What is bad breath?

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.

Is bad breath seen in everyone?

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.

Does bad breath increase with age?

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.

What are the reasons for bad breath ?

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.

From where does this odor come as my oral and
dental health is fine?

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
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.

Should I give importance to the bad breath I have?

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
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.

My mouth smells bad. What should I do?

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

Why should I brush my tongue?

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.

My child has bad breath. What should I do?

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

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