The other day, we had a chat with you about “How to politely tell someone you have bad breath“.
Many friends left us messages and asked a lot of other questions about bad breath, such as—
The bad breath hurts my feelings, and I’m also drunk.
There are many other problems, it seems that everyone is really suffering from bad breath!
In fact, at least 1 in 5 people has bad breath[1], and probably you are (most people with bad breath don’t know they have it).
Today, we have selected some of the frequent halitosis problems you are most concerned about and will solve them together!
Mainly the mouth! Stomach is very aggrieved!
80% to 90% of the causes of bad breath are from the oral cavity itself (oral halitosis) [2], such as periodontitis, dental caries (tooth decay), oral ulcers, stumps Remnant crown, etc.
Diseases in the nasal cavity, throat, stomach, etc., such as rhinitis, bronchitis, gastroesophageal reflux disease, etc., may also have symptoms of bad breath[3]. Such non-oral halitosis accounts for 4% to 10% [4].
The odor of bad breath, mainly sulfides, can be volatile. These substances are produced by specific oral bacteria breaking down proteins.
Oral halitosis is most closely related to 2 of these bacteria, Bacillus melanogenum and Fusobacter nucleatum[ 5].
Substances such as food residues, renewing and shedding epithelial cells, periodontal bleeding and other substances in the mouth are the “food materials” that feed these bacteria.
And improper oral hygiene, decomposition of food scraps, etc., are common causes of bad breath.
Especially disease periodontal tissue and thick tongue coating can affect the balance of oral flora and lead to bad breath.
Image source: Zhanku Hailuo
Yes!
Normally, close contact between adjacent teeth, and good tooth shape, prevents food from jamming. However, if there are problems such as tooth decay, dislocation, excessive loosening, etc., the gap between the teeth may become larger, and clogging is inevitable[6].
If you’re too lazy to clean up, the accumulated food scraps can become a “big meal” for bacteria. After the protein in the food is decomposed, it will produce sulfide, which is the main component of “fart”…
Be sure to floss your mouth after meals, it is better to brush your teeth if you can!
This is it.
Smoking itself is the cause of gingivitis and periodontitis[7].
The tar and nicotine in tobacco can cause chronic pharyngitis and bronchitis[8].
Smoking also results in decreased saliva production, dry mouth, and reduced self-cleaning ability of the mouth [9].
These factors can lead to bad breath.
It is recommended to quit smoking!
This is it.
The main component of meat is protein. The Dietary Guidelines for Chinese Residents recommends that 80-150 grams of meat per day is enough [10]. If it exceeds 80-150 grams, eating too much meat will increase the workload of the intestinal tract, and it will not be able to digest that much at once, and the intestinal bacteria will help to decompose the excess protein, resulting in smelly sulfide >.
These odor soldiers divide into two ways, one way is to rush downstream and turn into farts; the other way is to exhale from the mouth, causing bad breath.
No.
Coke contains sugar, and coffee may contain milk, all of which bacteria love to eat. Different bacteria form a “bacterial community” known as plaque. Everyone has a happy dinner together, and of course excretes…
Coffee and cola can also temporarily reduce saliva production, resulting in dry mouth and a sticky feel in the mouth. At this time, the self-cleaning ability of the oral cavity is reduced, which is more conducive to the colonization of bacteria, followed by reproduction and fermentation (decomposing protein), causing bad breath [11].
It is recommended to rinse your mouth with water after drinking coffee and cola.
But better than nothing!
There are many reasons for bad breath, which cannot be completely eliminated by simply brushing your teeth. Use a floss or irrigator after meals to remove food debris that brushing can’t remove.
If it still smells and is very troublesome, you can go to the dentist to check for dental caries (tooth decay), gingivitis, periodontitis and other oral diseases. If so, dental caries repair, scaling, scaling, root planing and other treatments can be performed to remove plaque.
If oral problems have been ruled out, but bad breath still persists, go to an ENT department to check for sinusitis, pharyngitis and other diseases; or go to a gastroenterology department to check for gastrointestinal diseases [8] , 12].
It’s all about treating the symptoms, not the symptoms.
Chewing gum only temporarily masks bad breath. The vast majority of bad breath comes from oral diseases, and bad breath cannot be tolerated.Still going to the dentist!
Not sure!
There is currently not enough evidence that Helicobacter pylori (HP) causes bad breath.
Some researchers have performed eradication therapy on people with halitosis and Helicobacter pylori, but the results are inconsistent.
Some studies have found significant improvement in halitosis after HP eradication, while others have found no improvement in halitosis even after eradication [13,14].
Mainly lazy!
Halitosis in children is mainly due to poor oral hygiene, plaque deposition, or pubertal gingivitis caused by hormonal changes during puberty.
Hormonal changes can make the gums sensitive, and local irritants such as plaque can easily induce inflammation. Children often bleed when brushing their teeth or biting on hard objects, along with bad breath.
Image source: Zhanku Hailuo
Treatment is mainly to remove local irritants[15]. That is, removing plaque and calculus through scaling, combined with local medicine on the gums, gargle, etc., can generally be cured.
Parents should also supervise their children to develop a good habit of brushing regularly to prevent recurrence.
Fake!
There is indeed some literature mentioning that vitamin B6 deficiency can cause severe gingivitis and bad breath [16].
Image source: Zhanku Hailuo
However, the vast majority of bad breath is caused by poor oral hygiene and plaque deposition. Vitamin supplementation alone cannot effectively alleviate it. It should be based on the advice of a dentist. systemic therapy [13].
