Why does my mouth always smell. Dysbacteriosis of the oral cavity. How to get rid of bad breath in the morning

Bad breath (the medical term is halitosis) is not just a problem that interferes with communication with people, often appear from the inside serious illness that require timely diagnosis and elimination.

Bad breath periodically causes discomfort to all people, but if it is persistent and does not go away even after daily hygiene procedures, it is imperative to identify the causes of bad breath and begin adequate treatment.

How to tell if you have bad breath

Many people do not even suspect that they have bad breath, so they do not look for its cause. It is not worth waiting for someone from your acquaintances to point out this shortcoming. Many relatives are afraid to offend loved one, while colleagues and strangers will simply keep such communication to a minimum. Therefore, it is advisable for everyone to periodically check themselves for bad breath.

There are several ways to help determine bad smell from mouth:

1. With the help of the wrist. You need to lick your wrist, wait a few seconds and smell it. This is the smell from the mouth, or rather, from the tip of the tongue. The front of the tongue smells much better than the back, as it is well cleansed by saliva, which contains various antibacterial components.
2. With the palm of your hand. It is necessary to exhale sharply into the palm of your hand and quickly sniff its contents. Approximately the smell from the oral cavity is felt by others.
3. With a spoon. If you run an inverted spoon over the surface of the tongue, you can collect a certain amount of white plaque, the smell of which can be used to determine whether bad breath is present.
4. Using a jar. It is necessary to exhale sharply into a small clean plastic or glass jar and tightly close the container with a lid. After five minutes, you can open the jar and smell the contents.

Also, the condition of the mucosa may indicate appearance oral cavity. Inspection can be done independently at home in front of a mirror. The back of the tongue should have the same pinkish hue as the rest of the mouth. The presence of a white, brown or creamy coating, the presence of an unpleasant aftertaste in the mouth indicates violations and possible halitosis.

In modern medicine, there are quite effective methods for diagnosing bad breath. One of the most accessible and convenient is the use of a halimeter device. Using a halimeter, you can determine the strength of an unpleasant odor, as well as monitor progress during treatment.

AT laboratory conditions carry out microbiological studies that help to identify the presence of pathogenic bacteria, which are a prerequisite for halitosis.

Doctors divide halitosis into the following types:

• True. Bad breath is felt by others during communication. Likely Causes such a terrible smell is insufficient hygiene, violations metabolic processes in the body, especially the physiology of a particular person. Very often, bad breath is just a symptom of some internal disease.
• pseudohalitosis. It smells bad, but not very strong, and only close people can feel it through direct contact. In such cases, it is often found that the cause of bad breath is poor oral hygiene.
• Halitophobia. A physically healthy person is convinced that he has bad breath, but neither the surrounding people nor the doctor confirm this. it mental disorder only a psychotherapist treats, no other specialists can help.

Bad breath: causes

The main source of bad breath is the vital activity of anaerobic bacteria located there. They give off volatile sulfur compounds, which are smelly gases.

There are a number of factors that contribute to the reproduction of these anaerobic bacteria:

Also, the causes of bad breath can be hidden in lifestyle and nutrition:

1. Poor hygiene. If a perfectly healthy person does not use dental floss and does not remove food debris between the teeth, over time these accumulations will rot and begin to exude bad breath.

   A large number of bacteria accumulate on the back of the tongue, so when brushing your teeth, you should not leave this place unattended - it must be cleaned with a special brush located on the side of the tongue. reverse side toothbrush.

