Causes of foul breath?
Bad breath is a common health problem that greatly affects the day-to-day activities of many people. The offensive odor from the mouth is unpleasant to those who come into close contact with bad breathers. Psychological trauma, which leads to depression, will compound the problem. Individuals grappling with this issue will find themselves cut off from society. This can even lead to marital disharmony.
Literally speaking, all human beings are evil breathers. The oral cavity contains millions of anaerobic bacteria like Fusobacterium and Actinomyces, which act on the proteins of food materials and putrify them. This process leads to the formation of offensive gases such as hydrogen sulfide, methyl mescaptan, caverin, skatol, putrescine, and others, which in turn cause unpleasant odor. If we don't maintain proper oral hygiene, we will all experience foul breath. Most of us control this by regular brushing, tongue cleaning, and gargling. Despite maintaining oral cleanliness, some individuals experience offensive smells due to various causes, necessitating proper diagnosis and treatment.
Some common causes of unpleasant breath.
1) Poor oral hygiene:
If one fails to maintain proper oral hygiene, the mouth becomes a breeding ground for millions of bacteria that break down food debris to produce offensive gases. Not brushing teeth and cleaning their mouths after meals causes severe foul breath. Snacks taken in between meals can also produce foul breath because of improper cleaning.
Almost everyone wakes up in the morning with bad breath. During sleep, there is less production of saliva. Saliva has some antibacterial properties that help keep your mouth clean. Saliva contains oxygen molecules, essential for the oral cavity to become aerobic. Therefore, the decrease in its quantity during sleep creates a favorable environment for anaerobic bacteria.
2) Food habits:
The main cause of offensive smell is the degradation of protein by the bacteria, and hence all food products rich in protein favor offensive breath. Food items such as meat, fish, milk products, eggs, cakes, nuts, pears, and so on can contribute to foul breath. Certain food items can emit a specific odor that may not be pleasing to the senses. Raw onions can produce a typical unpleasant smell. An apple a day keeps the doctor away, and a raw onion a day keeps everyone away. Eating groundnuts can also produce a foul smell. However, regardless of the food's nature, proper cleaning can reduce the smell. Irregularity in food timing can also cause foul breath. Small food items consumed in between meals can also contribute to foul breath.
3) Biofilm:
The tongue and oral mucosa develop a thin, sticky coating known as biofilm. The posterior aspect of the tongue exhibits a thick coating, home to millions of gram-negative bacteria. The thick coating on the tongue is always associated with foul breath. Even a thin biofilm can make an anaerobic condition favorable for bacterial proliferation.
4) Dental caries:
This process causes decalcification by destroying enamel and dentine, leading to the cavitization of the tooth. The lactobacilli primarily produce these substances. The anaerobic bacteria deposit food particles inside these cavities, putrifying them and producing unpleasant odors. Regular brushing does not easily remove the food debris, leading to their complete putrification. Caries are common in schoolgoing children and in those who do not maintain proper oral hygiene. Calcium and vitamin deficiencies can also predispose to caries.
5) Gingivitis:
The gum, a mucus membrane with supporting connective tissue, covers the tooth-bearing borders of the jaw. The main function of gum is protection. Gingivitis is the inflammation of the gum. Gum tissue becomes infected due to various causes, leading to swelling, pain, and discharge. If the condition becomes worse, the infection spreads toward the peridontal area, leading to continuous discharge called pyorrhoea. Sometimes the infection spreads deep, resulting in an alveolar abscess that discharges pus. Infection can even reach the bone, causing osteomyelitis. All these conditions can produce an offensive smell.
6) Gum retraction:
Retraction of the gums from the teeth creates a gap that traps food particles and leads to bad breath.
7) Dental plaques and tartar deposits: These deposits primarily occur in the spaces between the teeth and gums. This will provide shelter for the food debris and bacteria causing foul breath.
8) Ulcerative lesions & coatings:
Almost all ulcerative lesions of the mouth are associated with foul breath. Bacteria, viruses, food allergies, or autoimmune disorders may cause these lesions. The aphous ulcer is the most common type of ulcerative lesions. Other ulcerative lesions include herpes, fungal infections, Vincent's angina, infectious mononucleosis, scarlet fever, diphtheria, and drug reactions, among others. Cancerous ulcers produce severe foul breath. All fungal infections produce a white coating (candidiasis). Leucoplakia is a white, thick patch on the mucus membrane of the mouth and tongue. It is considered a precancerous condition. Offensive breath is associated with these conditions.
9) Diseases of the salivary glands:
Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and cause an aerobic condition that is unfavorable for the bacteria. Any condition that reduces the production of saliva can increase bacterial activity. Stones or tumors can sometimes obstruct the salivary duct. Cancer of the salivary gland is associated with offensive odor. In suppurative parotitis, purulent discharge into the mouth causes foul breath.