Buy, buy, buy!
Try special products that clean your tongue (like tongue scrapers), or some electric toothbrushes with a tongue-cleaning feature.
Image source: Zhanku Hailuo
Retching while brushing can also be a symptom of chronic pharyngitis, bile reflux gastritis, gastroesophageal reflux, etc.
Have normal sex life and appearWomen with delayed menstruation may also have a pregnancy reaction after pregnancy [17].
In these cases, choose a small head toothbrush and try to avoid brushing too close to the throat when brushing.
To the hospital!
Bite breath caused by periodontitis is mainly caused by calculus, residue on soft scale, bacteria, and inflammatory substances that form.
Scaling, scaling, root planing and other periodontal treatments can completely remove foreign bodies in the oral cavity and control inflammation. Combined with strengthening oral hygiene, it can effectively Treatment of bad breath [17,18].
Image source: Zhanku Hailuo
It’s possible!
The first thing to do is to rule out oral diseases. If there is no abnormality in oral health, it cannot be ruled out that it is caused by tonsil stones.
In the tonsils, there are tonsillar crypts of varying shades, which are easy to hide sloughed epithelial cells, white blood cells, as well as food debris and bacteria.
Tonsil stones can interfere with the passage of these items from the crypts.
If the stone is relatively small and does not cause obvious discomfort to the body, generally no special treatment is required.
If there is an obvious foreign body sensation and repeated infection of the tonsils, it will produce odor and cause bad breath.
Pay attention to oral hygiene, and some bad breath can be alleviated.
If bad breath is very obvious and seriously affects work and life, tonsillectomy is necessary. After surgery, the bad breath caused by tonsil stones was resolved [18].
Help you focus
1. Poor oral hygiene and certain diseases of the oral cavity and digestive tract are the main causes of bad breath. Chronic pharyngitis, tonsil stones, etc. may cause bad breath.
2. There is not much scientific basis for the relationship between Helicobacter pylori and bad breath.
3. Bad breath, gum recession and bleeding are all symptoms of periodontitis. Periodontal treatments such as scaling, scaling, and root planing can be resolved.
4. Children with bad breath should focus on developing the good habit of brushing their teeth regularly.
5. Simply supplementing with vitamin B cannot cure bad breath.
6. Brushing your tongue while brushing your teeth can reduce bad breath.
Do you have any other questions about bad breath?
Tell us in the comments
Please also share this article with those in need
Let’s breathe fresh every day~
Contributing Author: Wang Fengze
Doctor of Dentistry, University of Basel, Switzerland
Reviewer: Xiaomin Yin
Deputy Chief Physician, Department of Oral Medicine, Xiangya Hospital, Central South University
References
[1] Meng Huanxin. Periodontology [M]. People’s Health Publishing House, 2012. 12: 202-205.
[2]Scully C, Greenman J. Halitosis (breath odor). Periodontal 2000, 2008, 48: 66
[3]Wang Songling, Cheng Bin. Stomatology (3rd Edition) [M]. Peking University Medical Press, 2013.
[6]S-H Oh, M Nakano, E Bando, et al; Relationship between occlusal tooth contact patterns and tightness of proximal tooth contact. Journal of oral rehabilitation 2006;33(10):749 -53.
[7]”Satoshi Shizukuishi; [Smoking and periodontal disease]. Clinical calcium 2007;17(2):226-32.
[8]“Arif anl , Eda Bekmez, Gazi Y ld z, et al; Relationship between smoking and otorhinolaryngological symptoms. Journal of ear, nose, and throat 2016;26(1): 28-33.
[9]I D Macgregor; Smoking, saliva and salivation. Journal of dentistry 1988;16(1):14-7.
[10] “Dietary Guidelines for Chinese Residents (2016)”.
[11]Y Gov, N Sterer, M Rosenberg; In vitro effect of coffee on oral malodor-related parameters. Journal of breath research 2010;4(2):026004.
[12] Karin Kislig, Clive H Wilder-Smith, Michael M Bornstein, et al. Halitosis and tongue coating in patients with erosive gastroesophageal disease versus nonerosive gastroesophageal reflux disease. Clinical oral investigations 2013 ;17(1):159-65.
[13]Aydin M, Harvey-Woodworth CN. Halitosis: a new definition and classification. Br Dent J. 2014 Jul 11;217(1):E1.
[14]Tangerman A, Winkel EG, de Laat L, van Oijen AH, de Boer WA. Halitosis and Helicobacter pylori infection. J Breath Res. 2012 Mar;6(1):017102 .
[15] Yan Fenghua, Liu Jian, Hu Yongqing, et al. Investigation on the relationship between oral hygiene habits and bad breath [J]. Chinese Journal of Practical Nursing, 2011, 27(007):1- 3.
[16]Ana Gutierrez Gossweiler, E. Angeles Martinez-Mier. Chapter 6: Vitamins and Oral Health[M]https:// The Impact of Nutrition and Diet on Oral Health. 2020.
[17] Tang Jinqiang, Xiao Xinyun, Zhao Xianping, et al. Study on oral microflora in patients with halitosis [J]. Chinese Journal of Microecology, 2015, 27(001):46-48.
[18] Zhang Yanlin, Shi Ling P, Li Yuanmei. Correlation between halitosis and gastrointestinal diseases and oral diseases[J]. Journal of Clinical Stomatology, 2011(09):533- 535.
Editors: Zhang Jie, Zhang Li | Typesetting: Han Ningning
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