The Sunday News
Health Promotion with Kimberly Nyathi
HALITOSIS, colloquially called bad breath, or fetor oris, is a symptom in which a noticeably unpleasant odour is present on the exhaled breath. It is one of the most frequent reasons for people to seek dental care.
Causes: There are three major classes of halitosis based on its cause.
(1) Genuine Halitosis: The odour is caused by bacteria present below the gumline and on the back of the tongue. In about 90 percent of genuine halitosis cases, the origin of the odour is in the mouth itself. This is known as intra-oral halitosis, oral malodor or oral halitosis.
There are other causes, however these are all much less common than the above. Deep carious lesions (dental tooth decay). Recent dental extraction sockets. Interdental food packing — (food getting pushed down between teeth) — this can be caused by missing teeth, tilted, spaced or crowded teeth, or poorly contoured dental fillings. Acrylic dentures (plastic false teeth) — inadequate denture hygiene practises such as failing to clean and remove the prosthesis each night, oral infections, oral ulceration, fasting, stress and anxiety.
Menstrual cycle — at mid cycle and during menstruation, smoking, alcohol, volatile foodstuffs — e.g. onion, garlic, durian, cabbage, cauliflower and radish also cause bad breath.
(2) Halitosis as a symptom of a systemic disease or disorder (Psuedohalitosis): The following are some of the major causes of Psuedohalitosis — disorders of the (a) nasal cavity: In this case the air exiting the nostrils has a pungent odour that differs from the oral odour. Nasal odour may be due to sinus infections or foreign bodies. (b) throat (c) sinuses (d) lungs (e) oesophagus: The valve between the stomach and the esophagus, may not close properly due to GERD (Gastroesophageal reflux disease), allowing acid to enter the esophagus and gases to escape to the mouth. (f) stomach (g)metabolism: “Fruity” breath caused by acetone, present in diabetes. (h) medication induced: often medications can cause dry mouth which results in increased bacteria growth in the mouth, such as Anticholinergic, sympathomimetic, or diuretic drugs. (i) tonsils:
Tonsilloliths: also known as tonsil stones, are clusters of calcified material that form in the crevices of the tonsils,they give off a putrid smell.
(3) Halitophobia: Also known as delusional halitosis, or as a manifestation of Olfactory reference syndrome. These patients are sure that they have bad breath, although many have not asked anyone for an objective opinion.
Treatment: Gently cleaning the tongue surface twice daily is the most effective way to keep bad breath in control; that can be achieved using a toothbrush, tongue cleaner or tongue brush/scraper.
Eating a healthy breakfast with rough foods helps clean the very back of the tongue.
Chewing gum: Since dry-mouth can increase bacterial buildup and cause or worsen bad breath, chewing sugarless gum can help with the production of saliva, and thereby help to reduce bad breath. Chewing on fennel seeds, cinnamon sticks, mastic gum, or fresh parsley are common folk remedies.
Gargling right before bedtime with an effective mouthwash.
Maintaining proper oral hygiene, including daily tongue cleaning, brushing, flossing, and periodic visits to dentists: every six months. Flossing is particularly important in removing rotting food debris and plaque from between the teeth, especially at the gumline. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by one’s dentist). Probiotic treatments are effective.
Remember a healthy smile and fresh breath is a healthy you.
