Bad breath is a delicate and very unpleasant problem, which often interferes with normal communication with others. Most often, the problem of bad breath is associated with dental diseases or poor oral hygiene. But there are a number of ENT reasons that also provoke the appearance of a strong odor. Why does my breath smell? What is the most effective treatment for bad breath? You will find the answer in our new article.
Have you heard of a condition called halitosis? Most likely no. Although, according to medical statistics, a quarter of the adult population is directly faced with this problem. Behind this “strange” diagnosis lies the delicate and unpleasant problem of bad breath.
In many cases, a person gets used to this smell and stops noticing it, and tactful people around them do not want to offend the person. As a result, the patient does not even try to get rid of the problem, although strong bad breath is a symptom of pathological changes in the body.
There are also opposite situations when a person literally “lives” with his unpleasant problem: he masks the bad breath with chewing gum, refreshing sweets or special sprays. But one should not expect a strong effect from these measures. They only help to temporarily hide this deficiency. As a result, the patient becomes so fixated on his problem that he tries to avoid contact with others and spends most of his time alone. But this is a step towards severe depression.
The main thing in solving a problem is not to go to both extremes. It is necessary, first of all, to understand why your breath smells, that is, to establish the causes of the strong odor, and then carry out high-quality treatment.
Treatment of halitosis, like any other disease, must begin with a visit to the doctor. It will be extremely problematic to determine the cause of a strong odor on your own, without the help of a specialist.
The causes and treatment of strong bad breath is the topic of our new article.
Bad breath
The content of the article
Bad breath (stench ex ore, halitosis) is the first symptom of gastrointestinal diseases. In approximately 90% of cases, the unwanted odor comes directly from the mouth; in the rest, the source of the odor is from other parts of the gastrointestinal tract.
The causes of bad breath are multifactorial:
- diseases of the upper gastrointestinal tract;
- respiratory system;
- some systemic diseases;
- metabolic disorders;
- taking medications;
- malignant tumors.
An unpleasant odor is most often the result of the action of bacteria that break down organic substances present in saliva, exfoliated epithelium and food debris. The main products of this decomposition are volatile sulfur compounds. Normal oral flora consists of gram (+) and gram (-) granulomas and bacilli. The source of bad breath most often is the waste products of gram (-) anaerobes.
A breakthrough in research on this issue occurred in 1934, when scientists designed an osmoscope that allowed a semi-quantitative assessment of odor intensity. In the 1970s, gas chromatography was used to identify VSC as the main cause of odor.
The identified compounds are:
- hydrogen sulfide (H 2 S);
- methanethiol – methyl mercaptan (CH 3 SH);
- dimethyl sulfide (CH 3 SCH 3).
Today, halimeters are used to assess the presence and concentration of volatile sulfur compounds in exhaled air. Gastroenterologists also have a test that determines the activity of enzymes in saliva, which proves the presence of bacteria that produce volatile sulfur compounds.
Other causes of bad breath include: smoking, drinking alcohol and drinking coffee. In these cases, it is easy to determine the cause of bad breath.
Bad breath due to oral diseases
Bad breath in diseases of the oral cavity
Causes of bad breath in diseases of the oral cavity:
- coating on the tongue;
- periodontal disease (including tissue around implants);
- widespread caries;
- ulcers in the mucous membrane;
- food debris between teeth and in gum pockets;
- uncleaned teeth and dentures;
- the contents of the cysts flowing into the oral cavity through the fistula;
- cancerous lesions of the oral cavity;
- factors that reduce saliva production.
The most common source of unpleasant odor is the layer that covers the top of the tongue. It consists of thickened saliva, bacteria, exfoliated epithelium and food debris. The smell intensifies with anatomical defects of the tongue - cracks and cuts, ulcerations on the tongue, hairy tongue. Improper use of a brush when cleaning the tongue leads to the formation of ulcers.
Bad breath in ENT diseases
Patients with ear, nose, or throat diseases often complain of bad breath. Reasons include:
- viral and bacterial pharyngitis;
- tonsillitis;
- deep crypts in the tonsils;
- sinusitis of the nose;
- foreign bodies in the nasal cavity or sinuses;
- nasal discharge with an unpleasant odor.
Due to difficulty in nasal breathing, the oral cavity dries out, which accelerates the detachment of the epithelium and the formation of plaque on the tongue.
