According to statistics, 80% to 90% of bad breath comes from the oral cavity. However, it should not be overlooked that there are some organic disorders that can also cause bad breath.
Bad breath of oral origin
The mouth is the beginning of the human digestive system, there are many beneficial bacteria in the mouth, including “digestive bacteria” and “digestive enzymes”, digestive bacteria and digestive enzymes in the mouth, so that food can be initially digested in the process of chewing. The oral cavity is like a micro factory, which lives about 50 trillion bacteria, they stay in the dark corners of the “day and night work”, gnawing on food debris, creating a fermented and rotten odor, and emitted with breathing. This is the reason why the bad breath is heavier after waking up. Bad breath can be caused by untreated caries, root and crown remnants, bad restorations, abnormal anatomy, gingivitis, periodontitis and oral mucosal diseases in the oral cavity. Among them, dental caries and periodontal disease are the most common related diseases. Food residues and plaque often remain in deep cavities and under the overhang of bad restorations, and bacteria decompose through fermentation to produce bad odor. Pulp necrosis or septic pulpitis, untreated can also emit odor; periodontal disease patients are often accompanied by a large number of tartar, plaque, periodontal pocket bacterial fermentation produces hydrogen sulfide, indole and ammonia, thus producing odor. In addition, periodontal abscesses and periodontal pockets overflowing pus, mostly Staphylococcus aureus combined with periodontal pathogenic bacteria infection, will also emit odor.
The quality and quantity of saliva also play an important role. The decrease of saliva quantity and the increase of organic components such as proteins reduce the scouring and buffering effect of saliva, which makes bacteria multiply and decompose organic components in saliva, gingival sulcus and food residues, producing a large amount of volatile sulfide, indole and other substances, causing bad breath.
Causes of insufficient saliva secretion: one is the stage change of the body’s physiological state disorder, such as staying up late and missing sleep, talking too much every day, or body on fire, etc. These people with bad breath have a common symptom: dry mouth. The second cause is the physical degeneration of old age, resulting in reduced saliva production; the third is congenital salivary gland dysplasia. But regardless of the cause, there is a common denominator: dry mouth.
Non-oral bad breath
1, oral adjacent tissue diseases such as purulent tonsillitis, chronic maxillary sinusitis, atrophic rhinitis, etc., can produce purulent secretions and emit odor;
2, common clinical internal diseases such as acute and chronic gastritis, peptic ulcers appear acidic odor; pyloric obstruction, advanced gastric cancer often appear stinky duck egg bad breath;
3, diabetic ketoacidosis patients can exhale acetone gas, uremic patients exhale rotten apple odor;
4, in addition to leukemia, vitamin deficiency, heavy metal poisoning and other diseases can cause bad breath.
Physiological halitosis
Hunger, consumption of certain drugs or onions, garlic and other irritating foods, smoking, sleep due to reduced saliva secretion of a large number of bacteria decomposition of food residues, etc. may cause transient bad breath.
Bad breath in healthy people may be caused by the increase and thickening of plaque on the back of the tongue due to poor oral habits and oral hygiene. Due to the large surface area of the back of the tongue, there are many papillae, furrows and depressions, which are conducive to the retention of bacteria, oral mucosa shedding epithelium, food debris, etc., acting as a “bacterial storage room”, which is conducive to the production of bad breath. Some studies have shown that there is a positive correlation between the degree of bad breath, the amount of volatile sulfide and the thickness and area of the tongue moss, with a closer relationship with the thickness of the tongue moss, and a reduction in volatile sulfide after removal of the tongue moss. This may be because the thicker the tongue, the more anaerobic environment is formed, the more conducive to the growth of anaerobic bacteria, and thus the more conducive to the production of volatile sulfides, leading to bad breath. This is causally related to the imbalance in the pH level of the mouth.
How to know that there is bad breath
1, self-perception method: cover the mouth and nose with your hand, mouth exhale, and then smell the exhaled gas has no odor;
2, according to the feedback of relatives and friends to assess;
3, the professional bad breath nasal test physician to diagnose: using a score of 0 ~ 5 to measure the degree of bad breath.
