In this modern civilised world, everyone gives importance to cleanliness, perfection and fragrance in everything. Bad or offensive breath i.e., Halitosis – in medical terminology – hinders this trend. Halitosis is a social and cosmetic related sensitive problem which makes persons avoid close
relationship and gatherings. It is often noted when others turn when we speak or when they complain, and not by self-identification, since we get used to persistent odours.
Usually, smell can reflect the quality of the substance. You can notice the fragrance of flowers, smell ripe fruits, but they later turn to putrid smell when they decompose. These are all due to bacterial or fungal or yeast action on the flowers and fruits.
Likewise, everyone has his/her own individual odour due to their normal secretions. People are smellier mostly due to abnormal secretions or ulcer or necrosis or decompositions or decayed foods in the holes of the teeth, infection in sinuses or tonsils, etc. Usually, moist places act as bacterial or fungal or yeast harbours. So the mouth ranks first due to its moisture. For halitosis, people initially feel shy to consult a dentist and later go on consulting a dentist, an ENT surgeon, lung specialist, gastroenterologist, skin specialist and so on to rule out or get rid of the complaint.
Pathology – Usually, our body secretions give protection by forming a slimy covering. It protects us from acidic things, bacterial invasion, abrasions, etc. Saliva is also one of the protective secretions, which is absolutely necessary to neutralise the food, to clean the mouth and to remove particles that may cause odour. The odour occurs due to the action of bacteria and chemical changes that take place in our body due to composition differences or decompositions. Normally, the odours differ in intensity according to the site and type of infection and substances which get putrefied.
The anaerobic bacteria digest the food particles, producing sulphur compounds which give the offensiveness. Sulphur compounds are nutrients which help our body metabolism. These are present in all fruits, vegetables, etc. Cabbage has its peculiar odour from its presence of sulphur compounds. Usually these offensive sulphur compounds get absorbed during digestion and enter the bloodstream. Blood, while getting oxygenation in the lung, expels or spreads this smell during exhalation. Likewise, blood spreads the same through sweat and urine.
Causes – This may be due to a generalised reason or due to a local pathology. Most of the time, offensive breath originates from the mouth, due to the action of anaerobic bacteria. But it may also be from sinuses, nose, lungs, stomach, liver and blood circulation.
Generalised causes are
Physiological or normal
- Starvation – due to mobilisation and metabolism of proteins, on exhaustion of glucose
- Strenuous exercises – ketone breath due to protein metabolism (after protein rich diet) likewise, exertional dysnoea induced by stress may also cause dry mouth and bad breath
- Less intake of water – causes mouth dryness and makes breath offensive
- Aromatic foods or spicy foods
- Pathological or abnormal
- Diabetic coma – acetone breath due to keto-acidosis
- Renal failure – ureamic breath due to acidosis
- Liver failure or in severe jaundice – fetor hepaticus
- Medicines that cause dryness of mouth and thus lead to bad breath (antihistamines and decongestants)
Habits of smoking, chewing tobacco, drinking alcohol can affect teeth, gums, throat, oesophagus and cause offensive breath
Local pathology is mainly due to bacteria or virus or fungus i.e. from mouth or nose or lungs or any other local manifestation.
Dryness of the mouth is one of the major causes for the offensive odour, since during drying, the bacteria get concentrated and there will be lack of oxygen and decomposition of particles. Decreased secretion or decreased flow or stagnation of saliva will also result in odour due to concentrated bacteria and its increased activity. Physiologically, halitosis is often found in the morning, after sleeping, long speech, vigorous exercises and starvation. Pathologically, it is often found in the case of nasal obstruction due to polyps or infection or foreign body or salivary gland problems. It can also occur in breath due to diabetes, hypertension, liver failure and renal failure. The causes are
- Dental – decays, plaques, erosions, pockets or holes where foods can get lodged
- Gums – inflamed swollen gums, bleeding gums, abscesses, unfit dentures, sticking of foods, ulcers due to dentures, poor hygienic measures in cleaning, etc.
- Tongue – due to coating or mapping or ulcers, stomatitis and lack of cleanliness
- Tonsils – infection of tonsil or peritonsillar abscess (Quinsy)
Nose – Sinusitis or post-nasal drip or allergy, stagnation and thick mucous, nose block
Stomach – usually protein rich food contains enormous sulphur compounds and causes halitosis for ex – garlic, onion, grains, milk, cheese, ice creams, etc. Indigestion also accounts for bad breath which is mostly due to belching and not because of breath or will not persist for a prolonged time. Smells are mostly due to formation of hydrogen sulfide and methyl mercaptans which give odour of rotten eggs and faeces respectively.
