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 Halitosis is never a pleasant experience for your friends and family.

Halitosis or better known as just "bad breath" is unfortunately quite a common problem among Malaysians. Halitosis is actually the actual term to describe the condition of a foul smelling odour originating from your mouth.

A common complaint in adults, halitosis (bad breath; fetor ex oris) is characterised by a wide variety of causes, with the possible inclusion of altered taste as a complaint as well. Although the precise incidence is not known, a preliminary report noted that up to

- 40% of adults about this issue in the morning. It is more common in those with nasal obstruction or those who sleep in a hot, dry environment (which is an all year climate in Malaysia).

- Up to 17% of adults state that halitosis is a concern at one time or another, and 1% or less indicate that their lives are disrupted as a result.

 Although Bad breath originates chiefly from the mouth and less so from the nose, tonsils, and a wide variety of other sites: (below are some examples of "some other sites")

Brushing-your-tongue-halitosis-dentistsnearby.jpg

Brushing your tongue helps in reducing or controlling halitosis

Some Possible Causes Of Bad Breath:

From the Oral cavity (your mouth)


- Poor oral hygiene/denture hygiene
- The back surface of your tongue
- Smoking / Tobacco

Periodontal pathogens (The bacteria receding in your gums)

- Porphyromonas gingivalis
- Prevotella intermedia
- Fusobacterium nucleatum
- Bacteroides forsythensis
- Treponema denticola

Oral infection of Candidiasis (Fungal Infection in the mouth, usually due to suppressed immune system)
- Pericoronitis (Inflammation of your gums at the back due to erupting/ unerupted wisdom tooth)
- Postextraction alveolitis (Commonly known as dry-socket and it usually happens after a recent extraction)
- Oral ulcerative and erosive diseases

Dietary considerations
- Volatile sulfur-containing foods (onions, garlic, others)
- Hydrogen sulfide
- Dimethyl disulfide
- Methyl mercaptan

Xerostomia (Dry mouth caused by other diseases or the medications you're taking, consult your physician if your drug will have this side-effect)

Nasal cavity (Your nose)
- Nasal infection

- Sinusitis

- Nasal polyps and nasal foreign bodies

Other airflow obstruction
- Tonsils
- Infection
- Tonsilliths
- Neoplasia (Cancer or tumour)

Other sites
- Bronchial and pulmonary infection (Lung infection)
- Renal failure (Kidney failure)

Within the mouth, Gum Diseases are the most important catalyst of bad breath.

 denture-care-halitosis-dentistsnearby

Denture-wearers have to keep their dentures clean at night.
(Denture cleaning solutions can be bought at Watson's, Guardians or any pharmacy outlet)

A broad range of medical conditions and factors can be related to the development or promotion of xerostomia (dry mouth) which may including oral, oropharyngeal, and lung diseases; metabolic diseases; dietary constituents including alcohol, tobacco, and sulfur-containing foods (onion and garlic in particular).

 

In cases of a failure to confirm the presence of halitosis by others in the your family or friends, consideration must be given to the possibility of a delusional halitosis; which means you are imagining your bad breath. The concept of delusional halitosis is well known and likely accounts for a significant portion of those who complain of bad breath.

 Mouth-rinse-halitosis-dentistsnearby

Mouthrinses may help in camouflaging bad breath and only serves as a temporary measure.

An assessment on the part of your own halitosis is quite difficult. A third party is often needed to confirm the presence of bad breath and it's intensity.
There may be times where the severity of your bad breath fluctuates and this can be due to your salivary flow at different time throughout the day.

Your dentist may be able to clarify the severity of your halitosis. Specific methods of breath analysis include the organoleptic approach, which means comparing the odour coming from your nose and from your mouth.

Monitoring devices capable of detecting levels of sulfide and mercaptan compounds may be available at specialty dental clinics or hospitals.

Gas chromatographic analysis (a highly accurate machine used to analysis what's in a gas compound) is considered the gold standard but is it quite impractical in the normal dental setting.

Stay-hydrated-halitosis-dentistsnearby

Keeping yourself hydrated in our hot Malaysian weather will at least reduce or eliminate physiological bad breath.

Management of bad breath subsequent to establishment of an dental cause includes routine dental check-ups and treatments along with proper oral hygiene measures.

Mouth rinses containing chlorhexidine may have a role in halitosis' management, but this is unproven.

Commercial mouthwashes contain high concentrations of alcohol and flavoring agents and likely work only to temporarily camouflage your bad breath caused by organic oral disease.

 Tongue scrapers halitosis-dentistsnearby

Tongue "scrapers" can be used to clean the back of your tongue. (Also can be bought in major pharmacies)

In a nutshell, how to beat halitosis:

- (Most Important) Proper oral and denture hygiene care
- Treatment of existing dental and gum disease (See A Dentist!)
- Daily gentle scraping of the back of the tongue.
- Avoidance of foods containing sulfide compounds (Onions, Garlics etc)
- Daily use of mouth rinses with antimicrobial properties
- Always stay hydrated for a hot day

 

Note: if your bad breath persists or worsens, please consult your dentists or physician for a thorough check-up for further investigations.

 

Reference: Oral Pathology Clinical Pathologic Correlation 6th edition

 

 

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