- by Dr Som Ranjan Pathak
- 3 Shares
- Mar 07 2017
Are you troubled with Halitosis-Bad Breath
Have you ever attempted to smell your own breath? It’s a typical myth people use, but deprived of any truth. It is not possible for one to know how their breath smells by holding your hand to your nose and trying to smell the breath.
This is because our mouth and nose and are not different organs, and because our nose is inclined to filter out our own smells, therefore smelling one’s own breath is practically impossible... Each day, while many have faulty understanding about having bad breath by which their whole life is affected, there are a few others who have halitosis are not aware of their condition: this is called the ?Bad breath Paradox?
There are a lot of general terms that are used to describe this not so pleasant breath that is released from a person’s mouth like: oral malodor, halitosis, bad breath or fetor oris, irrelevant of whether the smelly substances in the breath develop from oral or non-oral sources.
Bad breath or Halitosis is an oral health state identified by consistently exhaling odorous breath and may be caused by a number of agents including particular foods, poor oral hygiene, inappropriate cleaning of dentures, and decrease in salivary flow rate, tobacco products or a medical condition.
Bad Breath or Halitosis is mainly caused due to volatile sulfur compounds (VSC) which is the outcome of protein broken down by the bacteria and it can be measured quantitatively and qualitatively in the bad oral breath.
In eight to ninety percent of cases, halitosis develops in the mouth due to poor plaque control, periodontal disease, dry mouth, faulty restorations, deep carious lesions, periimplant disease, oral infections, pericoronitis, ulcers of the mouth, gastric problems , impacted food or debris, elements causing lowered salivary flow rate and, the main reason being, tongue coating and particularly as a result of uncontrolled bacterial growth which is generally on the posterior third of the dorsal surface of the tongue.
The tongue is a major area of bad breath production, while periodontal disease and other elements seem to be only a very small part of the overall problem. Adding to it; current social norms stress the importance of interpersonal association and personal image. Thus, halitosis may be an important aspect in social engagement and, therefore, may be the beginning of concern not only for a possible health condition but also for constant psychological alterations which lead to social and personal isolation. Although bad breath is not a pleasant condition experienced by most people, it typically results in short term discomfort.
In the remaining 10% -20 of cases, bad breath is a result of systemic disorders such as nephritic insufficiencies hepatic, trimethylaminuria and pancreatic, upper and lower respiratory tract infection, some kind of medication and cases where gastric matter may generate oral bad breath.
A more reliable, analytical system which will be able to exactly detect the volatile compounds in the expired air and give the results to a particular cause is not yet available.
Halitosis can be managed by involving maintenance of elimination of active periodontal disease, plaque control and cleaning the tongue on a regular basis. Rinsing the mouth with a mouthwash could be suggested in some cases, as a temporary measure.
Other rare causes of halitosis maybe:
Chronic kidney failure
It is important to know if a given complaint of bad breath is reasonable and whether the odor develops in the mouth, nose or elsewhere. A complete history and an oral examination will be needed. The first step in evaluating is to decide whether halitosis is actually present. This is important as most people are poor judges of their own breath odor.
A dentist will clinically assess bad breath based on smelling the air that is exhaled from the nose and mouth, by comparing the two.
If odor is detected from the mouth but not from the nose is likely to be coming from oral or pharyngeal origin. Odor from the nose only is possibly coming from the nose or sinuses. In rare cases when the odor from the mouth and nose and are of the same intensity, a systemic cause of the bad smell may be likely.
There are a variety of highly developed detectors that can rate odor more accurately, they include the following:
Halimeter: low levels of sulfur are detected
Gas chromatography: measures 3 volatile sulfur compounds - methyl mercaptan, dimethyl sulfide and hydrogen sulfide
BANA test: It is used to measure a particular enzyme produced by bad breath -causing bacteria
Beta-galactosidase test- mouth odor has been found to correlate with levels of the enzyme beta-galactosidase.
Management of Halitosis:
The management of halitosis begins by taking a complete history of the condition, time span, severity, and effect on the patient’s day to day life. Examination involves radiographic, clinical and special tests. A proper treatment can be referred once the contributing factors are identified. By performing the clinical examination checkup the patient’s periodontal status oral hygiene, and caries; The factors for plaque retention are also recorded. Radiographic examination should look for evidence of dental caries, alveolar bone defects, and defective restorations.
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