Bad breath is a common occurrence. Nearly 65% of people have experienced bad breath at one time or another.
1, the chemical causes of bad breath: bad breath is latent in the teeth and the back of the tongue after the breakdown of bacteria, proteins, peptides and amino acids, resulting in sulfur-containing gases. Proteins have two sulfur-containing amino acid components, namely cystine and methionine. The sulfur-containing compounds produced by their breakdown are mainly hydrogen sulfide and methyl mercaptan. This is followed by dimethyl sulfide and dimethyl disulfide. In addition, there are some organic acids also associated with bad breath, such as butyric acid and propionic acid, as well as compounds like indole, methylindole and cadaverine.
2, the microbial causes of halitosis: there are at least 82 microorganisms in the oral cavity that can produce hydrogen sulfide, methyl mercaptan and fatty acids during the metabolic process. These bacteria are mainly Clostridium perfringens, Haemophilus, Veronococcus and dental tartar dense spirochetes.
3, bad breath and body immune factors: IgA in saliva can inhibit bacterial activity. Therefore, the increase of anaerobic bacteria on the tongue and teeth may be related to IgA deficiency. About 0.l% of people suffer from congenital IgA deficiency. In addition to genetic factors, there are acquired IgA deficiency disorders and these patients are prone to respiratory tract infections. Allergies, arthritis and a variety of autoimmune diseases.
4, local causes of halitosis: the diseases most closely related to halitosis are caries, periodontal disease and oral cancer. In addition to oral diseases, diseases of organs near the mouth, such as tonsil stones, sinusitis, nasal polyps, respiratory foreign bodies, etc., are also more common causes of bad breath.
5, halitosis and systemic diseases: many patients with systemic diseases exhale gas with certain special flavors. For example, the breath of diabetic patients with a fruity taste, renal failure patients with fish breath, liver cirrhosis patients with a strong sulfur taste in the mouth.
6, the physiological causes of bad breath: saliva secretion is reduced during sleep, the tongue and cheek muscles are basically at rest, which can easily lead to bad breath. People who are easily agitated, angry or depressed are more likely to have bad breath. Menstruation, pregnancy and other periods are also more likely to occur bad breath.
7, diet and bad breath: eating habits play an important role in the formation of bad breath. Onions, garlic, animal fats and other foods can cause special bad breath. This bad breath can not even be removed by brushing your teeth. Some patients taking certain drugs can produce bad breath, such as dimethyl sulfide, quinine and antihistamines, etc.
8, psychological bad breath: it is the patient’s self-perception, but there is actually no bad breath.
9, even physicians are prone to make the mistake: that gastrointestinal disorders are an important cause of bad breath. In fact, the esophagus is closed when not eating. It is only when you burp that gas from the gastrointestinal tract is expelled through the mouth. Therefore, the bad breath that can often be felt has little to do with the gastrointestinal tract. Unless it is a more serious gastric disease, such as gastric cancer, malabsorption syndrome, etc., coupled with the closed esophagus, it may be accompanied by persistent bad breath.
How to determine if you have bad breath.
1, the feedback of people in close contact with life: their own bad breath, they often can not smell, but friends and family can smell
2, spoon scraping method: spoon scraping the back of the tongue, or others to smell it.
Diagnosis of bad breath in the hospital: slightly
Find the source of bad breath.
First determine whether the odor comes from the oral or nasal cavity. Alternate open-mouth exhalation and closed-mouth exhalation, the odor from the nasal cavity is obvious when exhaling with the mouth closed, and not obvious when exhaling with the mouth open; bad breath from the mouth is the opposite.
Bad breath from the mouth also has the characteristic of becoming more and more obvious with the prolongation of the conversation time. However, after rinsing and cleaning the mouth, the bad breath will get better.
In the oral cavity, the common sources of bad breath are the back of the tongue (especially the root of the tongue), subgingival, adjacent surfaces of the teeth, poor dental fillings, dentures, and areas of food impaction. There are the following characteristics.
1, pinch the nose and exhale, you can still smell the odor.
2.The back third of the tongue has a relatively thick tongue bitterness, and bad breath disappears after thorough removal of tongue moss.
3.There is food residue under or around the filling or restoration, and the four odors disappear after removal.
4.There are ulcers in the mouth, and bad breath is reduced and disappears with the improvement and healing of the ulcers.
5.The depth of periodontal pocket is more than 4 mm, and the gums bleed or overflow pus.
6.Loose fillings; dental cavities; alveolar abscesses, calculus, bad restorations.
7.Oral fungal infection.
8.Dry mouth syndrome when there may be oral flora imbalance.
9.Tonsil infection and enlargement.
Odor from the nasal cavity: bad breath from the nasal cavity and upper respiratory region is caused by the mucus secreted during sleep that is not discharged in time and accumulates locally. There are the following characteristics.
1, bad breath occurs mainly in the morning, and the back of the tongue has no obvious tongue coating.
2. Increased body temperature and enlarged peripharyngeal lymph nodes.
3, with allergies, self-conscious discharge from the back of the nose
4.History of chronic sinusitis and recent symptoms of sinusitis
5, after excluding the causative factors of the oral cavity, the symptoms of bad breath have not improved significantly.
This type of bad breath is easy to coexist with bad breath caused by oral factors, because of poor local ventilation, increased secretions, bacteria are easy to breed. And oral hygiene can be improved to significantly reduce bad breath.
A small number of patients with systemic diseases can also occur bad breath. For example, when diabetes is out of control, weight loss, dry mouth and other symptoms, bad breath can easily occur. The bad breath that occurs in systemic diseases is often associated with recurrent illnesses that last for a relatively short period of time and are mostly expelled through the lungs. This type of halitosis is less related to volatile sulfur-containing substances and more related to volatile blood-borne substances.
Before visiting the clinic for bad breath, do not eat, drink, rinse, smoke, chew gum or anything like that for at least two hours, and do not use perfume, lipstick, or other cosmetics that may affect the diagnosis. If you are taking antimicrobials, you should also stop taking them two days before your appointment. To make the diagnosis more accurate, it is best to have someone closest to you (such as a husband or wife) with you to provide more detailed, objective information.
Bad breath can be prevented. Good oral hygiene practices can provide good control of plaque in the mouth. For example, brushing your teeth can maintain no noticeable bad breath for up to 2 hours. Toothpastes containing sodium bicarbonate are more effective in removing bad breath than fluoride toothpastes.
Treatment of bad breath
1, the teeth are rotten to fill
2.Dirty teeth to be cleaned
3, gum bleeding, loose teeth to treat periodontal disease
4.Fix the bad dentures
5, there is a food embedment to see the hospital
6.Mouth ulcers should be treated
7, movable dentures should be brushed regularly, do not wear dentures to sleep at night
8.Patients with dry mouth, give drugs to stimulate saliva secretion
9.2％ chlorhexidine gargle
10.2％ sodium bicarbonate solution gargle
11.Use some drugs to improve the body’s resistance
If you can’t eliminate bad breath even after ruling out diseases of the oral cavity and neighboring organs, please go to the internal medicine department for consultation.