Bad Breath (Halitosis)
Bad breath (halitosis) and its social implications may be a major problem to a patient.
The addictive habit of smoking is often to blame. Smoking causes the tongue to become deprived of its normal lubrication and it becomes hairy and coated. This in turn traps microscopic food particles that decay in the crevasses of the tongue causing the offensive odours.
Dental health is the other major factor involved. The gums may become very slightly detached from the teeth, forming tiny pockets in which food may become trapped. This is periodontal disease and the breakdown of saliva, food, bacteria and other foreign bodies in these pockets causes the production of rotten egg gas (hydrogen sulfide).
Sinusitis and other infections of the nose (e.g. rhinitis), throat (e.g. tonsillitis) and lungs (e.g. bronchitis, pneumonia) can cause bad breath because of the infected saliva and pus present in the airways. Damaged and scarred lungs will become infected more readily, or may have a constant low level of infection present in them (e.g. bronchiectasis, emphysema).
Fad diets that have excess protein and not enough carbohydrates are another cause, because the breakdown products of proteins are highly volatile acids that are expelled in the breath.
Alcoholics have halitosis because the alcohol alters the balance of micro-organisms that normally live in the gut, causing an increase in the number of odour producing bacteria.
Other causes of bad breath include liver failure, hepatitis, diabetes, some types of cancer, dehydration and some drugs, such as those used to treat angina, certain tranquillisers, lithium (used in psychiatry), griseofulvin (for fungal infections), penicillamine (for rheumatoid arthritis) and fluid tablets (diuretics).
The management of bad breath involves identifying the cause and then giving the appropriate treatment.
Causes of bad breath: