Halitosis

¿What about Halitosis?

halitosisHalitosis, aka “bad breath”, are all the forms of unpleasant odours present on the exhaled breath, whatever its origin.

Statistically, about 30 % of the adult population suffers or has suffered from halitosis at some point.
The paradox of this condition is that whoever has it cannot smell their own bad breath, and this turns it into a social problem. Sometimes we may need the collaboration of our friends and relatives to realise that we have such a condition.

It needs to be pointed out that halitosis is not a disease but rather a symptom. It is a problem that may have diagnostic significance and its origin may have to be identified.

Bad breath may originate in the mouth itself (true in 90 % of the cases), or it may originate in the upper respiratory tract.
It is important to identify whether bad breath emanates only from the mouth or both from the mouth and nose.

If halitosis is present on both the breath exhaled through the mouth and through the nose, this indicates a problem in the upper respiratory tract, which may include all sorts of ear, nose and throat conditions likes rhinitis, nasal polyps, chronic sinusitis, tonsillitis, etc. if bad breath breath emanates only from the mouth, then it is a specific problem of the oral cavity and we should detect where in the mouth it comes from in order to treat it.

Origins may vary: it could stem from gingivitis, chronic periodontal disease (gum disease) with periodontal pockets, which causes a very characteristic odour due to the formation of deposits under the gumline and the build up of bacteria in said pockets. Therefore, once you undergo a periodontal treatment, bad breath and bad taste in the mouth disappears, as we would have eliminated its cause.

Other sources of halitosis may be the retention of odour particles between the teeth, fillers that haven’t been properly smoothed, poorly adapted dentures, cavities, mouth dryness… anything that promotes the accumulation and retention of microbial plaque can lead to bad breath.

The tongue is another spot that needs looking into, as it has been demonstrated that there is a link between oral halitosis and the substances deposited on the back of the tongue.  For instance, in patients with a healthy mouth, no cavities and no gum disease but who suffer from bad breath, the origin may be at the base of the tongue.   Under the tongue, the accumulation of food debris, coupled with the presence of certain bacteria, promotes de formation of sulphur volatile compounds, like hydrogen sulphur and methyl mercaptan or other non sulphur volatile compounds, like indole and skatole or other amines.  All these compounds come from different bacteria that need to be detected and quantified.

In other cases, infections in the upper respiratory tract may lead to the so called post-nasal drip, where a runny nose provokes a drip in the back of the pharynx that builds up onto the back of the tongue.  This drip contains bacteria that, by building up in the back of the tongue and at its base, where usual hygiene measures cannot eliminate them, lead to the production of sulphur gases. Those gases emanate when we talk or move the tongue, and that’s why most cases of bad breath worsen when we talk.

Regarding treatment, the most important part is identifying its origin and having a protocol for procedure. There are antibacterial and mechanical treatments that, combined and adapted to each particular case, can provide an effective solution to a condition capable of causing great upset in the people suffering it. We invite these patients to consult with us and ask for information. Let us assess your condition so that we can apply the array of measures we now have available for an effective treatment.