2. Wearing dentures. Food debris can accumulate in dentures. The polymer base of the prosthesis tends to absorb unpleasant odors, so even after the cause of halitosis has been eliminated, you may experience discomfort during communication. When installing a denture, the dentist should give advice regarding permanent care behind them, these recommendations should definitely be followed. After each regular cleaning, to get rid of the terrible aroma, the dentures must be placed in a special antiseptic liquid.
3. Taking certain medications. Very often, antihistamines, diuretics and antidiabetic drugs cause dryness of the mucous membrane and, as a result, bad breath.
4. Eating strong flavored foods. Onions, garlic, too fatty meat food can cause an unpleasant odor, which should pass on its own soon enough.
5. Smoking. If you are a regular smoker and you are wondering what causes bad breath and how to get rid of it, it is worth considering that this feature is often associated with smoking and chewing tobacco. Tobacco products dehydrate mucous membranes and release harmful chemicals that linger in the mouth, causing bad breath. If quitting smoking does not work out, you need to more carefully monitor the cleanliness of the oral cavity.
6. Alcohol intake. Alcohols cause xerostomia ( chronic dryness in the mouth), so the stinking bacteria multiply rapidly and begin to release hydrogen sulfide substances. There is also a stench after drinking various alcoholic beverages and fatty snacks, which enters from the stomach through the esophagus into the oral cavity. Over the years salivary glands begin to function worse, so the smell after the holiday in the mouth of an elderly person is much stronger than that of a student.
7. Overdried mucous membranes. Saliva effectively moisturizes, cleanses, washes away dead cells and plaque. If there is not enough saliva, the cells on the gums, tongue, inner surface cheeks decompose and cause halitosis. Dryness is a consequence of certain pathologies, taking medications or alcoholic beverages. People of some professions, due to the nature of their activities, are more prone to overdrying of the oral mucosa, these are lawyers, teachers, doctors who are forced to talk a lot throughout the day. All diseases that cause nasal congestion (allergies, rhinitis, etc.) lead to drying of the mucous membrane.
8. Stress, nervous tension . The manifestation of a terrible smell will disappear immediately after the normalization of the mental state.
9. Diet, fasting, overeating fatty, hard-to-digest foods. Hunger leads to the fact that with a lack of fats and proteins, the human body begins to utilize endogenous reserves, which leads to bad breath, so you need to eat fully and on time.

Whatever the causes of bad breath, the source is still pathological bacteria. They are always in the mouth and are activated only under certain circumstances.

How to identify a problem in the body by breathing

How to treat a terrible smell

Treatment of bad breath depends on what exactly caused it and at what stage the disease is. Sometimes it is enough to improve the quality of hygiene procedures, but often you have to get rid of diseases of the oral cavity and internal organs.

Neutralize bad taste and stink after eating or on an empty stomach can be as follows:

• drink a cup of strong tea;
• chew a coffee bean;
• eat an apple or carrot;
• chew a parsley leaf, celery root, a slice of lemon.

At home, for fresh breath, you can make your own natural rinses:

How to prevent halitosis

An unpleasant smell is much easier to prevent than to treat it later. Oral hygiene is of great importance. It is very important after each meal to clean the teeth of small particles of food, which can subsequently rot and create favorable conditions for the reproduction of pathogenic organisms.

To prevent such causes of bad breath as tartar and plaque, you must constantly:

• brush your teeth with a medium bristle brush after each meal, that is, several times a day;
• clean the gaps between the teeth with dental floss;
• clean the surface of the tongue with a brush located on the back of the toothbrush, in the direction from root to tip;
• if it is not possible to brush your teeth after eating (at work, at a party), you can rinse your mouth with warm water or chew sugar-free gum;

  Do not abuse chewing gum, as they negatively affect the functioning of the digestive tract.

• stick to right image life, order of nutrition, introduce into your diet enough vegetables and fruits. This contributes to the normalization of salivation;
• visit the dentist in a timely manner for the purpose of preventive examination and for dental treatment.

If proper attention is paid to oral hygiene and diseases of the oral cavity and internal organs are excluded, the unpleasant smell of saliva can be reduced with the help of special liquid cleaners in the form of liquid rinses or sprays.

Purifiers have antibacterial properties, which can reduce the number of anaerobic bacteria that produce volatile sulfur compounds. These compounds contain special substances that neutralize the vile odor that these bacteria have managed to secrete, making breathing cleaner and more pleasant.

