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[ARTICLE] What causes bad breath?
Filed Under: Dentistry | Published: Aug 11, 2009 | Author: unknown

Bad breath or Halitosis

Bad breath plagues just about everyone at one time or another.  Bad Breath is devastating for ones social life. Many people have been denied employment, failed in business and social engagements and relegated to low social status because of it.  

There are four sources of bad breath:
1. The mouth: This includes the teeth, the gums, and the top surface (dorsum) of the tongue, especially the very back of the tongue.  Since this type of bad breath is the most common, its diagnosis and treatment will be covered extensively.
2. The upper respiratory tract: Including the nasal cavities, sinuses, throat, tonsils and the larynx (voice box). This is the second most common type of bad breath.
3. The lungs: This could be a temporary issue caused by consumption of certain foods, drugs, or a chronic issue caused by a disease.
4. The stomach: This type of bad breath could be caused by diseases, which could cause chronic vomiting.

80% of all bad breath originates from bacterial overgrowth in the mouth.  If you are young, healthy, and do not suffer chronic sinusitis, tonsillitis or laryngitis, chances are good that this section is the most relevant to your problem.

Sulfur compounds created by these bacteria causes the bad breath in the mouth.   Anaerobic bacteria grow in the absence of oxygen and produce a chemical call Volatile Sulfur Compound (VSC) which includes things such as rotten egg smell, rotten cabbage smell, and rotten vegetable smell.  The anaerobic bacteria metabolize proteins such as dead tissue cells, blood and mucous.  Proteins are made from building blocks called amino acids, and the digestion of these amino acids supply the bacteria with energy.  Some of the amino acids contain sulfur, and these sulfur compounds are converted to VSC's as a waste product.

In a healthy mouth there is no bad smell because there is a balance of bacteria flora in the mouth. When the conditions in the mouth change due to disease or other factors such as dehydration or the presence of fermentable substances such as blood, dead cells and shreds of food, the balance of bacteria changes, allowing the overgrowth of anaerobic bacteria at the expense of the rest of the normal floral organisms.  The bad odor becomes the result.

There are  several chronic or temporary conditions that can shift the balance of bacterial flora toward an overgrowth of the bacteria which produce VSC's:

Xerostomia or Dry Mouth:   Dry mouth dehydrates and creates a concentrated mucous coat over the teeth.  The most common type of bad breath caused by dry mouth is morning breath, which is a result of breathing through the mouth while sleeping.  Sjorgren's Syndrome, aging and consumption of numerous drugs cause further dry mouth as well.

Some drugs actually cause Halitosis (not originating in the mouth).  Recovery room and operating room personnel can all attest to the incredibly bad breath (originating from the lungs) exhaled by patients recovering from general anesthetic agents after operations. Illegal recreational  

Due to lifestyle diet changes and damage from the Illegal drug use, there are tooth decay, poor oral hygiene, and gum disease that can be added to this group as well. have the added liability of lifestyle issues which interact with the dry mouth and make the bad breath much worse.

  • People who have high sugar intake, tend to have bad breath, since the sugar sticks to the teeth, harboring bacteria and decaying of the teeth. Decay inside a tooth provides an anaerobic environment and is thus a great place to live if you are a sulfur metabolizing germ.  This decaying (dead tooth structure) of the tooth, harbors anaerobic bacteria. Dead things smell bad and since the decay is fairly soft, it absorbs juices from the foods you eat, and that decays as well. As a result, the first place to start on the road to recovery from bad breath is a visit to the dentist for a check up for decay. Even without decay, if the oral hygiene is poor a film of plaque which is composed of bacteria and food debris, accumulates on and between the teeth.  Bacteria in the plaque produce VSC's, causing bad breath.  In healthy individuals, this type of bad breath can generally be eliminated simply by brushing and flossing the teeth properly once a day.  Flossing is essential since the area between the teeth is more likely to be free of oxygen than any other area of the mouth, and therefore is always a source of bad breath if not kept clean.  If you have a problem with bad breath, try smelling a piece of floss after using it to clean between the teeth and see for yourself.

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