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Chronic Bad breath
I’ve had chronic bad breath for over 10 years. I notice a persistent white coating mainly on the back of my tongue, which returns quickly even after cleaning. The smell is strong, sometimes fecal or metallic, and does not improve with brushing, mouthwash, or mints. I’ve already been tested for Helicobacter pylori and other gut issues, and results were negative. I would like evaluation for posterior tongue biofilm and anaerobic bacteria, and guidance on proper treatment.
• It’s worse in the morning
• Water gives only temporary relief
• Coating is mainly at the back of tongue
• Halitosis (oral cause)
• Tongue coating / bacterial biofilm
• Gum disease (even mild)
• Tonsil stones (hidden cause sometimes)
• Dry mouth
Tip (important)
Ask specifically if they can:
• Do a tongue scraping + bacterial assessment
• Suggest antibacterial treatment (like chlorhexidine or zinc-based rinses)
• Check if you need a tongue microbiome
Any clinic available in Hyderabad
Answers (5)
Tongue back coating cause is
Gum infection (gingivitis)
Tonsil stone(tonsilolithiasis)
Xerostomia
Next Steps
halitosis in the morning due to xerostomia
tongue cleaning use
tongue scraper clean gently 1-2 time a day
chlorhexidine mouthwash(7-10days)or zinc based mouthwash mostly safe for longterm
proper brushing 2times a day
floss
for tonsil stone visit ENT
Health Tips
drink more fluid
sugar free chew gum
visit dentist for scaling and proper diagnosis
Answered
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Hello
Tongue coating can suggest fungal infection as well.
Try to keep tongue clean.
Candida (oral fungus) has various forms.
It can appear white over tongue and also show redness in the throat region.
Next Steps
Kindly visit a dentist and they may prescribe you anti-fungal agents esp topical for tongue and throat.
Also a dry mouth requires moisturizing mouthwash to keep your mouth moist and wet.
Get yourself assessed for high blood sugar as well.
Health Tips
Are you consuming alcohol?are your renal function tests and liver function tests normal?
U must get these done after consulting the physician.
Answered
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Does the lesion bleed if tried to physically scrape it off ?? Or there's a velvety feeling ?? As per your symptoms, it could be oral thrush as you have already checked & tested negative for H. pylorii.
Next Steps
Visit a nearby clinic & get prescribed for an Antifungal treatment for the next 10-15 days.
Candid Mouth paint applied thrice a day with a cotton swab for the next 10 days on the affected area may help.
Health Tips
Try to avoid sugar, alcohol consumption. Avoid or quit smoking & maintain proper oral hygiene until relieved and beyond.
Answered
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Having bad breath since such a long time usually suggest either a gastric related cause, which has been ruled out, an infection of the back of the tongue or even something related to poor salivary flow. Getting a microscopic examination of the scrapings would be helpful to determine the likely cause
Next Steps
Get a evaluation done by a dentist in person
Health Tips
Start using betadine mouth wash to reduce the bacterial load
Answered
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Chronic oral halitosis due to posterior tongue coating (biofilm) with anaerobic bacteria Examine posterior tongue coating
Check for:
Gum disease (periodontitis)
Deep cavities
Dry mouth (xerostomia)
If available:
Halimeter or VSC testing
Microbial assessment (optional)
Next Steps
Proper tongue cleaning (most important step)
Use a tongue scraper (not just a brush)
Clean far back on the tongue
Do it 2 times daily
Expect gag reflex initially and improves with time
Answered
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