadaverin,skatol,putrescine ect causing | | | | throat;which are very offenssive in nature. These |
| bad odor. If oral hygiene is not maintained | | | | are formed inside the tonsillar crypts which |
| properly all will suffer from bad breath. Most of us | | | | contain thousands of bacteriae. In such conditions |
| control this by regular brushing,tongue cleaning and | | | | tonsillectomy gives noticiable relief from bad |
| gargling. Even after maintining cleanliness in the | | | | breath. |
| mouth some individuals suffer from offenssive | | | | 12) Pharyngitis& pharyngial abscess: |
| smell due to various causes which has to be | | | | Pharynx is a fibromuscular tube which forms the |
| diagnosed and treated properly. | | | | upper part of the digestive & respiratory tract. |
| Some common causes of bad breath. | | | | Inflmmation of the pharynx is called pharyngitis, |
| 1) Poor oral hygiene: | | | | caused mainly by bacteria and viruses. Bad breath |
| If oral hygiene is not maintained properly the | | | | is present in pharyngitis along with other signs like |
| mouth becomes the seat for millions of bacteria | | | | cough and throat irritation. Abscesses in the wall |
| which produce offenssive gases by degrading the | | | | of pharynx can also produce offenssive discharge |
| food debris. Bad breath is severe in those who do | | | | of pus in to the throat. |
| not brush their teeth regularly and clean their | | | | 13) Dentures: |
| mouth after every food. Snacks taken inbetween | | | | Denture users may complain about bad smell due |
| meals can also produce bad breath because of | | | | to lodgement of small food debris in between. |
| improper cleaning. | | | | Proper brushing may not be possible in denture |
| Badbreath is common in almost all people in the | | | | users especially fixed dentures. |
| morning on waking. During sleep there is less | | | | 14) Tobacco: |
| production of saliva .Saliva has got some | | | | Tobacco chewing is associated with bad breath. |
| antibacterial properties which help to keep the | | | | The smell of tobacco itself is unpleasent for |
| mouth clean. Saliva conains oxygen molecules | | | | others. Tobacco can irritate the mucus membrane |
| which is needed to make oral cavity aerobic. So | | | | and cause ulcers and coatings. Gingivitis and |
| the reduction in it's quantity during sleep makes a | | | | pyorrhoea are common in tobacco chewers. |
| favourable condition for anaerobic bacteria. | | | | Tartar is deposited on the teeth mainly near the |
| 2) Food habits: | | | | gums. Tobacco chewers get gastric acidity with |
| The main cause of bad smell is due to | | | | eructations. All these causes offenssive smell. |
| degradation of protein by the bacteria and hence | | | | 15) Smoking: |
| all food products rich in protein favours bad | | | | Smokers always have bad smell. It can also |
| breath. Meat,fish,milk products, | | | | produce lesions in the mouth & lungs causing bad |
| eggs,cakes,nuts,pear and ect can cause bad | | | | breath.Smoking increases carbon dioxide in the |
| breath. Some food articles can produce particular | | | | oral cavity & reduces oxygen level,causing a |
| type of smell which may be unpleasent. Raw | | | | favourable condition for bacteria. Smoking reduses |
| onion can produce typical bad smell. It is said that | | | | appetite & thirst hence acid peptic disease is |
| an apple a day keeps the doctor away,a raw | | | | common in chain smokers. |
| onion a day keeps everybody away. Eating | | | | 16) Lesions in the nose & ear: |
| groundnuts can also produce bad smell. However | | | | Bad breath is occasionally seen in sinusitis(infection |
| if proper cleaning is done smell can be reduced | | | | of para nasal sinuses). In case of post nasal |
| irrespective of the nature of food. Irregularity in | | | | dripping bad breath is common due to the |
| timing of food can also produce bad breath. Small | | | | presence of protein in the discharges. These |
| food articles taken in between the meals can also | | | | proteins are degraded by the bacteria. Infection in |
| produce bad smell. | | | | the middle ear with discharge of pus in to the |
| 3) Biofilm: | | | | throat through the eustachian tube(passage from |
| There is formation of a thin sticky coating called | | | | middle ear to the throat)can also cause offenssive |
| biofilm on the tongue and oral mucosa. This | | | | odor. Chronic rhinitis(infection of mucus membrane |
| coating is thick on the posterior aspect of the | | | | of nose) and forign bodies in the nose can also |
| tongue where millions of gram negative bacteriae | | | | produce bad smell in the expired air. |
| are seen .The thick coating on the tongue is | | | | 17) Diabetes mellitus: |
| always associated with badbreath. Even a thin | | | | Mostly all diabetic patients suffer from bad breath. |
| biofilm can make anaerobic condition favourable | | | | Coated tongue,ulcers &coatings in the mouth |
| for bacterial proliferation. | | | | ,increased sugar level in tissues ect are responsible |
| 4) Dental caries: | | | | for bad breath.Bacterial growth in diabetic patient |
| This is a destructive process causing | | | | is very faster than non diabetic individuals. |
| decalcification with distruction of enamel and | | | | 18) Fevers: |
