HALITOSIS
Prof Dr Vinayak
Why i need to write this article....Halitosis or bad breath estimated to be the third most frequent reason for seeking dental aid, following tooth decay and gum disease.
Recently this area has witnessed growing technology and communications, particularly an enormous increase in advertisements for bad breath remedies on television, internet and in magazines. This, in turn ,has raised the levels of information and misinformation about bad breath among the patient population.
Lack of knowledge on how to prevent halitosis allows for its occurrence, limiting quality of life. As social relationships are one of the pillars of quality of life , -halitosis needs to be considered a factor of negative interference in our day to day social interactions.
Who can Have bad breadth.....No one appears to be immune to having bad breath one time or another. Bad breath can mean.....
1. a problem with your digestion,
2. gum disease.
3. point to an allergy,
4. an acidic system,
5. low immunity or
6.most often ----inadequate oral hygiene or bacterial overgrowth.
Impact on you...
most people have some element of transient unpleasant oral odour at some time.When severe or longstanding, it may
1.decrease self confidence
2.decrease your social interactions. You may hear “Please don't breathe until you have reached a desert.
3. personal discomfort
4.social disagreements among colleagues and friends.
Incidence and occurence of bad breadth.....
1. 10-30 percent of USA popultion
2. approximately 50% of middle-aged and older individuals emit socially unacceptable breadth
3.The reported incidence ratio between female and male patients with oral malodour is almost the same; no gender-based differences . However, it has been observed that women seek treatment more often than men.
A brief history of our ancestors bad breadth.....
1.References have been found in papyrus manuscripts dating back to1550 BC
2. During Christianity, the devil's supreme malignant odor smelled of sulfur, and it was presumed that sins produced a more or less bad smell.
3.A treaty in Islamic literature in the year 850 talked about dentistry, referring to the treatment of fetid breath, and recommended the use of siwak when breath had changed or at any time when getting out of bed.
4.The Hindus consider the mouth as the body's entry door and, therefore, insist that it be kept clean, mainly before prayers. The ritual is not limited to teeth brushing, but includes scraping the tongue with a special instrument and using mouthwash.
5. Buddhist monks inJapan also recommended teeth brushing and tongue scraping before the first morning prayers.
What factors cause Bad Breadth ....
Longstanding oral malodour is usually caused by
1.oral diseases(90% due to mouth diseases)
2. nasopharyngeal diseases.
3. bacterial decomposition of food particles,
4. decomposition of used cells, blood and some chemical components ofsaliva.
Bugs causing bad breadth...
There are many. Lets name a few...
1. Prevotella (Bacteroides)melaninogenica,
2.Treponema denticola,
3. Porphyrgingivalis,
4.Porphyromonas endodontalis,
5.Prevotellaintermedia,
6.Bacteroides loescheii,
7.Enterobacteriaceae,
8.Tannerella forsythensis (Bacteroides forsythus),
9. Centipedaperiodontii,
10. Eikenella corrodens,
11. Fusobacterium nucleatumvincentii,
12.Fusobacterium nucleatum , and
13. Fusobacterium periodonticum..........................should i go on........
.Local sources of mouth odors..... are
1. the tongue
2. the gum sulcus
3. food particles on and between the teeth,
4. coated tongue
5., dehydration states,
6. caries,
7. artificial dentures,
8. smoker's breath,
9. healing surgical or extraction wounds.
Common causes of halitosis...
1) Local Causes
A.Oral disease
1.Food impaction
2.Acute gum disease
3. Pericoronitis (flap like gum over your last molar)
4.Dry socket (unhealed tooth socket after extraction)
5. Xerostomia ( dry mouth/ less saliva in mouth )
6.Oral ulceration
7.Oral malignancy
B. Respiratory disease
1.Foreign body
2.Sinusitis
3.Tonsillitis
4.Malignancy Bronchiectasis (lung disease)
C. Volatile foodstuffs ...
1.Garlic
2.Onions
3.Spiced foods
2) SYSTEMIC (body )CAUSES
1.Acute febrile long standing illness
2.Respiratory tract infection
3.Helicobacter pylori infection ( a dirty bug)
4.Pharyngo-oesophageal diverticulum
5.Gastro-oesophageal reflux disease ( your burping)
6.Pyloric stenosis
7. duodenal obstruction ( your intestines)
8 Hepatic failure (your liver)
9. Renal failure (your kidneys)
10 Diabetic ketoacidosis
11 Leukaemias
12 Hypermethioninaemia Menstruation (menstrual breath)
How you can be certain....
1. smelling the exhaled air of the mouth and nose and comparing the two .)
2. spoon test,
3. dental floss odour test,
4.saliva odour test.
Ways to treat bad breadth......
STEP 1...Find the source of the malodour and then STEP 2.... do the exact treatment corresponding to the source.
some effective methods are.....
.1.Effective teeth cleaning, including brushing and interdental flossing,
2. If oral hygiene is already good and still oral malodour persists,then check your tongue and hence tongue cleaning may be indicated.
3.Chewing gum seems to lead to only transient reduction in oral malodour.
4.The range of mouthwashes may be effective in few cases but again transient.
a. Triclosan containing mouthwashes and toothpastes
b..Chlorhexidine gluconate containing mouthwashes.
c.. A mouthwash containing combination of chlorhexidine/cetylpyridinium chloride and zinc lactate
However,please remember when you use mouth washes for too long it
1., can give rise to a burning sensation of the oral mucosa if used too frequently,and
2.can cause (reversible) staining of the teeth.
CONCLUSION...
The relation between mouth odors and social aspects has always been a source of concern to society which, in the attempt to hide them, used different tricks and substances.
To keep your breath smelling minty-fresh remember to
1.routinely rinse after meals, either with natural mouthwash or water,
2. practice brushing your tongue daily, and
3.incorporate more of the digestive herbs and spices into your diet.
Remember ...it's wise not to ignore bad breath, and shrug it off as annoying, embarrassing, or simply insignificant.