Caution should be taken with the so-called antiseptic neutralizers: they contain alcohol, which dries out the mucous membrane, which is why the smell appears.

How to choose oral care products

When buying personal care products, you need to carefully study their composition. Only natural ingredients will help not only mask bad breath with another smell, but directly affect the causes of the problem.

If you choose a toothpaste that contains alcohol, you may not be surprised why your breath smells bad. Alcohol dries the mucosa, thereby promoting the development of anaerobic microorganisms, that is, the very cause of bad breath.

It is good if the care product contains antibacterial components, which, through chemical reactions, reduce the manifestation of halitosis.

Which doctor to go to cure bad breath

When halitosis occurs, you should initially consult a dentist. The doctor will examine the oral cavity for the presence of ulcers and inflammatory processes, professional cleaning from plaque and stone, cure caries, periodontitis and other diseases of the teeth and gums.

If treatment at the dentist does not work, doctors of a different profile should look for the source of the unpleasant odor: an ENT doctor (should exclude rhinitis and sinusitis), a pulmonologist (bronchiectasis), an endocrinologist ( diabetes), gastroenterologist (stomach problems).

Halitosis is a problem that interferes with normal life, it lowers self-esteem, makes a person less sociable, unattractive to others. Therefore, bad breath must be eliminated in time, do not neglect the traditional hygiene procedures, you need to go to the dentist on time and visit other specialized specialists to check your health.

Breath odor is a concept defined as the perception of the breath of another person. This feeling can be both pleasant and attractive, and repulsive and disgusting. The terms “bad breath”, “halitosis” and “bad breath” apply to the second category of odors. However, unpleasant odors do not always come from the oral cavity, so these names cannot be considered full synonyms, and the terminology common name"bad breath" does not cover all causes of the disease. The definition of breath odor should be distinguished from odors derived from the consumption of strong-smelling foods (such as onions or garlic), cigarettes, or medications (corvalol, etc.), as their appearance does not indicate a health problem. A similar characteristic is the "morning" stale breath, which appears at the time when the person woke up. It is caused by a decrease in saliva secretion and the processing of food debris, and after brushing your teeth, the smell disappears without a trace. Only the appearance of a stable “ombre” from the mouth indicates the presence of a deviation.

Epidemiology

In general, bad breath is a common reason for complaints and visits to the doctor in society.
Its presence forms the position of a person in society, but for a long time this position was not considered by scientists or doctors. Halitosis is one of the causes of social discomfort, and is also unacceptable in society. Many people regularly spend large sums of money on chewing gum, refreshing hard candies, aerosols, and other means of eliminating bad breath. However, few people know that it would be more efficient to invest in diagnosing and correcting the causes of heavy aromas.

Bad breath: classification

There are 3 types of halitosis: true, pseudohalitosis and halitophobia. True halitosis is a concept that characterizes the existence of bad breath, which is diagnosed organoleptically or by measuring various compounds. If it is impossible to recognize an unpleasant odor, but the patient is sure of its presence, pseudohalitosis should be diagnosed. If, after treating both of the above varieties of halitosis, the patient is sure of their presence, then halitophobia is diagnosed. It belongs to the category of psychiatric diseases.

