Halitosis (bad breath) It is the bad odor in the
breath that comes out from mouth or nose
which disturbs both the person and the people around. Bad bad breath has a negative impact on interpersonal relations and it causes for problems like social pressure, psychological stress and lack of self confidence to occur for the person. And even social and individual isolation can be seen due to problems relating with bad breath (Halitosis).
Patients apply to doctors for bad breath either themselves or as a result of warning of others.
After decayed teeth and periodontal diseases, the most frequently seen reason for applying to dentists is bad breath.
Within last 35 years, information about bad breath began to increase and direct management of volatile sulfur (USB) which is produced by bacteries in saliva and breath is developed and reasons and sources of odor could be specified more clearly.
Bad bad breath can be frequently seen in people from all ages in the community. In at least %50 of adults, at some time in their lives and especially after waking up, a bad breath which can not be socially accepted is observed.
Researches made revea§ that in men bad breath is observed 3 times more than in women.
Furthermore, in individuals above the age of 20, it is observed 3 times more than the youngsters.
Although frequency of Halitosis is reported with a ratio as high as %50, very few patients visit the doctor for treatment. The situation where people having bad breath problem can not fully become aware of it, is named as "Odor paradox". Furthermore, it is stated that nearly %50 of men and %60 of women use cosmetic mouth spray.
In individuals from middle age group, especially during morning times, a heavy bad breath is observed. In people with advanced ages, mouth odor is seen more due to the prosthesis used, loss of fluidity of saliva, and systematic diseases.
Reasons for bad breath could be patological or physiological and in some cases, both of them could be seen together.
%80-90 of patological halitosis arise as relating with mouth and %10-20 of it arise due to reasons not relating with mouth.
Gingival and mucosa diseases, mycetes and infections, tongue and tongue root layer (fur), reflux and postnasal (epipharynx) flow, implants and prosthesis in bad condition, dental decays, poor fillings, loss of saliva, mouth dryness, mouth cancers, cleft palate, tonsil diseases can be listed as reasons originating from mouth.
The easiest way to discriminate those with mouth origin and those originating from areas other than mouth is to compare mouth and nose odors because when reasons arising from areas other than mouth are considered for halitosis, the first organ coming to one's mind is nose. Respiration from nose should be the preferred respiration type. Respira- tion from mouth which has an important place in the etiology of halitosis, happens as a result of nose stuffiness.
If odor originates from nose or has medical reasons, it should be applied to a medical doctor. It is known that the most frequently seen one among anatomic reasons of nose stuffiness is septal deviation. In a patient with septal deviation, other related nose patologies are observed more frequently as being persistent. If there is no reason originating from the mouth and explaining the patology, it should be considered that in a patient with bad breath, septal deviation could cause halitosis through oral respiration.
Physiological reasons for bad breath are hunger, menstruation, drinking cigarettes, poor oral hygiene, food remains, food with high protein, odoriferous food such as onion, garlic, radish coffee, alcohol and some spices.
As bad breath could be the sign of upper and lower respiratory diseases, gastrointestinal system(stomach-intestine), gullet, liver, autoimmune systemy (immunity) and blood diseases, chronic kidney deficiency, leucemia, AIDS and metabolic diseases, it should be taken seriously and if it does not originate from mouth, a visit should be paid to the doctor.
Can I have bad breath because I am smoking cigarettes?
Due to dental and gingival diseases which it causes directly or indirectly, cigarettes is an indirect reason of halitosis. Cigarette smoke contains USB (volalite sulfur components). Extreme smoking causes damaged tooth which gives rise to the situation where tobacco odor and food remains are held. Bad breath arising from cigarettes continues for 24 hours. It is notified that back of tongue is the primary source for the formation of USB and it is revealed that cleaning the fur at the back of tongue reduces formation of fur. It has been observed that the effectiveness for longest period was achieved by cleaning the fur on the tongue.
Halitosis treatment is based on paying attention to mouth hygiene, brushing teeth and tongue, cleaning the parts between the teeth, and having treatment for dental infections. Patients having bad breath should be encouraged to reduce smoking cigarettes. Harmful food should be avoided and nutrition should be had with regular intervals. Dentists should be visited once in 6 months.
While many products are used to avoid aligner formation on teeth, cleaning of tongue, which is an organ bearing millions of bacteria causing mouth odor, has been neglected.
Back of the tongue is covered with bacteria. Gulping and getting nutrition with a soft diet does not eliminate this cover and a layer rich with microorganisms in the colors of white and gray stay there.
Hydrogen sulphide and methyl mercap that form as relating with this layer is directly related with
bad breath. For this reason brushing the tongue is as important as brushing the teeth.
In order to scratch the tongue surface, plastic tongue scratchers and small brushes have been designed. These provide easiness especially for patient having nausea reflex. Tongue can come out as much as it can and the tongue cleaner/stratcher is placed at the very back of the tongue and by applying force it is pulled towards the front. Patients having halitosis should repeat this process a few times a day.
People from different ages have specific mouth
odors. For example in children between the ages of
2-5, a specific bad breath that develops as relating
with food remains in tonsil crypts and bacteria is
First it should be applied to a pedodontist. If bad breath cannot be eliminated despite the diagnosis and treatment, an appointment should be taken from pediatric dentist.
The Author of the Article: Dt. Bijen Muhit