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FOUL BREATH


Root causes of bad breath?

Foul-smelling breath is a typical illness which greately influences the daytoday tasks of somany individuals. The offenssive odor from the mouth is unpleasent to those that come in close contact with negative breathers. The problem will certainly be increased by emotional injury bring about anxiety. The victims from this problem wil be isolated from the culture. This can also lead to marriage disharmony.

Essentially talking all humanbeings are badbreathres. Mouth contains numerous anaerobic bacteria like fusobacterium as well as actinomyces which acts on the healthy protein of food materials and also putrifies them. This process causes the development of offenssive gases like hydrogen sulphide, methyl mescaptan, cadaverin, skatol, putrescine ect triggering bad odor. If dental health is not maintained correctly all will struggle with halitosis. Most of us control this by normal brushing, tongue cleansing and also gargling. Also after maintining cleanliness in the mouth some people deal with offenssive scent because of different reasons which has to be diagnosed and dealt with correctly.

Some usual sources of foul breath.

1) Poor oral health:


If dental hygiene is not maintained appropriately the mouth becomes the seat for numerous microorganisms which produce offenssive gases by weakening the food particles. Bad breath is extreme in those that do not comb their teeth frequently and also clean their mouth after every food. Snacks taken inbetween meals can also create halitosis as a result of incorrect cleaning.
Badbreath prevails in mostly all individuals in the morning on waking. During sleep there is much less production of saliva.Saliva has actually obtained some antibacterial buildings which assist to maintain the mouth tidy. Saliva conains oxygen particles which is required to make mouth cardio. So the reduction in it's quantity during sleep makes a favourable problem for anaerobic microorganisms.

2) Food routines:


The primary cause of poor smell is due to deterioration of healthy protein by the bacteria as well as thus all food products rich in protein favours halitosis. Meat, fish, milk items, eggs, cakes, nuts, pear and also ect can create foul breath. Some food articles can create specific type of odor which might be unpleasent. Raw onion can produce regular poor smell. It is claimed that an apple a day maintains the medical professional away, a raw onion a day maintains everybody away. Eating groundnuts can additionally create negative scent. Nevertheless if appropriate cleaning is done odor can be decreased regardless of the nature of food. Abnormality in timing of food can also produce foul breath. Little food short articles taken in between the dishes can also generate bad smell.

3) Biofilm:


There is development of a thin sticky finishing called biofilm on the tongue as well as dental mucosa. This finishing is thick on the posterior facet of the tongue where millions of gram negative bacteriae are seen.The thick coating on the tongue is constantly associated with badbreath. Also a slim biofilm can make anaerobic condition beneficial for microbial expansion.

4) Tooth decays:


This is a destructive procedure causing decalcification with distruction of enamel and dentine causing cavitisation of the tooth. These are generated mostly by the lactobacilli. Food particles are deposited inside these dental caries as well as are putrified by the anaerobic germs generating poor odor. Regular cleaning will not remove the food particles easily as well as thus they are putrified totally. Decays are common in schoolgoing children as well as in those that donot keep proper oral hygiene.Calcium as well as vitamin shortage can also incline caries.

5) Gingivitis:


Gum tissue is a mucus membrane with supporting connective cells covering the tooth bearing borders of the jaw.The main feature of gum is protection.Gingivitis is the swelling of the gum.Due to various causes gum tissue obtain contaminated leading to swelling, pain and discharge. If the condition become worse the infection spread in the direction of peridontal area leading to continuous discharge called pyorrhoea. Times the infection goes deep generating alveolar abscess with discharge of pus. Infection can even get to the bone causing osteomyelitis.All these conditions can produce offenssive odor.

6) Periodontal retraction:


When the periodontals withdraw from the teeth a void is developed which will lodge food fragments as well as create foul breath.

7) Oral plaques and tartar down payments; 

Plaques and tartar is transferred primarily in the spaces between the teeth and gum tissue. This will certainly provide sanctuary for the food particles as well as microorganisms creating foul-smelling breath.