Etiology

Usually the root cause of the appearance of an unpleasant odor is the oral cavity. Diseases such as gingivitis, periodontitis, and often the presence of plaque on the tongue are considered the most common sources of stench. According to studies conducted in this area, there are two reasons for the development of pathogenesis. The first is an increase in the number of certain circulatory metabolites that are released when air is exhaled from the lungs through the alveoli. This outcome is usually caused by the presence of a systemic disease in the patient. The second reason is characterized by an increase in the number of substrates of the bacterial load on the area of ​​the respiratory tract, oropharynx or esophagus, that is, the presence of tumors or infectious lesions in these areas causes the appearance of odors. The most common halitosis-causing bacteria are spirochetes and Prevotella intermedia/nigrescens, Aggregatibacter actinomycetem comitans (formerly Actinobacillus actinomycetem comitans), Fusobacterium nucleatum, Peptostreptococcus micros, Campylobacter rectus, Tannerella forsythia, Eubacterium spp, Porphyromonas gingivalis.
There is a certain category of patients who are sure that they have bad breath. For them, there is the concept of imaginary breath syndrome, or halitophobia, which is associated with the presence of hypochondria and obsessive-compulsive disorder in a person.
The appearance of a persistent aroma is usually attributed to the presence in the patient's body of volatile sulfuric substances: hydrogen sulfide (H2S), methyl mercaptan (CH3SH) and dimethyl sulfide [(CH3)2S], which was originally discovered by Professor Joseph Tonzetich.
In private precedents, the catalytic function is performed by diamines (putrescine, cadaverine), indole, skatole, and volatile compounds. organic acids(for example, oil or propionic). Most of these substances appear as a result of the proteolytic degradation of peptides by bacteria contained in the salivary fluid, in the desquamated epithelium, the remains undigested food, gingival-reticular fluid, interdental plaque, nasal drops or blood. Gram-negative anaerobic microorganisms possess such proteolytic energy.
Extraoral causes of halitosis also include substances that are not isolated separately and contain volatile sulfur compounds. Metabolites can appear and be absorbed in any organ (liver, stomach, etc.) and spread with blood streams to the lungs. Exhalation of foul-smelling metabolic end products high concentration and causes halitosis.
The gum fluid, by trapping circulating molecules in the blood, also plays an important but small (due to its volume) role in creating the ground for the development of the disease.
The presence of a characteristic odor accompanies extraoral causes, but they are much more difficult to detect. So, for uncontrolled diabetes mellitus, a sweetish taste of ketones is typical, the smell of sulfur is present in liver pathology, and kidney failure accompanied by a specific aroma of fish due to the content of dimethylamine and trimethylamine.

Proteolytic degradation of four amino acids by bacteria (2 - sulfur-containing, 2 - sulfur-free), which leads to the formation of halitosis

