Have you ever been told that you have bad breath? Have you sat with someone or had to talk face to face with someone who had bad breath? How did you feel?
Bad breath also called halitosis, oral mal-odour, fetor oris or simply mouth odour is a common dental condition and statistics shows it is the third most common reason why people seek dental care after gum disease and caries.
It is described as a persistent unpleasant odour or smell from the mouth. This is different from the occasional mouth odour you have when you wake up in the morning or after eating certain foods eg tuna fish, meat, cheese etc. True halitosis persists even after brushing, flossing, rinsing and other oral care solutions. It is demoralizing and embarrassing and is a social concern to many.
What causes Bad breath?
Bad breath is said to occur from bacteria usually present at the back of the tongue and throat, which produce volatile sulphur compounds from the breakdown of highly proteinaceous substances. The individual causes of halitosis can be summarized thus;
1. Poor oral health.
This is the commonest cause of bad breath, resulting in about 85-90% of cases. Accumulation of dirt in the mouth from oral neglect results in build-up of bacteria which produce odorous compounds
2. Gum disease.
This usually results mainly from poor oral health. This leads to pocket formation (an enclosed space between the gum and the teeth, that is a stagnation area for food and bacteria), and bleeding gums and a resultant smell.
3. Poor maintenance of dentures and other oral appliances.
4. Cavities(holes) in the mouth. This harbours food debris which begins to decay and results in a terrible smell
5. Dry mouth.
Saliva in the mouth is very important. It functions to clean the mouth and it contains certain antibacterial substances. A reduced production or absence of saliva will result in bad breath. Saliva reduction can occur due to smoking, certain medications( eg nitrates for treating angina, some cancer medications, phenothiazine, metronidazole etc), and some medical conditions eg Xerostomia.
6. Tobacco smoking.
Tobacco itself has a smell.in addition, it causes dry mouth and gum disease which themselves are causes of bad breath
Certain foods eg onion, garlic, and other highly proteinaceous foods like beans are known causes of bad breath. On digestion of these foods, they produce odoriferous breakdown products
8. Crash diets
In a bid to lose weight quickly, people tend to take diets that have low or absolutely no carbohydrates. This result in break down of fat to produce ketone bodies released through the breath, and present as bad breath.
9. Throat infections.
This is the commonest cause of bad breath in children and results from persistent sinusitis and upper respiratory tract infections
10. Other systemic causes not related to the mouth eg, gastric reflux, liver disease. Kidney disease, diabetes mellitus etc. These other causes are less common and account for a very small percentage of bad breath.
How does one know they have bad breath?
Usually, people know they have bad breath when they are told by those close to them. Many times this doesn’t happen often as many people shy away from telling others about their bad breath to avoid embarrassing them. No wonder the saying that it is only a true friend that tells you about your smelling mouth.
Another way to know if you have bad breath is by doing the “wrist-lick test”. It’s simple. just lick your wrist allow the saliva dry and smell. If it smells you have bad breath. This is however subjective as our smelling abilities differ.
Lastly, there are a number of objective tests that can be carried out in the dental clinic to diagnose bad breath. They range from test which analyses the level of volatile sulphur compounds to those which check for enzymes which indicate bad breath.
Can bad breath be treated and prevented?
Luckily bad breath is a completely preventable and treatable condition. Join us on our next article as we talk more about bad breath and on its treatment and prevention!
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