10) Tonsillitis:
The tonsils are two pieces of lymphoid tissue located in the lateral wall of the oropharynx. Tonsillitis is the term for inflammation of the tonsil. Both acute and chronic tonsillitis can cause bad breath. Quinsy or peritonsillar abscess can also produce foul breath.
11) Tonsillar plaques and tonsillar fluid:
If you continue to experience bad breath despite maintaining proper oral hygiene, you may be suffering from this condition. The serous fluid that emerges from the folds of the tonsil is highly offensive. Some patients complain about the presence of cheesy materials in their throats, which they find offensive. The tonsillar crypts, home to thousands of bacteria, form these materials. In such conditions, tonsillectomy gives noticeable relief from foul breath.
12) Pharyngitis & pharyngial abscess:
The pharynx is a fibromuscular tube that forms the upper part of the digestive and respiratory tract. Bacteria and viruses primarily cause pharyngitis, an inflammation of the pharynx. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Tumors in the pharynx wall can also release pus into the throat.
13) Dentures:
Denture users may complain about a foul smell due to the lodgement of small food debris in between. Proper brushing may not be possible for denture users, especially fixed dentures.
14) Tobacco:
Tobacco chewing is associated with foul breath. The smell of tobacco itself is unpleasant for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhea are common in tobacco chewers. The teeth deposit tartar, primarily near the gums. Smokers experience gastric acidity due to eructations. All these cause an offensive smell.
15) Smoking:
Smokers always have a foul smell. Smoking can also cause lesions in the mouth and lungs, which can lead to bad breath. Smoking increases carbon dioxide in the oral cavity and reduces oxygen levels, causing a favorable condition for bacteria. Smoking reduces appetite and thirst; hence, acid peptic disease is common in chain smokers.
16) Lesions in the nose and ear:
Sinusitis, an infection of the paranasal sinuses, occasionally causes bad breath. In cases of post-nasal dripping, foul breath is common due to the presence of protein in the discharges. The bacteria degrade these proteins. Infection in the middle ear with discharge of pus into the throat through the eustachian tube (passage from the middle ear to the throat) can also cause offensive odor. Chronic rhinitis (infection of the mucus membrane of the nose) and foreign bodies in the nose can also produce a foul smell in the expired air.
17) Diabetes mellitus:
Most diabetic patients experience bad breath. Bad breath can be caused by various factors such as a coated tongue, ulcers and coatings in the mouth, and an increased sugar level in tissues. The growth of bacteria in diabetic patients is significantly faster than in non-diabetic individuals.
18) Fevers:
Bad breath is common in almost all fevers. Even an acute fever can produce unpleasant breath. Typhoid causes severe bad breath. Other infectious diseases like tuberculosis, AIDS, et cetera produce unpleasant smells.
19) Fasting & dehydration:
Dry mouth favors bacterial activity. Therefore, any condition that causes dryness in the mouth can lead to unpleasant breath. While food particles are known to cause bad breath, fasting can also have the same effect. Fasting also reduces the production of saliva. Chewing and swallowing also help keep the mouth clean.
20) Bedridden patients:
Bedridden patients suffer from offensive breath due to a thick coating on the tongue. These patients also restrict their water intake. Regurgitation of food aggravates the condition. They talk less, which reduces aeration in the oral cavity and favors the activation of anaerobic bacteria.
21) Diseases of the stomach and esophagus:
The eructation of gas and food produces an unpleasant smell. Abnormality in the function of the lower sphincter can allow the food to regurgitate upwards, causing unpleasant breath. Bad breath is also common in gastritis, gastric ulcers, and cancer of the stomach.
22) Intestinal diseases:
Bad breath is common in patients suffering from ulcerative lesions of the intestine, like ulcerative colitis. Other diseases include malabsorption syndrome, intestinal tuberculosis, peritonitis, among others.
23) Diseases of lungs:
Lung diseases like pneumonia, lung abscess, chronic bronchitis, bronchiectasis, tuberculosis, lung cancer, et cetera can produce a foul odor during expiration.
24) Liver disorders:
Liver diseases like hepatitis and cirrhosis can cause foul breath. Gall bladder diseases associated with vomiting can also result in an unpleasant odor.
25) Psychiatric patients:
Psychotic patients often experience bad breath due to various factors such as poor hygiene, irregular food habits, and reduced water intake.
26) Somatization disorder:
This is a psychiatric disorder characterized by the presence of a physical symptom that suggests a medical illness. These patients present with physical complaints such as pain, nausea, difficulty in breathing, bad smell, among others. We diagnose this condition after thoroughly examining the patient and conducting all necessary investigations. A psychological approach is necessary to manage this psychiatric disorder.
The points mentioned in this article are for general information. Any person having foul breath should consult a qualified doctor.
Post a Comment for "BAD BREATH-1"