Bad breath: intraoral causes

Language and features of its surface.
The mucous membrane of the back of the tongue (occupying about 25 sq. cm) has a specific irregular landscape of texture.
Rough oval lymphocytes are located on the dorsal area. The frontal area is characterized by greater roughness due to the many papillae located here: filiform (0.5 mm long.), Mushroom-shaped (0.5 to 0.8 mm long.), Leaf-shaped and trough-shaped (2 to 3 mm in diameter.) . A huge number of these recesses are an excellent place for bacterial adhesion and reproduction, sheltered from third-party interference when cleaning the surface. In addition, desquamated cells and food waste accumulate here.
The folded tongue, which has significant ulcers in depth (otherwise - scrotal) or hairy tongue, are characterized by the greatest surface roughness. Accumulating food residues, together with cells and microorganisms separated from the oral cavity, provoke the development of deposits on the back of the tongue. They are difficult to remove due to the peculiarities of the linguistic plane with characteristic irregularities. These two elements are the best way to contribute to the process of decomposition and decay, so most scientists point out the back of the tongue as the main culprit of bad breath. As the practice of treatment shows, the repulsive aroma is directly related to the content of anaerobic bacteria in the salivary fluid and plaque.
Diseases of the periodontal group.
Specialized studies have proven the relationship between the appearance of halitosis and periodontitis. However, in practice, there are patients who are not bothered by bad breath despite gingivitis or periodontitis, and the literature on this issue does not give a clear answer to the relationship between bad breath and periodontal disease. The microbes that cause these diagnoses can indeed release volatile sulfur compounds.
The level of volatile sulfur compounds in breath correlates well with the capacity of periodontal pockets (the relationship between these two factors is direct: the number of anaerobic microbes increases as the pocket deepens), and the quantitative indicator of the presence of sulfur compounds during exhalation progresses with an increase in the number, depth and bleeding of periodontal pockets. In the course of its development, volatile sulfur compounds exacerbate periodontitis, increasing the permeability of the pocket and mucous epithelium, and subject the main periodontal connective tissues to the influence of bacterial metabolites. It should also be noted that methylmercaptan increases the production of interstitial collagenase, the production of interleukin-1 (IL-1) by mononuclear cells and the release of cathepsin B, thereby predetermining tissue destruction. There is sepsis of the fibroblast cytoskeleton, proliferation and migration of cells when using methylmercaptan.
The influence of volatile sulfur compounds, in addition to the above actions, complicates the process of wound healing. For this reason, when planning periodontal surgery, in particular the placement of implants, the likelihood of pathological exposure to sulfur-containing substances should be included in the calculations of doctors.
Plaque as the central circumstance in the development of halitosis is indicated by studies that prove that the correlation between periodontitis and halitosis is much weaker with active layers of plaque on the tongue. The appearance of plaque causes the presence of a large number of bacteria that cause periodontal disease on the back of the tongue, and patients with periodontitis are 6 times more likely to have abundant plaque. This is due to the peculiarity of the course of periodontal disease, characterized by the appearance of plaque, and, as a result, bad breath.
An alternative cause of bad breath is thought to be pericoronitis("hood" of soft tissues, under the surface of which bacteria multiply and plaque accumulates), multiple ulcerations, herpetic and necrotizing gingivitis or periodontitis. Experiments by microbiological scientists show that stronger odors are emitted due to infection with gram-negative anaerobes (eg Prevotella and Porphyromonas species) before non-infected ones.
Dental pathologies.
The etiology of bad breath may lie in the condition of the teeth: extensive carious lesions are possible, filled with rotting food debris, wounds left after removal and filled blood clots or purulent secretions. The accumulation of plaque and the appearance of a specific smell contributes to the crowding of teeth or the presence of a large number of gaps, as well as wearing acrylic dentures. Bacteria also constantly accumulate on the inner surface of the tooth facing the gums due to its porous texture.
Dry mouth.
The disease of xerostomia causes a decrease in the amount of saliva secreted, as a result of the lack of performance of the main salivary function - disinfection - the patient has a large amount of plaque and layers on the tongue. The increased content of microbes in the body and the reaction of the release of sulfur compounds in the form of gases with reduced salivation cause the appearance of an unpleasant odor. Some scientists equate stress to the causes of increased sulfur formation in the surface of the mouth, but this theory is not accepted by all researchers due to the impossibility of finding an exact relationship between stress and a decrease in salivation. Other causes of xerostomia include medication, Sjögren's syndrome (a type of disease), diabetes, and alcoholism.

"Coated tongue

Bad breath: extraoral causes

Extraoral causes can be divided into several groups:
1. Diseases of the ENT organs, which include bacterial and viral infections of the nose, throat, ear
2. Diseases of the respiratory tract (bronchi and lungs)
3. Diseases of the gastrointestinal tract represent the most numerous group, starting from various forms esophagitis, stomach diseases, including peptic ulcer (helicobacter infection)
4. Diseases of the liver of the kidneys are considered as a pathology of the excretory system
5. Pathologies of metabolic processes most often leading to the accumulation of ketone bodies (substances with a characteristic odor) and other compounds.
6. Hormonal shifts (associated with the menstrual cycle)

