What is halitosis, or bad breath?
Halitosis is a noticeable unpleasant smell, which is present when a person exhales. Halitosis is the third most common reason people meet with their dentists, right after tooth decay and gum disease. About 20% of people are reported to have concerns about halitosis up to some degree.
Not all people who think they have halitosis have a genuine problem when they are professionally examined. Of those who have genuine halitosis, often the smell is caused by bacteria present below the gumline and on the back of the tongue.
There are several causes for bad breath. These can be from:
- the respiratory system (air way and sinus)
- the digestive system ( stomach)
- the oral cavity ( mouth)
What do we do when a patient comes to our office and has concern about bad breath?
First step, we take a look at the patient’s breath. Does the patient breathe through their mouth or nose. If a patient is a mouth breather, the next step is to check the tonsils. In some occasions, the patient has a cold . Some patients have cryptic tonsils. This means that there are cave like spaces in the tonsils that will retain food particles secretions from the oral cavity. If the crypts are not clean, they can cause a bad smell. In this case, the patient will be recommended to gurgle mouth wash or salt water.
If the patient is a mouth breather but the tonsils are not large or cryptic, we will look for other options.
Does the patient have any sinus problems? If yes, the patient needs to check with their family doctor.
Next step, we check the mouth. All the soft tissues outside and inside the mouth will be checked.
In some patients, the tongue will be the cause of the smell. Brushing the tongue will help to get rid of the smell but this tongue brushing needs to be done regularly. The reason for the smell from the tongue is a bacteria that grows on the tongue.
Next step, we will check the patient’s gums and teeth. Gum disease such as periodontitis can cause bad smell from the mouth. This can be diagnosed by a dentist. If a patient has deep decays that cause food impaction, they may also have bad breath. This can be addressed by a dentist. In case the patient has an infection in a tooth for a different reason, he/she may also experience bad breath.
If none of the above was found in a patient, we will ask about any possible stomach problems. Usually every person’s mouth will have a bad smell when they wake up. After eating food or drinking, the smell will go away.
In case the halitosis is from the gums and teeth, the dentist will take care of the problem. If there are other reasons, the family doctors can be in charge of it.
Rarely halitosis comes from a medical problem such as liver failure, however in the majority of cases, the cause is minor and can be reduced by instructions given by an expert.
What needs to be done?
- Have a check up with your dentist every 6 months.
- Make sure you brush and floss properly.
- Brush the back side of your tongue every time your brush your teeth.
- Gurgle your throat with salt water.
Dr. Roushanak Shafaghi