| dentine resulting in cavitisation of the tooth. These | | | | Bad breath is common in almost all fevers. Even |
| are produced mainly by the lactobacilli . Food | | | | an acute fever can produce bad breath. Severe |
| particles are deposited inside these cavities and | | | | bad breath is seen in typhoid .Other infectious |
| are putrified by the anaerobic bacteria producing | | | | diseases like Tuberculosis , AIDS ect produce bad |
| bad smell. Normal brushing will not remove the | | | | smell. |
| food debris easily and hence they are putrified | | | | 19) Fasting & dehydration: |
| completely. Caries are common in schoolgoing | | | | Dry mouth favours bacterial activity. So any |
| children and in those who donot maintain proper | | | | condition which produce dryness in the mouth |
| oral hygiene .Calcium and vitamin deficiency can | | | | makes the breath offenssive. Eventhough the |
| also predispose caries. | | | | food particles are known to produce bad breath, |
| 5) Gingivitis: | | | | fasting can also produce the same. Production of |
| Gum is a mucus membrane with supporting | | | | saliva is also reduced during fasting. Chewing and |
| connective tissue covering the tooth bearing | | | | swallowing also helps to keep the mouth clean. |
| borders of the jaw .The main function of gum is | | | | 20) Bedridden patients: |
| protection .Gingivitis is the inflammation of the | | | | Bedridden patients suffer from offenssive breath |
| gum .Due to various causes gum tissue get | | | | due to thick coating on the tongue. water intake |
| infected resulting in swelling,pain and discharge. If | | | | is also limited in these patients. Regurgitation of |
| the condition become worse the infection spread | | | | food aggravates the condition. Since they talk less |
| towards peridontal area leading to continuous | | | | aeration in the oral cavity is reduced which |
| discharge called pyorrhoea. Some times the | | | | favours anaerobic bacteria to become active. |
| infection goes deep producing alveolar abscess | | | | 21) Diseases of stomach & esophagus: |
| with discharge of pus. Infection can even reach | | | | Eructation of gas and food produce unpleasent |
| the bone causing osteomyelitis.All these conditions | | | | smell. Abnormality in the function of lower |
| can produce offenssive smell. | | | | sphincter can allow the food to regurgitate |
| 6) Gum retraction: | | | | upwards causing bad breath. Bad breath is also |
| When the gums retract from the teeth a gap is | | | | common in gastritis,gastric ulcer and cancer of |
| developed which will lodge food particles and | | | | stomach. |
| cause bad breath. | | | | 22) Intestinal diseases: |
| 7) Dental plaques and tartar deposits; Plaques and | | | | Bad breath is common in patients suffering from |
| tartar is deposited mainly in the gaps between the | | | | ulcerative lesions of intestine like ulcerative |
| teeth and gum. This will provide shelter for the | | | | collitis..Other diseases are malabsorption syndrome |
| food debris and bacteria causing bad breath. | | | | intestinal tuberculosis, peritonitis ect. |
| 8) Ulcerative lesions& coatings: | | | | 23) Diseases of lungs: |
| Almost all ulcerative lesions of the mouth are | | | | Lung diseases like pneumonia, lung abscess,chronic |
| associated with bad breath. These lesions may be | | | | bronchitis,bronchiectasis,tuberculosis, lung cancer |
| caused by bacteria,viruses,food allergies or due to | | | | ect can produce bad odor during expiration. |
| autoimmune disorders. Apthous ulcer is the | | | | 24) Liver disorders: |
| commonest amoung ulcerative lesions. Others are | | | | Liver diseases like hepatitis, cirrhosis,can cause bad |
| herpes,fungal infections,vincents angina,infectious | | | | breath.Gall bladder diseases with vomiting also |
| mononucleosis,scarlet fever,diphtheria,drug | | | | causes unpleasent odor. |
| reactions and ect. Cancerous ulcers produce | | | | 25) Psychiatric patients: |
| severe bad breath. All fungal infections produce | | | | Bad breath is common in psychotic patients due |
| white coating(candidiasis). Leucoplakia is a white | | | | to poor hygiene,irregular food habits,less water |
| thick patch on the mucus membrane of the | | | | intake and ect. |
| mouth & tongue. It is considered as a | | | | 26) Somatisation disorder: |
| precancerous condition. Offenssive breath is | | | | This is a psychiatric disorder charecterised by the |
| associated with these conditions. | | | | presence of a physical symptom that suggest a |
| 9) Diseases of the salivary glands: | | | | medical illness .These patients come with physical |
| Saliva is very useful to supply oxygen to all parts | | | | complaints like pain,nausea difficult respiration, bad |
| of the oral cavity. Even a thin film of coating | | | | smell ect. This condition is diagnosed after detailed |
| called biofilm can provide an anaerobic condition in | | | | examination of the patient with all |
| the mouth. Saliva can wet these layers and make | | | | investigations.Since this is a psychiatric disorder it |
| an aerobic condition which is unfavourable for the | | | | has to be managed with a psychological approach. |
| bacteria .Any condition which reduces the | | | | [ THE POINTS MENTIONED IN THIS ARTICLE IS |
| production of saliva can increase bacterial activity. | | | | FOR GENERAL INFORMATION. |