Halitosis, or halitosis, is bad breath. This is not an independent disease, but only a symptom indicating other pathologies. The main ailment is not necessarily associated with poor oral health - the cause may be various painful conditions that cause the proliferation of anaerobic microflora. The product of their vital activity is sulfurous volatile compounds, which have a characteristic unpleasant odor.
Please remember that masking the smell with mints or chewing gum is not the best solution. It is necessary to identify the exact causes in order to cope with the manifestation and not only eliminate the discomfort, but also prevent other complications of the disease.
Causes
Halitosis can be general or local. In the first case, it is associated with dysfunction of internal organs, in the second - with the condition of the oral cavity. The main causes of local halitosis include:
- violation of oral hygiene rules, accumulation of bacterial plaque and the formation of hard dental deposits;
- single and multiple caries - superficial, medium, deep;
- stomatitis, periodontitis and periodontal disease;
- pulpitis, glossitis, cheilitis, gingivitis;
- alveolitis, peri-implantitis, pericoronitis, etc.
These are the so-called intraoral causes. For example, braces or orthopedic structures must be carefully maintained to prevent the accumulation of pathogenic microflora.
General halitosis can be associated with extraoral causes: diseases of the respiratory tract, digestive tract, intestinal dysbiosis, diseases of the liver, gall bladder, and kidneys. In addition, it occurs in endocrine pathologies - diabetes mellitus, thyrotoxicosis. Many ailments cause changes in the composition and viscosity of saliva and the volume of its production. Insufficient hydration of the mucous membranes contributes to a decrease in protective functions. If there are no obvious symptoms of dental disease, it is important to consult a therapist or specialist to find out the cause of bad breath. A separate category of causes is taking medications that cause changes in the composition of saliva or are accompanied by side effects such as dry mouth. Common medications with this effect are antibiotics, antiviral drugs, chemical dependency treatments, and drugs to normalize heart rate and blood pressure. In this regard, dry mouth and halitosis associated with changes in the composition of saliva are often found in older age groups - older people who constantly take many medications.
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Causes of bad breath
The main pathogenetic cause of the development of halitosis is the reproduction and active activity of pathogenic anaerobic bacteria (living without oxygen) that live in the oral cavity. The presence of these microorganisms in the mouth is normal, but under normal conditions their numbers are controlled and limited by aerobic flora (living in the presence of oxygen). Therefore, if everything is fine in the body, then halitosis does not appear.
Against the background of violations of the rules of oral hygiene, diseases of the digestive tract, gum pathology and other reasons, a microbiological imbalance occurs. Bacteria, which do not require oxygen to function, begin to predominate in the mouth. During the process of growth and development, pathogens produce various gases (hydrogen sulfide, propyl mercaptan, ammonia and others), which are the direct substrate of the unpleasant odor.
Symptoms and manifestations
If halitosis occurs exclusively in the morning and goes away after brushing your teeth, we are talking about the physiological nature of the symptom. At night, saliva production decreases and anaerobic microflora actively multiplies. After waking up and performing hygiene procedures, the unpleasant odor disappears, and this condition is the norm.
Pathological bad breath is also observed after brushing your teeth. It can be different, the nature of halitosis is determined by the reasons. Thus, a purulent smell can be observed with periodontal disease and pharyngitis, the smell of acetone - with diabetes mellitus, dehydration, the smell of ammonia - with liver dysfunction and diffuse toxic goiter, a sour smell - with fungal infections of the mucous membranes of the oropharynx. In addition, the cause of this symptom can be assumed based on the symptoms that accompany halitosis:
- bleeding gums - with periodontitis, periodontal disease, aphthous stomatitis, etc.;
- tooth mobility, the appearance of periodontal pockets - with periodontal disease;
- white or yellowish coating on the oral mucosa - with candidiasis, stomatitis;
- darkening of areas of enamel in the area of the gum line - with hard dental plaque;
- an increase in the volume of gingival papillae between the teeth, looseness of the gums - with gingivitis;
- pain and swelling of the mucous membrane of the tongue - glossitis, etc.
If there are no other symptoms other than halitosis itself, or nonspecific manifestations are present, there is a possibility of systemic pathologies, gastrointestinal diseases or endocrine disorders. Therefore, it is important to visit not only the dentist, but also the general practitioner.
Classification and diagnosis
The diagnosis of this disease should be carried out by a dentist; if no causes are found on this side, then it is necessary to undergo an examination by a therapist.
There are several types of halitosis:
- Physiological – in the absence of pathology, and the smell is the result of the accumulation of bacteria or plaque.
- Pathological, which is caused by diseases (diabetes, cirrhosis of the liver, internal bleeding, etc.).
- Pseudogynosis is a slight odor that is not perceived by others, but the patient often complains.
- Hapitophobia – occurs after treatment or examination. When no pathologies are found, there is no smell, but the patient continues to insist that there is an unpleasant odor.
The latter option refers to psychosomatic disorders and in this situation it is necessary to undergo a course of psychotherapy. It is also important to understand that the problem may be systemic and will require treatment from several specialists at once.
Principles of treatment of halitosis
Diagnosis of halitosis necessarily includes an examination by a dentist. This is necessary to confirm or exclude dental pathologies. The dentist will conduct a survey and examination of the oral cavity, and recommend sanitation, if necessary. The main principles of treatment are:
- professional cleaning: removal of hard dental deposits and soft plaque;
- elimination of oral diseases: treatment of caries, inflammatory diseases of the mucous membranes and gums, removal of teeth that cannot be restored, etc.;
- dieting: avoidance of specific foods, nutritional correction;
- compliance with personal hygiene recommendations: selection of a toothbrush of the required hardness, suitable toothpaste, rinses, as well as training in the use of dental floss.
