Monthly Archives: November 2010

Halitosis

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I want to open my blog on a medical note with this piece on Halitosis. Please do not hesitate to leave comments on your feelings concerning the piece:

Halitosis (bad breath) is an oral health condition characterized by consistently malodorous breath.  There are just as many causes of bad breath as there are sources of bacteria in the mouth.
Although several studies report the population prevalence of halitosis (physiological or because of underlying disease) to be about 50%, there is no reliable population prevalence for now. One cross-sectional study of 491 people found that about 5% of people with halitosis have pseudo-halitosis and about 40% have physiological bad breath not caused by underlying disease. Futile efforts have been made to find a reliable data about age or sex distribution of physiological halitosis.
Meanwhile, there is no gainsaying that a significant number of Nigerians have at one point or the other experienced halitosis. Information on the causes and preventive measures would therefore have a salubrious effect.
Generally, halitosis is caused by bacterial action. Bacteria, just like humans, consume food and excreting waste. The waste products produced by some oral bacteria are sulfur compounds which produce the offensive odour. While volatile sulfur compounds are the principal causative agents, the bacteria that live in the mouth produce other waste products too some of which have their own unique and unpleasant smell. A few of these waste byproducts are: Cadaverine – the smell we associate with corpses, Putrescine – the compound responsible for much of the foul odor produced by decaying meat, Skatole – the characteristic smell of human fecal matter, and Isovaleric Acid – the smell of sweaty feet.
How surprised you must be to discover that this wonderful mix of compounds could emanate from the mouths of humans. And no one is an exception. Everyone has some amount of these unpleasant compounds in their breath. Fortunately, however, at low levels these odorous compounds cannot be detected by the human nose. It’s only when the amount of these compounds becomes elevated that they can be perceivable.Halitosis may be caused by certain foods items such as garlic and onions. They are absorbed into the bloodstream, become transferred into the lungs, and become expelled in the air during expiration. The breath remains until the food becomes completely eliminated by the body.  Poor oral healthcare characterized by improper and inconsistent brushing and flossing of teeth allow food to remain in the mouth; this provides a breeding ground for bacteria, which, in turn, causes malodorous breath. Food that is allowed to collect on the teeth, gums, and tongue may cause the gums to rot, which causes an unpleasant odor and taste in the mouth.
More so, lack or improper cleaning of dentures, periodontal disease and xerostomia (dry mouth) may also be responsible. Xerostomia is often a large contributor to halitosis and is characterized by a significant decrease in saliva production which makes the mouth unable to cleanse itself and remove debris and particles left behind by food. Xerostomia may be caused by certain medications such as salivary gland disorder, or by continuously breathing through the mouth, instead of the nose.
One of the most commonly abused drugs in Nigeria (and the world at large) – tobacco products
such as cigarettes, cigars, smokeless tobacco, and snuff besides staining the teeth and increasing the body’s proclivity for a host of diseases, they also contribute to bad breath. Tobacco users also are at an increased risk for the following oral conditions: periodontal disease, a loss of taste abilities and irritated gums.
Furthermore, habitual nocturnal intake of sugary substances such as ice cream, mints, etc without brushing could encourage bacterial growth and subsequently lead to halitosis and tooth decay.
Halitosis may be an indicator or symptom of respiratory infection such as nasal, tracheal or pulmonary infections, chronic bronchitis, empyema, postnasal drip and chronic sinusitis. It may also be suggestive of diabetes mellitus as well as gastrointestinal, liver or kidney disorders. It must however be emphasized that halitosis is not diagnostic of any of the aforementioned medical conditions.
This highly embarrassing oral condition can be prevented by regular brushing of the mouth at least twice daily, non-consumption of tobacco products in any form, and prompt diagnosis and treatment of respiratory and oral diseases. Abstinence from eating of onions and garlic as a preventive measure for halitosis is strongly discouraged as both are of high nutritional value.
Specific treatment for halitosis will be determined by dentists, peridontists or physicians based on the patient’s oral health, cause or origin of the condition, extent of the condition, patient’s tolerance for specific medications, procedures, or therapies as well as his/her opinion or preference. Treatment primarily depends on the cause of the condition.