bad breath

Causes of bad breath ?

Bad breath may be a common ill health which greately affects the daytoday activities of somany people. The offenssive odor from the mouth is unpleasent to those that are available close contact with bad breathers. the matter are going to be doubled by psychological trauma resulting in depression. The sufferers from this problem wil be isolated from the society. this will even cause marital disharmony.

Literally speaking all humanbeings are badbreathres. mouth contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrifies them. This process leads to the formation of offenssive gases like hydrogen sulphide,methyl mescaptan,cadaverin,skatol,putrescine ect causing bad odor. If oral hygiene isn’t maintained properly all will suffer from bad breath. Most folks control this by regular brushing,tongue cleaning and gargling. Even after maintining cleanliness within the mouth some individuals suffer from offenssive smell thanks to various causes which has got to be diagnosed and treated properly.

Some common causes of bad breath.

1) Poor oral hygiene:

If oral hygiene isn’t maintained properly the mouth becomes the seat for many bacteria which produce offenssive gases by degrading the food debris. Bad breath is severe in those that don’t brush their teeth regularly and clean their mouth after every food. Snacks taken inbetween meals also can produce bad breath due to improper cleaning.
Badbreath is common in most people within the morning on waking. During sleep there’s less production of saliva .Saliva possesses some antibacterial properties which help to stay the mouth clean. Saliva conains oxygen molecules which is required to form mouth aerobic. therefore the reduction in it’s quantity during sleep makes a favourable condition for anaerobic bacteria.

2) Food habits:

The main explanation for bad smell is thanks to degradation of protein by the bacteria and hence all food products rich in protein favours bad breath. Meat,fish,milk products, eggs,cakes,nuts,pear and ect can cause bad breath. Some food articles can produce particular sort of smell which can be unpleasent. Raw onion can produce typical bad smell. it’s said that an apple each day keeps the doctor away,a raw onion each day keeps everybody away. Eating groundnuts also can produce bad smell. However if proper cleaning is completed smell are often reduced regardless of the character of food. Irregularity in timing of food also can produce bad breath. Small food articles taken in between the meals also can produce bad smell.

3) Biofilm:

There is formation of a skinny sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where many gram negative bacteriae are seen .The thick coating on the tongue is usually related to badbreath. Even a thin biofilm can make anaerobic condition favourable for bacterial proliferation.

4) Dental caries:

This is a destructive process causing decalcification with distruction of enamel and dentine leading to cavitisation of the tooth. These are produced mainly by the lactobacilli . Food particles are deposited inside these cavities and are putrified by the anaerobic bacteria producing bad smell. Normal brushing won’t remove the food debris easily and hence they’re putrified completely. Caries are common in schoolgoing children and in those that donot maintain proper oral hygiene .Calcium and vitamin deficiency also can predispose caries.

5) Gingivitis:

Gum may be a mucus membrane with supporting animal tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is that the inflammation of the gum .Due to various causes gum tissue get infected leading to swelling,pain and discharge. If the condition go to pot the infection spread towards peridontal area resulting in continuous discharge called pyorrhoea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis.All these conditions can produce offenssive smell.

6) Gum retraction:

When the gums retract from the teeth a niche is developed which can lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly within the gaps between the teeth and gum. this may provide shelter for the food debris and bacteria causing bad breath.

8) Ulcerative lesions& coatings:

Almost all ulcerative lesions of the mouth are related to bad breath. These lesions could also be caused by bacteria,viruses,food allergies or thanks to autoimmune disorders. Apthous ulcer is that the commonest amoung ulcerative lesions. Others are herpes,fungal infections,vincents angina,infectious mononucleosis,scarlet fever,diphtheria,drug reactions and ect. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating(candidiasis). Leucoplakia may be a white thick patch on the mucus membrane of the mouth & tongue. it’s considered as a precancerous condition. Offenssive breath is related to these conditions.

9) Diseases of the salivary glands:

Saliva is extremely useful to provide oxygen to all or any parts of the mouth . Even a skinny film of coating called biofilm can provide an anaerobic condition within the mouth. Saliva can wet these layers and make an aerobic condition which is unfavourable for the bacteria .Any condition which reduces the assembly of saliva can increase bacterial activity. Some times the duct is obstructed by stones or tumors.Cancer of the exocrine gland is related to offenssive odor. In suppurative parotitis purulant dischrge in to the mouth causes bad breath.

