Halitosis can be defined as an unpleasant breath odor that is noticed by others. Most adults and some children complain of bad breath. This symptom can occur from time to time, or it can continue regularly and show a chronic course. The problems caused by bad breath are primarily psychological and negatively affect the individual's social relationships. An indication of how serious this problem is is that mouthwashes, sprays and chewable tablets that are supposed to prevent bad breath have a large market share. Until recently, dentists and medical doctors did not pay much attention to bad breath. However, the majority of bad breath cases are of oral origin. Therefore, dentists have an important responsibility in the diagnosis and treatment of bad breath. If the bad breath complaint has been chronic for a long time, it is definitely caused by the mouth.
Physiological Halitosis
Every healthy individual may experience bad breath caused by gases accumulated in the digestive tract or bacteria growing on the back of the tongue when they wake up in the morning. Brushing the back of the tongue and using mouthwashes containing zinc, provided that it is not continuous, and chewing gum are solutions. The unpleasant smell in the breath (not in the mouth) after eating is also physiological. For example, the volatile aromatic compounds that pass into the blood of a person who eats garlic are excreted. This smell, caused by the excretion of blood gases from the lungs, is not a disease. It does not require treatment.
Pathological Halitosis
Patients with pathological halitosis may not apply to the dentist with complaints of bad breath. They are either unaware of the unpleasant smell in their mouth, tolerate it or have accepted it. These cases are divided into 3 categories:
- Type-1: The patient himself/herself detects that his/her mouth smells. 24.1% of such patients apply to the dentist. They usually accept the smell in their mouth. They apply to the dentist with a complaint other than halitosis. They are treated with the dentist's warning.
- Type-2: The bad breath is not detected by the patient himself, but by his relatives. 50% of such patients apply to the dentist.
- Type-3: The bad breath is not detected by the patient himself or his relatives, but by his suspicion or guess. Or the patient has vague complaints at intermittent periods. A larger portion of such patients apply to the dentist.
Causes of Bad Breath
Other Than the Oral Cavity:
Bad breath that originates from somewhere other than the mouth is meant. The incidence of bad breath due to non-oral causes is 13%, 4% of which are ear-nose-throat, 3% are both oral and ear-nose-throat, and 1% are digestive tract related. Sometimes intestinal gases cause this.
- Especially in sinus and lung-related (respiratory tract) infections,
- Diabetes (smells like acetone),
- Renal failure, uremia (smells like ammonia),
- Liver failure, cirrhosis (smells like spoiled blood),
- Metabolism disorders (may be difficult to diagnose, a bad fishy smell that occurs from time to time)
- Hunger, diet, dry mouth, being fasted (In case of liquid food deficiencies, fat and protein in the body begin to dissolve, the byproducts of this metabolism are reflected as bad breath).
- Constantly consumed odorous foods and beverages such as cigarettes, garlic, onion, coffee.
Oral Cavity-Related :
87% of the causes of bad breath originate from the oral cavity. Of these; 51% are from the tongue (Millions of bacteria live in the mouth, especially on the back of the tongue. These are the causes of bad breath in most people. The warm and moist environment of the mouth creates ideal conditions for these bacteria to grow),
- 17% from gingivitis,
- 15% from periodontitis,
- 17% from a combination of these.
These types of bad breath are not complex cases. The cause is obvious at the first examination. Problematic gum tissues can be easily detected by eye and easily treated. Sometimes the patient even shows the source of the smell himself.
Treatment (Oral)
Tooth and gum health
Tooth decay and gum inflammation are important causes of bad breath. Any infection in the mouth will increase bacterial growth and will always cause bad breath. Therefore, you should definitely listen to your dentist's recommendations.
Check existing dentures and bridges
Old bridges and dentures in the mouth can cause bad odors as they will cause food accumulation over time. In these cases, you should replace the ones that need to be replaced and have the necessary treatments done for the missing teeth.
Chew gum
Saliva is the most powerful way to fight bad breath. It contains strong enzymes that will dislodge food particles and send them to the stomach, and strong antibiotics that kill bacteria. For this reason, dry mouths, which occur as a side effect of many medications and in some diseases such as diabetes, always have a bad smell.
If you are wondering why your mouth smells bad in the morning, the answer is here; saliva secretion decreases during the night and food particles in your mouth stay there for a long time. Bacteria also use them with pleasure and rot them. Thus, your mouth may smell bad in the morning. Chewing sugarless gum helps clean your mouth by increasing your saliva secretion. Mints and sweet gums usually do not work and make the situation worse. However, chewing gums containing xylitol can also help you in this regard.
Use cinnamon
You can use cinnamon in your drinks and appropriate foods. Cinnamon is an important weapon in the fight against oral bacteria. If you have cinnamon sugar-free gums, they can also be a suitable suggestion.
Drink more water
Especially increasing body dryness with age is a situation that needs to be paid attention to in many ways. Drinking plenty of water, in addition to dozens of other benefits, can be used as an important weapon in the fight against bad breath by preventing your tongue from drying out. Water is a direct helper in keeping bacteria in the mouth to a minimum. It also helps by increasing saliva secretion.
Never sleep with your nose blocked
Airway disorders such as sinusitis and other conditions that cause nasal congestion cause us to breathe through our mouths at night. This dries the mouth and throat, creating an ideal environment for bacteria to multiply. Reduced saliva secretion makes the situation worse. Therefore, you should definitely not sleep with your nose blocked. You should consult an ENT doctor.
Reduce your simple sugar consumption
White flour, white sugar, and all ready-made foods sweetened with glucose/fructose syrup are an incredible treasure trove for bacteria in the mouth. They use these types of sugars very easily and multiply rapidly. Simple sugars (as in all sugary snack foods) cause tooth decay and damage oral health very quickly. Therefore, you should reduce your simple sugar consumption. This will not only provide you with dozens of benefits, such as drinking water, but will also help reduce bad breath.
Chew your bites well
This way, food and saliva mix well and the possibility of food particles remaining in the mouth decreases. More chewing motion helps more bacteria to break away and go to the stomach.
Use dental floss
You can remove bacteria and food residues from places where brushing cannot remove them with dental floss. Food residues that accumulate especially in narrow areas between the teeth bodies can cause rapid bacterial growth.
Do not smoke
Smoking causes dry mouth and causes bad breath. It also paves the way for gum disease, another cause of bad breath.
Chlorine dioxide treatment
In order to prevent the production of sulfur compounds that cause bad breath, all hard and soft tissues in the mouth are washed with 20 ppm chlorine dioxide (clo2). Clo2 oxidizes sulfur compounds and thiols and turns them into odorless salts. The method of application of this gargle is described to the patient by the doctor and repeated at home, and is effective in permanently eliminating bad breath.
Psychosomatic Halitosis
Although such patients have complaints, there is actually no real halitosis (Pseudohalitosis), and it is difficult to distinguish it from pathological halitosis. The cooperation of a dentist and a psychiatrist is required for the treatment of such patients. Because some of such patients do not have a smell but a fear of smell (Halitophobia).