Physiology of odor detection

Human breath contains up to 150 types of various molecules. The properties of the molecules during exhalation determine the possibility of their perception. Certain gases are characterized by a strong aroma even at low concentrations in the air, while others are distinguishable only in large volumes.
Molecular apperception is caused by several factors:
1) Olfactory reaction. It is, as a rule, completely different, the aroma can be liked, disliked or repulsed. Each molecule has its own threshold concentration that allows it to be detected.
2) The power of smell. This is the amount required to increase the odor per unit concentration.
3) The volatility of the compound. The stench-carrier molecules are palpable only in a volatile state.
4) Essence. The molecule must be stable, only if its nature is preserved, it can be the root cause of the smell.
Hydrogen sulfide and methyl mercaptan have the strongest power. In the case of strengthening the concentrate of these substances from 5 to 10 times, the smell receives an increased organoleptic rating. Other substances, for example, would need a 25-fold, perhaps 100-fold increase to achieve a similar effect. Skatol and methylmercaptan have the lowest detection threshold, their detection possibility exists even at the lowest concentrations. The fastest transition from liquid state in the volatile 3 molecules of sulfur.
In the works of researchers J. Kleinberg and M. Codipilli, there is a mention of an experiment: a small amount of an aqueous solution of an odorous volatile substance was placed on the skin of the back of the hand, and after the smells were given an assessment called organoleptic. All reagents exuded a noticeable, but weakening over time, smell. Some molecules (such as hydrogen sulfide and methyl mercaptan) disappeared almost instantly, while others created a stench for an extended period of time (these include indole and skatole, a ten-minute period).

Odor threshold and odor intensity of basic substances

Assessment of odors on the hand

Diagnosis of halitosis

Story
To correctly diagnose a patient with a disease that causes bad breath, you need to start with a detailed history taking. It is necessary to clarify the presence of pathologies inherent in this manifestation. Careful collection of information will not take much time, but it will save it in the future, when making a diagnosis and prescribing treatment. The interview with the patient should take place in the doctor's office without the presence of unauthorized persons and always before any clinical examination. In this case, the patient will feel more confident. This means that it is more likely to provide a complete description of the disease.
Questions to ask when taking anamnesis:
1) Frequency of bad breath (monthly or daily).
2) Time of manifestation during the day (after eating or waking up).
3) Date of initial manifestation.
4) Is the problem noticeable to others (the question will rule out pseudohalitosis).
5) Whether the patient is taking any medications.
6) The presence of predisposing circumstances: mouth breathing, dry mouth, allergies and diseases of the nasopharynx.
Clinical and laboratory research
Introspection
Involving the patient in monitoring the effectiveness of treatment through self-assessment yields good results, especially when diagnosing an intraoral cause. This can be an additional incentive for more thorough hygiene.
It is possible to use self-diagnosis methods:
The presence of an odor in a silver or plastic spoon after scraping on the back of the tongue.
Smelling after inserting a toothpick into the interdental area.
The appearance of the aroma of saliva in a small spoon (especially after drying).
The exhalation of odor from a licked and dried wrist.
