1st of 2 parts examing Halitosis (Bad Breath) - this week - we look firstly at the various causes of the condition

Halitosis (Bad breath)

Part 1

Causes

The source of the bad odour is located within the oral cavity in approximately 90% of cases of halitosis meaning only a small percentage of cases are due to non-oral causes such as a serious underlying medical condition which warrants immediate referral to a doctor (eg.) Diabetes

The tongue is considered the biggest source of bad breath and is considered the main cause in up to 90% of cases by some experts; so other causes like gingivitis are considered a cause in only a fraction of causes compared to tongue hygiene.

Oral microorganisms most likely to cause halitosis are gram-negative bacteria species which includes treponema denticola and porphyromonas gingivalis.

Common Causes

• Failing to brush twice daily
• Improper cleaning of dentures
• Bad breath in morning. Affects most people and dry mouth is the cause
• Alcohol: Alcohol causes dehydration and less saliva leading to bad breath
• Smoking: called “smokers’ breath”
• Certain foods and drinks such as onion and garlic or coffee and acidic fizzy drinks
• Infection

More specific causes

• Tongue bacteria: One of the main causes of bad breath. It can be caused by catarrh from the back of the throat and nasal area. It is more often caused by a general build-up of oral bacteria due to poor dental hygiene.
• Gum disease (gingivitis): due to poor oral hygiene. Bacteria in plaque cause a bad odour
• Tooth decay: like the bacteria that cause food to break down (creating plaque) and causing gingivitis, the bacteria trapped in a decaying tooth can emit a foul smell
• Trapped food: Food getting caught between the teeth getting broken down by bacteria
• Dry mouth: Poor saliva flow means food debris is less likely to get washed away.
• Acid reflux from the stomach: These acids have a sour odour causing bad breath
• Diabetes: Diabetics are more prone to high blood sugar levels meaning higher glucose levels in saliva which promotes oral bacteria growth leading more dental plaque.
• Chest infection: phlegm or mucus infected with bacteria or viruses that a coughed up can have a smell
• Other infections: Tonsil, throat, and sinus infection: the bacteria or viruses involved can emit a foul smell
• Other chronic conditions: Certain lung conditions, kidney and liver disease, chronic irritation of the stomachand oesophagus, and autoimmune disorders such as Sjogren disease.

To be continued…next week

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