Thursday, May 03, 2018

What is Bad Breath...

Bad breath, sometimes called halitosis, means that you have an unpleasant smell on your breath that other people notice when you speak or breathe out. The exact number of people with bad breath is not known, but it is common.
 How can I tell if I have bad breath?
A main problem with bad breath is that the only person not to notice it is the person affected. (You get used to your own smell and do not tend to notice your own bad breath.) Often, the only way to know about it is if a person comments on it. However, most people are too polite to comment on another person's bad breath. You may have to rely on a family member or a close friend to be honest and tell you if you have bad breath.
Some people suggest a simple test which you can do yourself to detect bad breath. Lick the inside of your wrist. Wait a few seconds for the saliva to dry. Then smell the licked part of the wrist. If you detect an unpleasant smell you are likely to have bad breath.
 Causes and types of bad breath
Most cases of bad breath come from problems within the mouth such as poor oral hygiene or gum disease.
Morning bad breath
Most people have some degree of bad breath after a nights sleep. This is normal and occurs because the mouth tends to get dry and stagnate overnight. This usually clears when the flow of saliva increases soon after starting to eat breakfast.
Foods, drinks and medicines
Chemicals in foods can get into the bloodstream, and then be breathed out from the lungs. Most people are familiar with the smell of garlic, spicy foods and alcoholic drinks on the breath of people who have recently eaten or drunk these. Various other foods and medicines can cause a smell on the breath. This type of bad breath is temporary and easily cured by not eating the food.
Most non-smokers can tell if a person is a smoker by their breath which 'smells like an ashtray'. Stopping smoking is the only cure for this type of bad breath. Smoking also increases the risk of developing gum disease, another cause of bad breath.
Crash dieting or fasting
Causes a 'sickly sweet smell' on the breath. This is due to chemicals called ketones being made by the breakdown of fat.
Medical causes
Gum disease is a common cause of bad breath. Some people with nose problems can get bad breath. For example, a polyp in a nose, sinusitis or a 'foregin body' stuck in a nostril (occurs most commonly in children) can cause a bad smell. In this situation the smell tends to occur only, or more severely, when you breathe out through your nose. Lung or tonsil infections are sometimes a cause. Other causes are rare.
However, in these 'medical' cases, there are usually other symptoms that would indicate the cause. For example, a blocked nose, sinus pain, chest symptoms, etc. If you are otherwise well and have no other symptoms apart from bad breath, the bad smell is likely to be coming from the mouth and other 'medical' causes are unlikely.
 Bad breath coming from within the mouth
As mentioned, in most people who have bad breath the bad smell is thought to come from bacteria within the mouth. As the bacteria break down proteins and other debris in the mouth, they release foul smelling gases. One or more of the following may contribute to the build up of bacteria and bad breath.
  • Food stuck between teeth. Normal teeth brushing may not clear bits of food (particularly tiny bits of meat) which can get stuck between teeth. The food then rots and becomes riddled with bacteria. Regular flossing can clear and prevent this problem.
  • Plaque, calculus and gum disease. It forms when bacteria combine with food and saliva. Plaque contains many types of bacteria. Calculus, sometimes called tartar, is hardened calcified plaque. It sticks firmly to teeth.
  • Coating on the back of the tongue. In some people, a 'coating' develops on the back part of the tongue. It is not clear why this occurs. It may be from mucus that drips down from the back of the nose ('post nasal drip'). The coating can contain many bacteria.
  • Mouth tumours that ulcerate and become infected are an uncommon cause of bad breath.
The treatment of bad breath coming from within the mouth is good oral hygiene.
 Routine oral hygiene - a cure for most cases of bad breath
It is important to get into a regular habit of good oral hygiene - in particular teeth brushing and flossing.
Teeth brushing
Brush your teeth at least twice a day. Use a soft-tufted brush. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (the inside, outside, and biting areas of each tooth). Pay particular attention to where the teeth meet the gum. Get a new toothbrush every 3-4 months.
Floss your teeth at least once a day after brushing, and preferably twice a day. (Some people who have not flossed before are surprised as to how much extra debris and food particles can be removed by flossing in addition to brushing.)
The gums may bleed a little when you first begin to floss. This should settle within a few days. If it persists then see a dentist as regular bleeding after flossing may indicate early gum disease.
Other general tips
Other things which are important to keep your teeth and gums healthy are:
  • If you smoke, try to stop. Gum disease is more common in smokers than non-smokers.
  • Eat a well balanced healthy diet. In particular, you should limit the amount of sugary foods and drinks that you have. Sugars and sugary foods in the mouth are the main foods that bacteria thrive on to make acid which can contribute to tooth decay.
  • Have regular dental checks at intervals recommended by your dentist (this is normally at least once a year). A dentist can detect excessive build up of plaque and remove calculus. Early gum disease can be detected and treated to prevent it from getting worse.
 Dr. Kumaresh Krishnamoorthy
Senior Consultant
Dr Kumaresh ENT Clinic

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