Oral Malodor: A Social Concern

  •   Mon, Jul 15 2024
  •   By Dr Akshata G Kamat

July 15, 2024

Bad breath also referred to as halitosis is unpleasant malodor emanating from someone’s breath, either attributed to oral or systemic factors.it is considered as a social problem, which impacts 50-60% of the world’s population. It can have a negative impact on the personal and professional lives of individuals causing embarrassment and social anxiety. It has a multifactorial aetiology.  Hence identification of the cause and treating it plays a significant role in management of bad breath

ETIOLOGY

INTRAORAL CAUSES

Most common causes being the sulphur producing bacteria, which reside on the intra oral surfaces such as tongue and throat. These bacteria start to break down proteins at a high rate in the saliva resulting in the release of volatile sulphur compounds (VSC’s)

  • Deeply carious teeth with food lodgement
  • Post teeth removal wounds filled with blood clot
  • Food impaction in large interdental spaces
  • Teeth crowding, favour food accumulation
  • Dentures not regularly cleaned
  • Periodontal infection deep gum pockets   favour the growth of bacteria which release volatile sulphur compounds (VSC’s), contributing foul odour
  • Dry mouth patients have reduced saliva flow, resulting in increased bacterial load causing strong unpleasant
  • Tongue coatings: accumulation of food debris and bacteria causes a coating causing a bad odor

EXTRAORAL CAUSES

  • Ear, Nose and Throat infections
  • Acute pharyngitis, chronic sinusitis are common causes for bad breath
  • Postnasal drip, where the liquid flows in the throat originating from nasal cavity causes a foul odor
  • Pulmonary infections such as chronic bronchitis often causes a strong unpleasant breath
  • Gastrointestinal cause: commonly seen in regurgitation esophagitis where acidic contents from the stomach from the stomach flow back to oral cavity causing an offensive odor
  • Kidney insufficiency: associated with increased uric acid in blood gives rise to ammonia like odor, typical of “fish odor”
  • Metabolic disorders: Such as diabetes mellitus leads to accumulation of ketones giving rise to” rotten apple” breath
  • Liver insufficiency: will result in ammonia accumulation in blood resulting in “dead mice” odor

TREATMENT OF MALODOR

MECHANICAL TREATMENT

  • Effective tooth brushing twice daily
  • Using interdental floss in between the teeth in the interdental spaces
  • Tongue cleaning using a toothbrush or a tongue scraper timely visiting the dentist and undergoing professional periodontal therapy which involves scaling and root planning
  • Regularly following these oral hygiene practices reduces plaque and tartar accumulation   and microbial colonisation in the oral cavity there by reducing the chances of mal Odor

CHEMICAL TREATMENT

  • Mouth rinsing with mouthwashes has been a common practice in patients who suffer from malodor.  Usage of   mouthwashes should be done judiciously after prescription by the dentist. The active components present in the commonly used mouthrinse such as chlorhexidine, triclosan, Listerine significantly decrease the VSC levels thereby reducing the organisms in the oral cavity

MASKING MALODOR

  • Oxidising lozenges: sucking of lozenges with oxidizing properties; reduces tongue dorsum malodor for 3 hours
  • Chewing gum helps to increase the solubility of malodorous compounds in saliva by lowering the saliva PH and increasing its production

Bad breath affects the psychological state of a person and becomes a barrier to developing social relationships. Early diagnosis and identification of the causative factors plays an important role in planning a treatment. Thus treatment should be aimed at eliminating the etiological factors and maintenance of proper and regular oral hygiene.

 

 

 
By Dr Akshata G Kamat
Dr Akshata G Kamat is consultant dental medicine, KMC Hospital, Mangaluru.
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Comment on this article

  • Chitra kamath, Mangalore

    Fri, Jul 19 2024

    V good information about dental hygiene.keep it up doctor.All the best for your future endeavours .I want to visit your clinic once .Do you have your own clinic Are you attached to kmc hospital.

  • Mithila, Mumbai

    Fri, Jul 19 2024

    Very informative article.

  • Rita, Germany

    Wed, Jul 17 2024

    Dear Doctor you have well explained about Malodor.I wish to tell you about my experience about it.I too never knew about it till I xperienced in lactating period .Had a very bad breath during this time and felt teeth were so lose and fall at any time.Couldnt get rid of this .Later I came to know why this is.Even good mouth wash or treatment didnt help.Only after diabetes treatment and Dental care ,brushing teeth before going to bed has helped a lot.Hope it helps others too

  • Zalman, Mangalore

    Tue, Jul 16 2024

    Hi Dr. Akshata, Thanks for the detailed explanation of the Malodor desease. Does the breath odour has anything to do with the digestions system and constipation? Greatful for your expert medical advice. Thanks,

  • HENRY MISQUITH, INDIA

    Tue, Jul 16 2024

    Why does bad breath occur, what are its reasons, how can it be treated, and how can it be reduced? Thank you very much, you explained it correctly. If articles like this reach people, they can avoid the problem of bad breath.


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