Medicines and folk remedies against halitosis
Drug treatment of local halitosis is based on the causes. If the source of the unpleasant odor were foci of infection or carious cavities, then halitosis goes away on its own after sanitation of the oral cavity. You can also cope with the problem with the help of antiseptics; they help suppress pathogenic microflora and participate in the prevention of relapses of inflammatory diseases. It is better to choose antiseptic rinsing solutions on the recommendation of a specialist.
If the cause of the unpleasant odor was infectious diseases of the gums and mucous membranes, the doctor will prescribe local medications: ointments, gels for application or application. The dentist will find out the nature of the infection and prescribe a drug with antibacterial, antiviral or antifungal action. Combined products also contain other components to relieve itching, burning, pain and eliminate halitosis. With severe inflammation, systemic antibacterial therapy may be required: antibiotics, fungicidal medications, powerful antiviral and immunomodulatory agents.
In cases where halitosis is promoted by orthodontic and orthopedic structures, the dentist will refer you to a specialist. You can discuss the prospects for choosing an alternative method of correcting your bite with your orthodontist. A visit to an orthopedic dentist is necessary for the correction of dentures or structures, as well as their replacement.
For periodontal disease, the course of treatment can be complex and quite complex, including removal of subgingival dental plaque, splinting and other measures. A periodontist can help treat the underlying cause of bad breath and prevent complications.
Many patients are interested in how to cure halitosis at home. It is important to remember that the use of traditional medicine methods must be agreed with a specialist; dentists do not recommend self-medication. One of the relatively safe methods includes rinsing with herbal infusions. Decoctions of chamomile, oak bark, and sage have an antiseptic effect. Remember: the solution must be warm; under no circumstances should you rinse your mouth with a hot solution, as this can cause a burn.
As folk remedies, you can resort to consuming certain foods that promote fresh breath. These include the following:
- apples, carrots, pears;
- watermelon, rosemary;
- fresh herbs - parsley, mint, basil.
Finely grated ginger root can also cope with unpleasant odors. Consider allergic reactions when choosing foods - choose your own diet based on preferences and individual characteristics.
Reasons for stimulating the growth of anaerobic bacteria
- Soft plaque on the teeth, remnants of protein and carbohydrate foods in the interdental spaces and in subgingival pockets; plaque on the tongue, buccal mucosa and tartar. Due to violation of the rules of oral hygiene, it is not cleaned sufficiently. Food remains are fixed on the teeth and other structures of the oral cavity, providing anaerobic bacteria with optimal conditions for growth and reproduction.
- Disorders of the stomach and intestines. Pathology of the digestive tract is a common cause of halitosis. Due to the dysfunction of these structures, a change in the microflora in the stomach, intestines and mouth occurs, with anaerobic microorganisms becoming predominant.
- Metabolic disease. Factors that trigger this process can be hormonal disorders, changes in diet, enzymatic disorders, etc. The pH of the oral cavity changes, which creates conditions for the growth of gas-forming bacteria.
- Lack of air access to the oral cavity, or internal halitosis. In this case, the unpleasant odor is caused by the reflux of air from the intestines, where the digestion of proteins, fats and carbohydrates occurs. At night, the stomach and esophagus are empty, allowing foul-smelling gases to rise into the mouth.
To get rid of halitosis, it is important to find out the root cause of this condition. This will allow you to get rid of “stale breath” for a long time, and not hide it for a certain time.
Prevention measures
Prevention can help prevent the development of halitosis: it is important to visit the dentist regularly, promptly treat oral diseases, and undergo professional teeth cleaning twice a year.
Prevention of halitosis also includes following individual oral hygiene recommendations. These include the following:
- selection of a toothbrush with a suitable degree of bristle stiffness. People with periodontal diseases - with soft ones, those who are prone to the formation of a large amount of soft plaque - with hard ones, but only if the enamel is strong and there is no hypersensitivity of the teeth. The average one is suitable for everyone else. You need to change your toothbrush every 1–3 months;
- using toothpaste without an abrasive effect - to prevent microdamage to the enamel and not increase the risk of developing dental diseases;
- Using dental floss and mouthwash after every meal;
- giving up bad habits - smoking, drinking alcohol, large amounts of tea and coffee;
- drinking enough water to prevent dry mouth and sufficiently moisturize the mucous membranes.
In case of chronic diseases of internal organs, it is necessary to pay attention to the prevention of complications and take therapy according to the doctor’s recommendations.
If you have a problem with bad breath, you can contact the dentists at STOMA clinics. The high qualifications of our specialists, as well as modern equipment, will help you quickly identify the cause of the symptom and prescribe effective treatment.
Do you talk a lot? Beware of halitosis
More often than others, halitosis affects workers of the so-called “conversational” genre - public politicians, lecturers, lawyers, radio show hosts... This happens due to the fact that during a conversation the oral cavity “dries out”, and active movements of the tongue help to “extract” the unpleasant odor from the most deeply hidden habitats of microbes. As you understand, in this case, neither candy nor chewing gum are helpful: diction suffers from them. And it’s not nice to chew or suck a pill during a performance. In this case, a traditional decanter of regular or mineral water will help.
