Bad breath (halitosis) occurs in healthy people after a night's sleep, when smoking, eating foods with a sharp aroma. The main pathological causes include diseases of the teeth and oral cavity, diseases of the digestive system, chronic infections of the upper respiratory tract. To establish the etiological factors of halitosis, dental and ENT examinations are indicated. Endoscopic, X-ray and laboratory methods of diagnostics are carried out. Treatment of bad breath involves careful oral hygiene, conservative and surgical methods to eliminate the underlying pathology.
In the morning, bad breath is observed in almost all people. It appears due to a decrease in saliva production and concomitant violations of the self-cleaning of the oral cavity. Sometimes the symptom is combined with an uncomfortable taste in the mouth, a coating on the tongue. In older people, halitosis also occurs during the day, even if hygiene requirements are observed. This is due to a decrease in salivation and an increase in the number of pathogenic microorganisms in chronic diseases of the gastrointestinal tract.
An unpleasant odor is provoked by the multiplication of microorganisms, their accumulation on the tongue and gums. Therefore, in people who rarely brush their teeth, halitosis is persistent. Also, the symptom is associated with eating habits and bad habits. For long-time smokers, the unpleasant smell cannot be removed even with the help of mint paste and chewing gums. Short-term halitosis is noted with the abuse of garlic and onions, eating dishes with a lot of spices.
There is the concept of "imaginary halitosis". This problem appears due to excessive concern about the nature of the smell from the mouth. At the same time, a person has normal fresh breath, and there are no real reasons for worrying about this. Halitophobia is observed with neurosis, emotional overstrain, increased anxiety. Sometimes imaginary halitosis is a sign of a mental disorder.
Dental diseases account for 80-90% of the pathological causes of bad breath. Halitosis becomes the first sign of dental caries, tartar, periodontitis. The symptom occurs in acute and chronic sialadenitis. An unpleasant smell is constantly felt by a person. Hygienic mouthwashes help to briefly cope with bad breath, but it is not possible to completely eliminate the problem.
In addition to this symptom, there is an increased sensitivity of the teeth to cold and hot food. Often a person experiences acute toothache. In the chronic process, halitosis is the main symptom of pathology, and the pain syndrome is slightly expressed. Another typical cause is stomatitis of various etiologies. Patients with this disease are concerned not only with an unpleasant odor, but also with burning, painful sensations that increase with eating.
The defeat of the digestive tract is the second most common group of causes of bad breath. The appearance of the symptom is mainly due to insufficient digestion of food. As a result, complex chemical compounds undergo fermentation and decay processes. During these reactions, substances with an unpleasant odor are formed. The most common conditions that provoke halitosis are:
Bad breath occurs when there is an overgrowth of pathogenic bacteria or fungi. Chronic inflammation occurs, pus is released, which is the cause of halitosis. Usually this symptom develops with atrophic and hypertrophic rhinitis, sinusitis. An unpleasant putrid odor is a symptom of a sore throat. Bad breath that can be heard from a distance is characteristic of lung abscess and bronchiectasis.
In patients, the frequency of infectious lesions of the skin and mucous membranes increases, so an unpleasant odor is often caused by stomatitis. With the development of a diabetic coma with ketoacidosis, the patient's mouth smells like acetone. The symptom is accompanied by severe weakness and drowsiness, dryness of the mucous membranes. There are sharp headaches and pains in the abdomen, in the later stages consciousness is disturbed.
In acute liver failure, an unpleasant sweetish-sweet smell from the mouth appears. It is caused by a violation of the excretory function of the organ and the accumulation of toxic products in the blood. For kidney failure, the aroma of acetone (the smell of pickled apples) is typical. In the terminal stage of peritonitis, the patient's breath becomes fetid, acquires a "fecal smell".
Bad breath is caused by drugs that reduce saliva secretion. The mechanism of symptom development is based on the insufficiency of natural cleansing of the oral cavity, the accumulation of food particles and the increased reproduction of opportunistic microorganisms. Xerostomia and halitosis often occur immediately after the appointment of the drug, or after increasing the dose. The symptom is caused by:
With the problem of bad breath, patients usually turn to a general dentist or gastroenterologist. The doctor conducts a diagnostic complex according to his profile, if necessary, appoints consultations of related specialists. To detect many dental diseases, a visual examination of the oral cavity is sufficient. With halitosis, the following laboratory and instrumental methods are used:
An important role in the treatment of halitosis is played by lifestyle, nutrition and hygiene habits. To eliminate the physiological causes of an unpleasant odor, it is necessary to brush your teeth 2 times a day for at least 3 minutes, do not forget to clean the tongue from plaque. For oral hygiene, it is necessary to use dental floss and refreshing rinses. To quickly freshen your breath, you can use sugar-free chewing gum.
It is necessary to reduce the eating of garlic and onions, reduce the amount of spicy meat dishes, red wine. It is advisable to limit your daily coffee intake to 1-2 cups. Available breath freshening foods are apples, carrots, green leafy vegetables. Doctors advise you to stop smoking, because the unpleasant smell of cigarette tar cannot be eliminated by any methods.
If halitosis occurs against the background of drug xerostomia, it is necessary to cancel or reduce the dose of drugs. There are no specific medications to eliminate bad breath from the mouth. Therefore, therapy is reduced to getting rid of its cause. Most often, a person needs qualified dental care. After sanitation of the oral cavity, halitosis disappears.
In case of gastrointestinal diseases, not only etiotropic treatment is carried out, but also the intake of enzyme preparations. Replacement enzyme therapy normalizes the processes of digestion, eliminates stagnation and fermentation of food. Thanks to this, the breath becomes fresh. With ENT diseases, etiopathogenetic therapy is selected. Emergency conditions are stopped in the intensive care unit.
Treatment of halitophobia is primarily aimed at normalizing the psycho-emotional state of the patient. Psychotherapy sessions are recommended, light sedatives and tranquilizers are used. People with imaginary halitosis are prescribed general measures: careful care of the oral cavity and teeth, control of the diet, limiting alcohol consumption.
Surgical intervention is carried out with advanced forms of gastrointestinal diseases, oncological processes. Given the nature of the disease, either excision of the pathological formation or partial resection of the organ is indicated. In calculous cholecystitis, cholecystectomy is performed. Lung lobectomy is recommended for bronchiectasis and destructive processes in the lung parenchyma.