The exclusion of foul-smelling substances from the body allows us to draw the most objective conclusions. It is pointless to draw conclusions from the result of exhalation into the hands, since the smells of skin and cleansers can be knocked down. One should also keep in mind the subjectivity of self-assessment and filter the information received from the patient.
Oropharyngeal examination.
This kind of review consists of complete picture the state of the oral cavity and the search for the root cause of the appearance of the smell. They can be: extensive carious lesion, the presence of food residues in the cavities between the teeth, wounds, bleeding gums, the formation of periodontal pockets, plaque on the tongue, dry mouth. You will also need to examine the tonsils and pharynx to determine tonsillitis and pharyngitis.
Organoleptic evaluation.
This method has long been considered the "gold standard" in diagnosing halitosis. It is easy to use and popular for providing a complete picture of the patient's daily condition. The basis of this technique is the award of an intensity rating to the smell on a scale from 0 to 5. An experienced trained “judge” is invited to participate, whose task is to smell the air exhaled by the patient and evaluate it for the degree of malodor. This method was developed by scientists Rosenberg and McCulloch, who proposed to evaluate breathing in this way: "0" - no smell, "1" - barely perceptible, "2" - weak, but detectable, "3" - moderate, "4" - strong and "5" - offensive.
Portable monitor of volatile sulfur compounds.
This is an electronic mechanism that analyzes the saturation of the air with hydrogen sulfide and methyl mercaptan, without dividing them among themselves.
exhaled by the patient air flow aspirated through a straw attached to the flexible tube of the device. It is held 2 cm beyond the lips, without affecting any surface, while the patient keeps the mouth ajar and breathing is carried out through the nose. The voltometric sensor used in the device gives a certain signal when interacting with sulfur-containing vapors.
Gas chromatography.
The instrument used in gas chromatography is capable of analyzing breath, saliva or gingival fluid. Its most important advantages are considered to be mass spectrometry - this is the ability to highlight the presence of many compounds in air or liquid (up to 100 in gingival fluid and up to 150 in air) and hypersensitivity. The device detects almost any substance under certain conditions.
Dark background microscopy or phase contrast microscopy.
Gingivitis and periodontitis are usually directly correlated with increased microbial and spirochete counts, so proportionate changes help control improvement in treatment. Alternative Advantage of this technique is the patient's awareness of the presence of bacteria in plaque, tongue coating and saliva. However, plaque is often mistaken for food leftovers.
Saliva incubation test.
Analysis of the empty area above incubated saliva using gas chromatography indicates the proximity of volatile sulfur compounds with elements such as indole, skatole, lactic acid, methylamine, diphenylamine, cadaverine, putrescine, urea, ammonia, dodecanol and tetradecanol. By combining with certain proteins, such as lysine or cysteine, cadaverine or hydrogen sulfide is released. Sensory assessment of the void space above the saliva enhances the tracking of ongoing therapy. Because of the minimal contact with the oral cavity, this method is preferred for those suffering from halitosis.
Electronic nose.
Electronic noses highlight some of the components of the aroma and consider its chemical component. The device includes detection programs chemical compounds, microelectronic sensor and odor recognition device. It is relatively inexpensive and compact in size, but its adaptation is possible only for highly specialized studies, when the desired metabolites are identified. The electronic model of the nose is considered to be an idealized and perfected human nose, but at this stage it needs significant improvements.