Lungs – pneumonia or any deep-seated infection can cause fetid breath for ex-pneumonia, chronic bronchitis, carcinomas, etc. Metabolic dysfunctions can also result in bad breath.
Hormone changes can also cause offensive breath.
- It can reflect in social behaviours, love and sex.
- Repeated sinus and nasal infections with halitosis can reflect in anosmia (loss of smell of sense or differentiation)
Caution – Everyone should be more careful when there is systemic suffering like diabetes, liver disorders, kidney ailments or metabolic disorders, since increased offensive breath indicates severity of the condition.
- Proper cleaning or brushing of the teeth in the morning and at bedtime
- Clear saliva and nasal secretion often and avoid accumulations
- Hawk to clear the throat often, if there is throat infection or secretions
- Dental check-ups for filling pockets or erosions if any, or to rule out any other dental or gum problem
- Clean the tongue properly with tongue scraper if there is coating
- Drink plenty of water or drinks to maintain good body hydration. Also take plenty of water after every meal to wash away the presence of food particles in the mouth or throat or oesophagus
- Clean dentures (if any) properly with antiseptic solutions
- Stimulants such as alcohol, cigarettes and chewing tobacco
- Dairy products
- Onions and garlic
Sweets or chocolates Diagnosis of the complaint should be done in different ways to attain complete analysis for getting complete cure. The tests often required may be
- Endoscopy for the sinuses
- CT scan to rule out nasal obstruction, lung disorders, etc.
- Blood investigations to rule out diabetes, infection, allergies, metabolic disorders
- Urine investigations to rule out diabetes, ketone bodies and metabolic disorders
Treatment – For temporary relief, anyone can use
- Cleanser, paste, mouthwash, mouth freshener or deodorant, gargles, tongue cleaner or wiper, etc.
- Chewing gum which influences secretion of saliva
- Cloves, cardamom, camphor, nutmeg, green pudhina leaves or guava leaves or betel leaves for masking the foul odour
Sometimes even doctors do give the same advice, but mouthwashes and deodorants are generally cosmetic and do not have a long-lasting effect on bad breath. Antibacterial and antiseptic preparations act for some more time than maskers like deodorants or chewing gums. Antibiotic treatment also will work for the time being only.
Homeopathic approach to halitosis
Everyone can notice that use of mouth freshener works only for the time being. Removing the actual cause or disease can only help in the long run. Treatment will be successful only when we find and remove the actual cause and treat the condition i.e. treat infection, sinusitis, lung infection, post-nasal drip, chronic bronchitis, etc.
Regarding treatment of halitosis in Homeopathy, there are different types of odours which mimic fermented beer, brandy, cabbage, cheese, chicken dung, putrid, fish brine, garlic, sulphur, tobaccos, cadaver, earth, rotten eggs, sour taste, sole leather, garlic, metallic, musty, onions, etc., i.e., odour differs from person to person depending upon the bacteria. Likewise, prescription also differs in Homeopathy from person to person. So, each patient is treated separately i.e., individually.
Homeopathic medicines can act as mouth wash, can remove the disease completely, and can act neurologically and stimulate the body for quality normal secretions. Treatment should be given for
the complaints like recurrent cold, sinusitis, dental problems, gingivitis, stomatitis, indigestion, etc. Evidence shows that the messenger for wellness – Homeopathy – has gained in importance in the tide of health fortunes and has made the world turn towards it with its fragrance of cure.
Homeopathic medicines commonly used in the case of offensive breath are – Asafoetida, Baptisia, Baryta mur, Benzoic acid, Bromium, Calc carb, carbolic acid, Carbo animalis, Carbo veg, Crot – hor, Graphites, Hepa sulf, Kali sulp, Merc sol, Nat sulp, Nit acid, Opium, Plantago, Psorinum, Pulsatilla, Rhus tox, Sepia, Silicea, Staphysagria, Sulphur, Tarentula, Tellurium, Thuja, Tuberculinum, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
Dr. S. Chidambaranathan, BHMS, MD (Homeo) 24 E. New Mahalipatti Road Tel: +91-452-233-8833 | +91-984-319-1011 (Mob) E-mail: firstname.lastname@example.org
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(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)