In most cases of bad breath or halitosis
(85-90%) , the bad smell originates from
the mouth itself. The intensity of bad
breath differs during the day, depending
upon oral wetness or dryness. Because the
mouth is dry and inactive during the
night, the odor is usually worse upon
awakening ("morning breath"). On the other
hand oral dryness depends upon various
factors such as stress, fasting, eating
certain foods (such as garlic, onions,
meat, fish and cheese), obesity, smoking
and alcohol consumption.
Bad breath can be TRANSIENT meaning that
it can often disappear after eating,
brushing the teeth, flossing, and rinsing
with specialized mouthwash.
Bad breath may also be PERSISTENT (chronic
bad breath), which is a more serious
condition, affecting some 25% of the
population in varying degrees. Bad breath
can negatively affect an individual's
personal, social and business
relationships, leading to poor self-esteem
and increased stress. Persistent bad
breath is usually caused by the metabolic
activity of certain types of oral
bacteria. Persistent odor can originate
from:
1. THE MOUTH - Most unpleasant odors are
known to arise from proteins trapped in
the mouth which are processed by oral
bacteria. There are over 600 types of
bacteria found in the average mouth.
Several dozens of these can produce high
levels of foul odors when incubated in the
laboratory. The most common location for
mouth-related bad breath is the tongue.
Large quantities of naturally-occurring
bacteria are often found on the posterior
dorsum of the tongue, where they are
relatively undisturbed by normal activity.
This part of the tongue is relatively dry
and poorly cleansed, and bacterial
populations can thrive on remnants of food
deposits, dead epithelial cells and
postnasal drip. Other parts of the mouth
that may also contribute to the overall
odor include: the inter-dental and
sub-gingival niches, faulty dental work,
food-impaction areas in-between the teeth,
abscesses and unclean dentures;
2. THE NOSE - The odor coming from the
nostrils has a pungent odor which differs
from the oral odor. Nasal odor may be due
to sinus infections or foreign bodies
trapped in the nose;
3. THE TONSILS - Putrefaction from the
tonsils is generally considered a minor
cause of bad breath, contributing to some
3-5% of cases;
4. THE STOMACH – The stomach is a very
uncommon source of bad breath (except
during belching). The esophagus is a
closed and collapsed tube, and continuous
flow (as opposed to a simple burp) of gas
or putrid substances from the stomach
indicates a health problem - such as
reflux or a fistula between the stomach
and the esophagus - which will demonstrate
more serious manifestations than just foul
odor;
5. SYSTEMIC DISEASES – there are several
diseases that can cause bad odor such as
Liver failure; Lower respiratory tract
infections (Bronchial and lung
infections); Renal infections and renal
failure; Carcinoma; Trimethylaminuria
("fish odor syndrome"); Diabetes mellitus,
and certain metabolic dysfunctions.
You can first consult a dentist and then
seek help from an internal medicine
specialist to identify the real origin of
the bad odor from your breath.
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