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Halitosis

by Dr. Eva Bell
(Bangalore)

Halitosis or bad breath is a common symptom which many adults and children suffer from. The individual is usually unaware that his breath smells. When it is brought to his notice he either refuses to believe or becomes embarrassed and self conscious, and tries to distance himself from others.

There are various causes of bad breath, the most common of which is the ingestion of spicy food, with excess of onions and garlic. The unpleasant odour may last for several hours after a meal in spite of gargling or brushing one’s teeth. Food when digested is absorbed into the blood stream, from where it reaches the lungs. Then the odour is exhaled with every breath.

Unhealthy habits like smoking, drinking or chewing tobacco can leave a fetid odour in the mouth.

The oral cavity is the largest contributor to bad breath. Unbrushed teeth, dirty dentures, poorly fitting dentures or dental caries can cause halitosis. Food particles remaining between teeth are decomposed by bacteria, and the acid produced causes decalcification of the enamel, cavity and plaque formation on the teeth. In areas where there is a natural deficiency of fluoride in the water, dental caries is more prevalent.

Pyorrohea is inflammation of the gums. It is also caused by stagnation of food between the teeth and the gums. The gums become red and swollen and may bleed easily. Pus formation may follow. Accumulation of food debris and pus gives out a foul odour which is most marked in the morning when one wakes up.

Xerostomia or dryness of mouth may be due to medicines or to blockage of the ducts of the salivary glands or to breathing through the mouth. Saliva is required to cleanse the mouth by neutralizing acid formed from the decomposition of food particles. When there is no saliva and the mouth is dry, bad breath follows.

Halitosis may be a symptom of lung diseases like pneumonia, lung abscess, chronic cough or bronchiectasis or bowel infections, acid reflux, and chronic liver conditions.

Thrush or furring of the tongue is a sign of gastrointestinal problems. Dirty feeding bottles used by children can also cause thrush. Fungus forms a white layer over the tongue and mucous membrane of the mouth.

Debilitating diseases like TB, Cancer, Diabetes or prolonged fever can also cause thrush, which in turn leads to bad breath.
Persistent bad breath needs proper investigations to diagnose the cause.

How to prevent Halitosis:

• Maintain good oral hygiene. The teeth should be brushed at least twice a day, vertically from the gum upwards. Dental floss helps clean between the teeth and get rid of tiny food particles. Tooth brushes should be kept dry after use, and changed every two or three months. Gargling after each meal with water or antiseptic mouth wash, will help clear the mouth of unwanted food particles.

• A dental check up at least once a year will detect teeth or gum problems which can be treated. Scaling of the teeth to remove plaque will keep the teeth white and sparkling. Prompt treatment for pyorrohea or other infections like tonsillitis or tonsillar abscesses will prevent bad odour.

• Chewing tobacco, smoking or alcoholic drinks should be curtailed.

• A well balanced diet with plenty of vegetables, cereals, fruits and nuts will help the stomach and intestines to function well. Fats should be reduced, and too much of carbohydrate, chocolates and sugar should be avoided. Overeating is to be discouraged. Drinking plenty of water will keep the mouth moist and will also flush out the system.

• Cleaning the mouths of bed ridden patients frequently will help get rid of bad breath. Similarly thrush on a baby’s tongue should be removed gently with cotton dipped in antifungal solution. The milk bottles and teats should be properly sterilized.

• Chlorophyll tablets, peppermint or other breath fresheners can only give temporary relief.

• Many home remedies have been used to keep the digestive system healthy. A teaspoon either of fenugreek or cumin, is boiled for fifteen minutes in a litre of water and strained. This can be drunk several times a day. Avocado helps in digestion and prevents constipation. Guavas and apples are rich in various acids and if chewed properly, can clean the oral cavity. A bunch of paisley boiled in two cups of water with two cloves makes a good mouthwash.

These home remedies however have very limited success in eliminating bad breath. Unless the cause of halitosis is diagnosed and treated, there can be no relief. The individual will continue to feel embarrassed and isolated.

The end