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You take my breath away

SECURITY BLANKET - SECURITY BLANKET By Dr. Nina Halili-Jao -
Dear Dr. Halili-Jao,

I have had terrible bad breath since high school. I consulted a dentist in the late 1990s about this and I was told that my gums were the problem. The dentist treated my gums twice a month for six months.

But I know the real problem is not my gums. I’ve found yellowish grains near my tonsils which emit a foul odor. Would you believe that because of my bad breath, I can even smell the bad odor coming from my throat?

I do all the hygiene that I need to do. I drink lots of water in the hope that all the bacteria inside my body will be washed out. I brush my tongue and teeth five times a day. Sometimes my tongue swells because of my brushing. But these have not helped and even the dentist was not able to solve my problem. The odor was not totally removed. I used a breath freshening system which is very expensive and which cost me all my salary, but still the odor remained, although not as strong as before. I cannot continue buying this product because it is very expensive.

Please help me to find the right doctor who is knowledgeable about curing bad breath. Which kind of doctor will be able to address my problem?

Hoping,

Miss Hopeless
* * *
Dear Miss Hopeless,

Don’t be too pessimistic. I have inquired from two dentists of the Commission on Audit Medical-Dental Division, Dr. Eden Dimaculangan and Dr. Jun Bangasan. You have already done all the things that are routinely advised for bad breath or halitosis like regular tooth brushing, flossing and using a mouth wash.

Now what is halitosis? It is bad breath that originates usually from the gums and tongue. The foul odor is caused by the bacteria from the decay of food particles, other debris in your mouth, and poor oral hygiene. The decay and debris will produce a sulfur compound that causes the unpleasant odor.

Halitosis is basically caused by poor oral hygiene, but it can also be caused by retained food particles or gum disease. Dentists say that proper brushing including brushing the tongue, cheeks and the roof of the mouth will remove bacteria and food particles. Flossing removes accumulated bacteria, plaque and food that may be trapped between teeth. Mouth rinses are effective in the temporary relief of bad breath.

A person with halitosis must immediately eliminate the anaerobic bacteria which produce the volatile sulfurous gas molecules. This is the prime cause of offensive foul breath odor. This must be prevented from feeding and multiplying in the soft tissue surfaces of your mouth, primarily the tongue. There is therefore a need to scrape away the foul smell-generating germs and other oral debris from the ridges of the tongue.

Researches in the field of dentistry have shown that tongue scraping with an effective tongue scraper (for example, a tongue scraper called Bad Breath Terminator) along with one’s routine tooth brushing and flossing will reduce a person’s mouth odor. Miss Hopeless, you have done all of these and you even went as far as purchasing that breath system for your dental treatment. The next step for you to do is to consult a physician, preferably a specialist in internal medicine.

Why do you need to consult a physician? It is because halitosis also may occur in people who have a medical infection, gum disease, diabetes, kidney failure, or a liver malfunction. So there is a need to rule out all the other possible causes of halitosis. Apparently, the condition called Xerostomia (dry mouth) and tobacco use also contribute to this problem.

Aside from these, cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on one’s breath. An odor that comes from the back of your tongue is indicative of a post-nasal drip. This is where the mucus secretion, which comes from the nose and moves down your throat, gets stuck on the tongue and causes an odor. Bad breath originating from the stomach, however, occurs in extremely rare cases.

Saliva is very important in helping control bad breath. Saliva helps keep the odor under control because it helps wash away food particles and bacteria, the primary causes of bad breath. When you sleep, however, your salivary glands slow down the production of saliva, allowing the bacteria to grow inside the mouth. To alleviate "morning bad breath," brush your teeth and eat a morning meal. Morning bad breath is also associated with hunger or fasting. So for those who skip breakfast, beware because the odor may reappear even if you’ve brushed your teeth. I certainly hope, Miss Hopeless, that with the help of your doctor, you can find out the real cause of your halitosis.

Let me just add that there is another kind of chronic halitosis that gets referred to psychiatrists. This pseudo-halitosis occurs when a person keeps on complaining of foul breath which others do not at all smell as such. In such conditions, the misperception that one has a foul breath is of a delusional character and is thus considered as an olfactory hallucination. Anti-psychotic medications like ziprasidone, quetiapine, olanzapine or amisulpride will help alleviate this psychiatric condition.

AUDIT MEDICAL-DENTAL DIVISION

BACTERIA

BAD

BAD BREATH TERMINATOR

BREATH

HALITOSIS

MISS HOPELESS

MOUTH

ODOR

TONGUE

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