8) Ulcerative lesions & coverings:


Mostly all ulcerative lesions of the mouth are related to halitosis. These sores might be triggered by microorganisms, infections, food allergic reactions or as a result of autoimmune conditions. Apthous ulcer is the commonest amoung ulcerative sores. Others are herpes, fungal infections, vincents angina, contagious mononucleosis, scarlet fever, diphtheria, drug responses and ect. Cancerous ulcers generate severe halitosis. All fungal infections create white covering( candidiasis). Leucoplakia is a white thick spot on the mucous membrane layer of the mouth & tongue. It is thought about as a precancerous condition. Offenssive breath is associated with these problems.

9) Diseases of the salivary glands:


Saliva is extremely useful to provide oxygen to all parts of the oral cavity. Also a thin film of finish called biofilm can give an anaerobic problem in the mouth. Saliva can damp these layers and also make a cardio problem which is unfavourable for the bacteria.Any condition which reduces the manufacturing of saliva can raise microbial activity. Times the salivary duct is obstructed by stones or tumors.Cancer of the salivary gland is associated with offenssive odor. In suppurative parotitis purulant dischrge in to the mouth causes bad breath.

10) Tonsillitis:


Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques & tonsillar fluid:


If bad breath persists even after maintaining proper oral hygeine there is possibility of this condition. Serous fluid secreated from the folds of tonsil is very offenssive. Some patients complain that they hawk some cheesy materials from the throat; which are very offenssive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteriae. In such conditions tonsillectomy gives noticiable relief from bad breath.

12) Pharyngitis & pharyngial abscess:


Pharynx is a fibromuscular tube which forms the upper part of the digestive & respiratory tract. Inflmmation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offenssive discharge of pus in to the throat.

13) Dentures:


Denture users may complain about bad smell due to lodgement of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:


Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasent for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhoea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these causes offenssive smell.

15) Smoking:


Smokers always have bad smell. It can also produce lesions in the mouth & lungs causing bad breath.Smoking increases carbon dioxide in the oral cavity & reduces oxygen level, causing a favourable condition for bacteria. Smoking reduses appetite & thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose & ear:


Bad breath is occasionally seen in sinusitis( infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the eustachian tube( passage from middle ear to the throat) can also cause offenssive odor. Chronic rhinitis( infection of mucus membrane of nose) and forign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:


Mostly all diabetic patients suffer from bad breath. Coated tongue, ulcers & coatings in the mouth, increased sugar level in tissues ect are responsible for bad breath.Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:


Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid.Other infectious diseases like Tuberculosis, AIDS ect produce bad smell.

19) Fasting & dehydration:


Dry mouth favours bacterial activity. So any condition which produce dryness in the mouth makes the breath offenssive. Eventhough the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:


Bedridden patients suffer from offenssive breath due to thick coating on the tongue. water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favours anaerobic bacteria to become active.

21) Diseases of stomach & esophagus:


Eructation of gas and food produce unpleasent smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis, gastric ulcer and cancer of stomach.

22) Intestinal diseases:


Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative collitis. Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis ect.

23) Diseases of lungs:


Lung diseases like pneumonia, lung abscess, chronic bronchitis, bronchiectasis, tuberculosis, lung cancer ect can produce bad odor during expiration.

24) Liver disorders:


Liver diseases like hepatitis, cirrhosis, can cause bad breath.Gall bladder diseases with vomiting also causes unpleasent odor.

25) Psychiatric patients:


Bad breath is common in psychotic patients due to poor hygiene, irregular food habits, less water intake and ect.

26) Somatisation disorder:


This is a psychiatric disorder charecterised by the presence of a physical symptom that suggest a medical illness.These patients come with physical complaints like pain, nausea difficult respiration, bad smell ect. This condition is diagnosed after detailed examination of the patient with all investigations.Since this is a psychiatric disorder it has to be managed with a psychological approach.


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