Chronic tonsillitis
Chronic tonsillitis is an inflammatory process that occurs in the palatine tonsils. The palatine tonsils, or otherwise tonsils, are an organ of our immune system. The first people encountered by viruses and bacteria that enter the mouth from the outside are the tonsils. As soon as the infection touches the surface of the tonsils, they trigger increased production of leukocytes - cells that kill pathogens. After the enemy is defeated, healthy tonsils remove them from their lacunae, and then the dead bacteria, along with the dead leukocytes, are removed from the body. This process is called the self-purification process. But if due to certain factors (hypothermia, stress, chronic diseases, etc.) the body’s defenses weaken, the palatine tonsils cannot cope with infections. Bacteria (most often streptococci) accumulate in the lacunae of the tonsils and cause an inflammatory process in them.
If you look at the inflamed tonsils in the mirror, you can see white accumulations on their surface - the so-called tonsillitis plugs. These clusters are nothing more than a compressed streptococcal infection. It's these plugs that smell bad.
To get rid of halitosis, it is necessary to undergo comprehensive treatment of chronic tonsillitis in an ENT clinic.
Treatment of a strong unpleasant odor in this case comes down to drug therapy, rinsing the palatine tonsils to remove plugs and physiotherapeutic procedures.
Bad breath due to gastrointestinal diseases
Bad breath in gastrointestinal diseases
Halitosis can be caused by diseases of the digestive tract, in which bacterial flora producing volatile sulfur compounds develops on the remains of dead tissue (for example, on the edges of ulcers), blood clots and food debris. Common pathologies:
- Gastroesophageal reflux disease (GERD);
- Zenker's diverticulum;
- Achalasia of the esophagus;
- Gastritis;
- Peptic ulcer;
- Tumors of the esophagus;
- Stomach cancer;
- Diseases in which there is an overproduction of volatile compounds with odor;
- Intestinal malabsorption syndromes (associated with excessive gas formation in the intestines);
- Liver failure associated with the accumulation of ammonia and other breakdown products of amino acids, causing an unpleasant odor, especially intense in hepatic encephalopathy.
The existence of halitosis caused by H. pylori infection is a controversial issue.
Can I delete it myself?
Everyone needs to know what to do if there are purulent plugs in the throat. Self-medication with them is highly undesirable.
Doctors do not recommend performing procedures to remove tonsil plugs on your own. The risk of harm in such a situation is much higher than the opportunity to cure a sore throat. As a result of such manipulations, there is a danger of injuring the lymphoid tissues, which will cause heavy bleeding, which may require urgent medical attention. Also, improper cleansing of the tonsils sometimes provokes the spread of infection throughout the body, which is dangerous to health.
Doctors consider squeezing out with the tongue to be the only relatively safe method of removing plugs on your own. They press on the tonsils, causing the plugs to come out. After this, the throat is gargled to remove them. Swallowing purulent accumulations is extremely harmful. The tongue does not injure the delicate tissues of the mucous membrane and will not exert dangerous strong pressure, at which pus can escape inside, when there is a high probability of developing sepsis. A person will not harm himself during such cleansing.
Also, although doctors do not recommend it, sometimes they do home cleansing of the tonsils using a cotton swab or swab. The method is risky and traumatic, since you can press too hard and provoke the release of pus into deep tissues with the subsequent development of dangerous complications.
If it is not possible to visit a doctor, but you need to clear your tonsils, the procedure is carried out at home. This can be done no earlier than 2 hours after eating. You need to brush your teeth and rinse your mouth and throat with an antiseptic solution. A swab made of sterile cotton wool or a cotton swab treated with an antiseptic is applied to the base of the tonsil and pressed upward. There should be no pain during the procedure. If after 3 attempts the purulent plug does not come out, then you cannot continue.
Other causes of bad breath
Other causes of bad breath include:
- Chronic kidney disease (most often the result of glomerulonephritis), during which the concentration of urea in the blood increases. The exhaled air smells of ammonia, the patient has a salty taste in the mouth;
- Improperly treated diabetes, leading to the accumulation of ketone compounds, giving the exhaled air the characteristic smell of acetone. Diabetes often presents with dry mouth;
- Trimethylaminuria (fish odor syndrome) is a genetically determined metabolic disease in which the oxidative pathway of trimethylamine in the liver is disrupted. Excessive amounts of trimethylamine in the exhaled air cause bad breath.
Diagnosis of bad oral odor
Diagnosis of bad breath
Bad breath leaves many unpleasant moments for the patient and the people around him. Therefore, when a smell appears in the mouth, patients first resort to unconventional methods of control, which include enhanced oral hygiene. And only when these methods do not produce results do they turn to a gastroenterologist for help.