What to do if you have bad breath
Find out the oral diseases that may cause bad breath, such as untreated caries, residual roots, residual crowns, bad restorations, gingivitis, periodontitis and oral mucosal disease, etc. We should carry out medical treatment for caries, extract useless residual roots and crowns, remove bad restorations, remove incorrect anatomical structures and treat oral mucosal disease in time, and for patients with periodontal disease, carry out basic treatment such as scaling and root scraping first, and then carry out systematic periodontal treatment and plaque control. For patients with periodontal disease, basic treatment such as scaling and root scraping is performed, followed by systematic periodontal treatment and plaque control.
For bad breath caused by systemic diseases, it is very important to treat and control the primary disease. For example, patients with gastrointestinal disorders should focus on the balance of intestinal flora while treating the cause of the primary disease, and maintaining a good balance of intestinal flora is beneficial for the recovery of gastrointestinal disorders and the control of halitosis. For respiratory diseases (infection and necrosis of the nasal cavity, maxillary sinus, pharynx, lung), parenchymal organ damage (liver failure, kidney failure) and diabetic ketosis, uremia, leukemia, vitamin deficiency, etc., local or systemic systemic treatment of these diseases should be carried out first.
Enhance oral hygiene
1.Choose the correct brushing method, brush at least 2 times a day, and develop the habit of rinsing the mouth after eating.
2.It is also very important to perform tongue cleaning. Since 80%-90% of bad breath comes from the back of the tongue, the dentist should teach the patient to use the tongue scraper to clean the tongue properly. In vitro tests can also be conducted to identify the main pathogenic bacteria of the patient and select a mouthwash that can effectively inhibit the growth of microorganisms on the tongue for local antibacterial purposes. Now commonly used mouthwash including chlorhexidine, chlorine-containing compounds, hydrogen peroxide, sodium salt, zinc salt, etc. A good mouthwash should be able to maintain the ecological balance of the normal oral flora and prevent new diseases caused by dysbiosis. But do not just use sterilization drugs in the mouth, and do not use chemicals to balance the pH of the mouth, because the mouth itself is a world of bacteria, many of which are beneficial bacteria.
3, stimulate saliva secretion or use alternatives, because saliva has antibacterial, bactericidal, clean mouth, treatment should also be considered to increase the amount and flow rate of saliva, enhance the movement of the tongue, chewing fiber-rich food or chewing gum, etc. are conducive to reducing bad breath. The ancient people called saliva as “jade liquid”, which is the best substance to maintain a hygienic oral environment. In fact, sufficient saliva secretion is one of the signs of human health, and also ensures a hygienic oral environment.
Prevention and treatment tips
1, pay attention to the combination of work and rest, improve physical fitness.
2, pay attention to oral hygiene, develop the habit of gargling after meals, so that germs are not easy to grow. Usually drink more light salt water, boiled water.
3, daily life to tea as a drink: in addition to preventing and improving the treatment of halitosis, but also regulate the balance of the human body mechanism, anti-inflammatory and antibacterial, detoxification of heat, clean mouth. Enhance the body’s resistance. These herbal teas are mainly wild chrysanthemum, tomato grass, turnip oak grass, honeysuckle, yellow lily, etc.
4, avoid smoking, alcohol, spicy, too cold, too hot stimulating food. Tobacco contains nicotine and other harmful substances, smoking will lead to bad breath, coupled with respiratory tract infections, resulting in dry mouth, saliva reduction aggravates bad breath.
5, maintain a regular diet nutritional balance, and eat more vegetables and fruits containing acids and vitamins. Healthy cereal food millet can reduce the growth of oral bacteria and prevent bad breath better. Winter amaranth, honey, tomatoes, poppy, lemon, green fruit, kelp, radish, sesame, raw pear, water chestnut, white fungus root, sugar cane and other foods have the effect of clearing heat and reducing fire, moistening the lung and kidney yin liquid, can be selected in moderation.