| | Bad breath is no joke
Bad breath plagues just about everyone at one time or another. People often jeered at it, but bad breath can be a devastating social disability. More than a few people have been denied employment, failed in business and relegated to low social status because of it. For effective course of treatment of bad breath,the cause must be accurately diagnosed.
There are basically four sources of bad breath:
1. The mouth: This includes the teeth, the gums, and the top surface (dorsum) of the tongue, especially the very back of the tongue.
The term for odors from the mouth is Fetor Oris (not halitosis)___Fetor means "a strong offensive smell" and is a generic term. Oris means "from the mouth". Fetor oris is a strong 0ffensive smell originating specifically from the mouth
o The structures in the mouth that can harbor bad breath are:
Most bad breath originates from the mouth.
80% of all bad breath originates from bacterial overgrowth within, or upon structures in the mouth. If you are young, healthy, and do not suffer chronic sinusitis, tonsillitis or laryngitis, chances are good that this section is the most relevant to your problem.
When someone has bad breath caused by structures in the mouth, the chemicals you actually smell are sulfur compounds created by anaerobic bacteria. Anaerobic bacteria grow in the absence of oxygen and they most easily colonize areas where there is some mechanism to limit exposure to oxygen. As a class, the chemicals these anaerobes produce are called Volatile Sulfur Compounds (VSC's), and they include such beauties as hydrogen sulfide (rotten egg smell), methyl mercaptan (smells like rotten cabbage, and is the chemical added to natural gas to give it a recognizable odor) and dimethyl sulfide (smells like decayed vegetables). There are over 400 types of bacteria found in the average mouth. Several dozen of these can cause bad breath when allowed to flourish. They metabolize proteins such as dead tissue cells, blood and mucous. Proteins contain sulfur compounds which supply them with energy, and these sulfur compounds are converted to VSC's as a waste product.
A healthy mouth does not smell bad because the conditions in all parts of it encourage a balance of bacteria that does not cause odors. We call a healthy balance of bacteria a normal flora, or a "normal floral pattern". There is a very wide range of floral patterns which are healthy. Everyone has a slightly different floral pattern. But when conditions in any area of the mouth change due to disease or other factors such as dehydration or the presence of fermentable substances such as blood, dead cells and shreds of food, the balance of bacterial species shifts, allowing the overgrowth of anaerobic bacteria at the expense of the rest of the normal floral organisms. Thus odors begin to emanate from that area due to the productuon of VSC's.
CAUSES OF BAD BREATH THAT ORIGINATES FROM THE MOUTH
. Xerostomia--This is the technical term for dry mouth. Dry mouth dehydrates and concentrates the layers of salivary protein and mucous that coat the structures of the mouth. This concentration of mucous, saliva and food detritus makes for overgrowth of all sorts of different bacteria in different parts of the mouth. In some areas of a dry mouth, anaerobic bacteria overgrow and produce serious amounts of volatile sulfur compounds. Other areas favor the overgrowth of aerobes which produce their own volatile waste products which can smell and taste nearly as bad as the vsc's produced anaerobes. The most common type of bad breath caused by dry mouth is morning breath, which is a result of breathing through the mouth while sleeping. Some people tend to develop chronic dry mouth due to conditions such as Sorgren's syndrome. Elderly people are also prone to dry mouth due to the ageing process.
.Drugs-Certain drugs tend to cause dry mouth and thus are a prime cause of chronic bad breath. These include both prescription and non prescription drugs as well as both legal and illegal drugs.
.Decay teeth(caries)-Decay inside a tooth provides an anaerobic environment for sulphur metabolizing bacteria.
.The gums--In a disease state provides a safe harbor for bacteria.
.The Tongue-Hair-like structures on the upper surface of the tongue called papillae when overgrown harbors food particles that serve as substrate for bacteria.
2. The upper respiratory tract: This includes the nasal cavities, sinuses, throat,tonsils and the larynx(voice box).The term for bad breath originating from the upper respiratory tract is ozostomia and is the second largest sources of bad breath
3. The lungs: Bad breath originating from the lungs is either a temporary phenomenon caused by consuming certain foods or drugs, or it is a chronic problem caused by disease processes.
.Stomatodysodia is the term for bad breath caused by outright disease processes in the lungs, such as various infections, emphysema, bronchitis or lung cancer.
.Halitosis is the term for bad breath that results from physiologic processes elsewhere in the body and carried to the lungs by the bloodstream, or to the mouth by chronic vomiting.
4. The stomach: Technically, this type of bad breath is a subcategory of halitosis, but one that does not originate from the lungs. Bad breath originating from the stomach is caused by disease processes which
TREATMENT OF BAD BREATH
This involves accurate diagnosis of the underlying cause and its management