| Halitosis
What is Halitosis?
Halitosis (bad breath) does not just have adverse social
implications - it is a condition that may have a number of possible causes and, in the
first instance, requires a consultation with dental and health practitioners.
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Known Causes
Foul-smelling bacterial infection and chronic mouth
inflammation are the most common causes of bad breath. Dental cavities and mouth, tongue,
and gum infections top the list. Bronchiectasis, an infection and enlargement of the
bronchial tubes, and lung abscess can also cause halitosis. It goes without saying that
many smokers have bad breath which unrelated to mouth and lung infection but is simply a
result of inhaling tobacco.
There are ,however, three serious illnesses which can all
give specific mouth odours:
* Liver failure causes a fishy odour (fetor hepaticus)
* Kidney failure an ammonia odour, and
* Diabetic coma (ketoacidosis) a fruity odour.
Finally, many healthy individuals have persistent bad
breath through poor digestion. (There is no research suggesting a connection with hormonal
cycles although it is well known that menopausal symptoms can affect digestion and the
functioning of the body organs mentioned above.)
Examination of the mouth will yield the diagnosis when
dental infection is responsible. A history of cough, fever and weight loss may suggest
bronchiectasis or lung abscess. Diabetic ketoacidosis, liver disease and kidney failure
each have a characteristic constellation of symptoms and physical and laboratory
abnormalities. It is for these reasons that a full consultation and diagnosis be sought to
identify the cause of the problem.
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Conventional
Treatment
Teeth brushing, flossing, mouthwashes and breath mints are
effective in many instances, but these yield only temporary, symptomatic relief. Although
bad breath is a common complaint, identifying the cause and developing an appropriate
treatment plan can be difficult. The underlying cause must be identified before the
appropriate therapy/remedy can be chosen. In all cases, the first thing to do is to
consult your dentist to check that the cause does not lie in the mouth.
Mouthwashes: - Remember, mouthwashes are only
applicable when the source of the problem lies with bacteria in the mouth. Remember also
that a mouthwash is symptomatic treatment and does not treat the underlying cause
(eg.
bacterial growth in a cavity).
A two-phase (ie. oil-water) mouthwash has recently been
developed because many oral microorganisms possess hydrophobic outer surfaces and may
therefore arequireoil/water base to remove such oral microorganisms.
In one study (1) olive oil and other essential oils was
mixed with an aqueous phase including cetylpyridinium chloride, which is a disinfectant
that promotes the adhesion of microorganisms to oil droplets. This study found that
whereas a reduction of only 30% of sulfide was observed when a commercial
mouthwash was used, this two-phase mouthwash led to approximately 80% reduction of
sulfide. Furthermore, volatile sulfide and 2-ketobutyrate in saliva putrefaction system
were completely inhibited by the two-phase mouthwash. It
concluded that the two-phase mouthwash strongly inhibits the production of volatile
sulfide and is therefore a valuable help in eliminating bad breath.
The mouthwash, Listerine, is a solution for washing the
oral cavity consisting of essential oils (thymol, methanol, eukalyptol) and methyl
salicylate. One study (2) found that Listerine inhibited the growth of microorganisms over
a very broad range. The bactericidal action of Listerine against from bacteria isolated
from saliva and dental plaque from 5 healthy normal subjects was tested. Listerine
exhibited a potent bactericidal effect on bacteria in saliva and dental plaque. Most of
the bacteria died after a 30 second exposure to Listerine. According to the results,
Listerine therefore does appear to be effective as a solution used for cleansing the oral
cavity and dentures.
(1) Effects of a two-phase oil-water mouthwash on
halitosis. Yaegaki K; Sanada K Nippon Dental University, Niigata. Clin Prev Dent
Jan-Feb 1992, 14 (1) p5-9,
(2) Antibacterial effects of Listerine on oral bacteria. Kato T; Iijima H; Ishihara K;
Kaneko T; Hirai K, Naito Y; Okuda K Tokyo Dental College. Bull Tokyo Dent Coll Nov 1990,
31
(4) p301-7,
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