10) Tonsillitis:

Tonsils are a pair of lymphatic tissue situated within the lateral wall of oropharynx. Inflammation of the tonsil is named tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or quinsy also can produce bad breath.

11) Tonsillar plaques & tonsillar fluid:

If bad breath persists even after maintaining proper oral hygeine there’s possibility of this condition. Serous fluid secreated from the folds of tonsil is extremely offenssive. Some patients complain that they hawk some cheesy materials from the throat;which are very offenssive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteriae. In such conditions tonsillectomy gives noticiable relief from bad breath.

12) Pharyngitis& pharyngial abscess:

Pharynx may be a fibromuscular tube which forms the upper a part of the digestive & tract . Inflmmation of the pharynx is named pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along side other signs like cough and throat irritation. Abscesses within the wall of pharynx also can produce offenssive discharge of pus in to the throat.

13) Dentures:

Denture users may complain about bad smell thanks to lodgement of small food debris in between. Proper brushing might not be possible in denture users especially fixed dentures.

14) Tobacco:

Tobacco chewing is related to bad breath. The smell of tobacco itself is unpleasent for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhoea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. of these causes offenssive smell.

15) Smoking:

Smokers always have bad smell. It also can produce lesions within the mouth & lungs causing bad breath.Smoking increases CO2 within the mouth & reduces oxygen level,causing a favourable condition for bacteria. Smoking reduses appetite & thirst hence acid peptic disease is common in chain smokers.

16) Lesions within the nose & ear:

Bad breath is occasionally seen in sinusitis(infection of para nasal sinuses). just in case of post nasal dripping bad breath is common thanks to the presence of protein within the discharges. These proteins are degraded by the bacteria. Infection within the tympanic cavity with discharge of pus in to the throat through the eustachian tube(passage from tympanic cavity to the throat)can also cause offenssive odor. Chronic rhinitis(infection of mucus membrane of nose) and forign bodies within the nose also can produce bad smell within the expired air.

17) Diabetes mellitus:

Mostly all diabetic patients suffer from bad breath. Coated tongue,ulcers &coatings within the mouth ,increased sugar level in tissues ect are liable for bad breath.Bacterial growth in diabetic patient is extremely faster than non diabetic individuals.

18) Fevers:

Bad breath is common in most fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis , AIDS ect produce bad smell.

19) Fasting & dehydration:

Dry mouth favours bacterial activity. So any condition which produce dryness within the mouth makes the breath offenssive. Eventhough the food particles are known to supply bad breath, fasting also can produce an equivalent . Production of saliva is additionally reduced during fasting. Chewing and swallowing also helps to stay the mouth clean.

20) Bedridden patients:

Bedridden patients suffer from offenssive breath thanks to thick coating on the tongue. water intake is additionally limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration within the mouth is reduced which favours anaerobic bacteria to become active.

21) Diseases of stomach & esophagus:

Eructation of gas and food produce unpleasent smell. Abnormality within the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is additionally common in gastritis,gastric ulcer and cancer of stomach.

22) Intestinal diseases:

Bad breath is common in patients affected by ulcerative lesions of intestine like ulcerative collitis..Other diseases are syndrome intestinal tuberculosis, peritonitis ect.

23) Diseases of lungs:

Lung diseases like pneumonia, lung abscess,chronic bronchitis,bronchiectasis,tuberculosis, carcinoma ect can produce bad odor during expiration.

24) Liver disorders:

Liver diseases like hepatitis, cirrhosis,can cause bad breath.Gall bladder diseases with vomiting also causes unpleasent odor.

25) Psychiatric patients:

Bad breath is common in psychotic patients thanks to poor hygiene,irregular food habits,less water intake and ect.

26) Somatisation disorder:

This is a psychiatric disorder charecterised by the presence of a physical symptom that suggest a medical illness .These patients accompany physical complaints like pain,nausea difficult respiration, bad smell ect. This condition is diagnosed after detailed examination of the patient with all investigations.Since this is often a psychiatric disorder it’s to be managed with a psychological approach.


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