Diagnosis of bad breath is a prerequisite for successful treatment of bad breath. The doctor begins with a thorough history and physical examination. Particular attention is paid to:
- rules of oral hygiene);
- the moment and circumstances associated with the occurrence of bad breath;
- dietary habits;
- condition of the oral cavity;
- respiratory symptoms.
Sinusitis
Sinusitis is the general name for inflammatory processes occurring in the paranasal (paranasal) sinuses. The paranasal sinuses include: maxillary, sphenoid, frontal and cells of the ethmoid labyrinth. The maxillary sinuses are also called maxillary sinuses, and their inflammation is, accordingly, sinusitis.
Inflammation of the frontal sinuses is called frontitis, the sphenoid sinuses are called sphenoiditis, and the cells of the ethmoidal labyrinth are called ethmoiditis. The most common type of sinusitis is sinusitis.
Sinuses are air cavities in the skull that perform a number of important functions, for example, warming and humidifying inhaled air, reducing the weight of the skull, participating in the formation of the timbre of the voice, etc. Each sinus communicates with the nasal cavity through small openings - anastomoses, through which the nose The secretion produced in them is released from the sinuses. If bacteria become active in the sinuses, inflammation occurs. The orifices become swollen, narrowed or completely blocked, as a result of which mucous masses cannot exit into the nasal cavity. Mucus accumulates, mixes with waste products of bacteria, and pus is formed. It is the purulent masses that emit an unpleasant odor that is noticeable to others. It disappears immediately after proper treatment.
Treatment of sinusitis includes antibiotic therapy, washing the paranasal sinuses from purulent masses in the clinic and physiotherapeutic procedures.
Differentiation of bad breath and halitophobia
A thorough examination can determine whether the problem is true halitosis or pseudohalitosis (halitophobia). If halitophobia is suspected, the doctor interviews the patient’s relatives. If they do not confirm the frequent occurrence of bad breath in the patient, it is likely that this symptom is a subjective sensation of the patient. In doubtful cases, a galimeter is used.
In most cases, a properly performed clinical examination can determine the cause of bad breath.
Symptoms
A bad smell from the throat may also be accompanied by additional symptoms, which help in making a diagnosis. During the examination, the specialist pays special attention to these signs.
Symptoms of halitosis:
- Pain in the area of damaged and loose teeth.
- Unpleasant sensations in the throat: soreness, pain.
- Drainage of mucus down the back of the throat.
- Breathing problems.
- Heartburn, belching, nausea and vomiting.
- Thirst and dry mouth.
- Unpleasant taste in the mouth.
- Spitting blood.
If the patient has the listed symptoms along with a bad odor, you should immediately contact a specialist and undergo all tests, undergo a full examination of the body in order to establish the true cause of the disorder. If this is not done, the disease will progress, the general condition will worsen, and halitosis will become more intense.
Treatment for bad breath
The main role is played by the treatment of the underlying disease that caused bad breath. If the disease is not cured, the smell will not go away.
In cases of problems related to oral hygiene, mechanical cleaning of the oral cavity is performed. The doctor prescribes toothpastes and rinses containing chlorhexidine, triclosan, cetylpyridine. chloride). Rinsing the mouth with baking soda, 3% hydrogen peroxide, and solutions containing zinc and magnesium is effective.
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Treatment of halitosis
Treatment of unpleasant odor can be carried out in several ways: medication, folk remedies and rinsing. Drug therapy is based on the provoking factor. If halitosis was caused by plugs on the tonsils, then the patient is prescribed antibacterial agents, immunostimulants, physiotherapeutic methods and rinsing. Treatment in this case should last no more than 10 days.
As for antibiotics, it is recommended to take them from the first day after the formation of plugs. The doctor may prescribe Ceftriaxone, Cefin or Augmentin. How can you gargle to get rid of an unpleasant odor? Antiseptics can be used for this: “Furacilin”, “Angilex”, “Dioxidin”. The procedure is carried out at least 4 times a day. To strengthen the immune system, it is recommended to take Levamisole. For chronic rhinitis, antiviral drugs are used to help get rid of flu, colds and runny nose. It is also possible to use antihistamines.
Bad smell from the throat without coughing can be eliminated using folk remedies. The patient is recommended to carry out inhalations, rinse the mouth with herbal decoctions - sage, oak bark, lavender essential oils. If it is not possible to rinse, then irrigation can be done. Folk remedies should be used in conjunction with medications.