Different types of tests for halitosis

Analyzer of volatile sulfur compounds. The device displays the total amount of sulfur compounds in parts per billion particles in the air exhaled by the patient

Portable gas chromatograph. Computer displays detected particles for 8 minutes

Equipment for gas chromatography. TD thermal desorber for molecules trapped in collectors; GC-gas chromatograph for separation of substances; MS spectrometer for the determination of substances

Bad breath: treatment

The appointment of therapy for bad breath is inextricably linked with its root cause. It should be taken into account that the appearance of odor is caused by the metabolic degradation of proteins by certain oral microorganisms, therefore, in the treatment should be applied following methods:
actual destruction of intraoral substrates and microorganisms;
destruction of microbes by chemical action;
transformation of fetid odors into non-volatile substances;
masking "ambre".
First of all, when prescribing treatment, it is necessary to reduce the content of micronutrients by mechanical hygiene of the oral cavity, without fail, capturing the cleansing of the tongue. The appointment should include procedures for the treatment and control of the periodontal status of the patient and the use of rinses containing chlorhexidine and other rinses to eliminate odor. If malodor persists during all of these procedures, non-oral sources of disease should be checked, such as lung disease, gastrointestinal infections, and metabolic disorders.
The problem of halitosis emphasizes the need for a doctor to have clear diagnostic skills and emphasizes the importance of knowledge in chemistry. The first feature is that the appearance of bad breath causes great amount both intraoral and extraoral diseases, and information important for treatment can be obtained from a meticulous patient history even before the examination. Second distinguishing feature is to recognize volatile substances and gases, understanding their methods of release and other characteristics. This knowledge helps to use effective methods of treatment. In addition to the above, this knowledge contributes to the development of long-term treatment planning and the prediction of the results of mechanical or chemical interventions to reduce oral microbial load.
Mechanical reduction of intraoral nutrients and microorganisms
Due to the constant accumulation of microorganisms on the back of the tongue, this area should be cleaned especially carefully. As practice shows, regular carrying out of this procedure helps to reduce plaque and reduces the quantitative content of microorganisms, thereby improving breathing. There is also an alternative view that the microbial load is not significantly reduced when mechanical plaque removal is used, and the improvement in odor is associated with a decrease in nutrients.
For the procedure of cleansing the tongue, it is possible to use both a regular toothbrush and a special scraper against plaque.
According to studies, with regular performance of this procedure, bad breath improves by about 75% in a week. In order to prevent violation of the integrity of soft tissues, a gentle but deep cleaning should be carried out. it is on the back of the tongue that the maximum accumulation of plaque occurs. Cleansing must be done before complete removal raid. During the procedure, a gag reflex may occur, but with frequent repetition it disappears, and during processing it is possible to use a gauze swab to pull out the tongue. A pleasant addition to fresh breath will be an improvement in taste perception.
Cleaning teeth and gaps between them essential methods mechanical control of the build-up of plaque on the teeth. They clean the mouth of food residues and microorganisms that cause decay and the corresponding aroma. At the same time, according to clinical observations, toothbrushing alone does not reduce volatile sulfur compound levels. Comprehensive measures, cleaning both teeth and tongue, show results 2.5 times better than one, and bad breath disappears for up to 1 hour.
Practical application of the theory
The multiplication of bacteria in the oral cavity is the most common cause of the development of halitosis. Most of the molecules emitting an embarrassing aroma are due to the anaerobic metabolic reaction of proteins with a further massive release of volatile sulfur compounds, including hydrogen sulfide. Microorganisms living in the biofilm adhering to the teeth, as well as bacterial plaque on the plane of the tongue, play a key role in sulfur formation. This is especially true for patients with subgingival deposits.
It is possible to control the bulk of the unpleasant odor using the methodology of periodontal treatment: plaque removal, pocket depth reduction, as well as regular additional cleaning of the oral cavity and tongue. Complete disposal and control of the appearance of unpleasant odors is facilitated by rinsing the mouth with chlorhexidine-containing solutions.
Despite the emergence of fairly accurate electronic appliances, recognizing sulfur compounds, as well as the widespread use of gas chromatography, which determines the exact proportions in 150 compounds, the classic doctor's sense of smell and assigning a result to smell from 0 to 5 is one of the most effective methods estimates. Separately, it should be noted that the patient's words on this issue should not be based on the subjectivity of the assessment. If a periodontal cause of the appearance of pungent odors is identified, it will be necessary to prescribe a therapy characteristic of such diseases, including: one-stage cleaning containing scaling and curettage of the roots using chlorhexidine. These procedures can reduce the level of malodorous substances by up to 90%. Treatment should also include oral hygiene, but with this problem, only hygiene measures will not give the desired result.
Chewing gum helps mask bad breath for a while, stimulating work salivary glands. Saliva itself has disinfectant properties, so patients with reduced salivary function are characterized by increased sulphurization and profuse tongue coating, compared with patients with normal secretion saliva.
According to Whaler's research, regular chewing of chewing gum that does not contain active ingredients helps to reduce halitosis, but to a limited extent.
Periodically, to check the area of ​​origin of the odor or the effectiveness of the rinse used, the doctor prescribes a product containing bacteria nutrient, which enhances the emitted unpleasant odor. So, when rinsing with a liquid containing amino acid compounds, the release of hydrogen sulfide sharply increases.
Reducing the number of microorganisms by chemical means
Active rinsing of the mouth in the treatment of halitosis is a fairly common practice. Most often, antimicrobial substances become reagents in rinses: chlorhexidine, cetylpyridinium chloride, essential oil, chlorine dioxide, hydrogen peroxide and triclosan. At the same time, it should be remembered that their action is limited in time, and the absence of an integrated approach to treatment will not help to achieve the desired result.
Chlorhexidine.
This reagent is used as the most effective antibacterial agent to combat plaque. The active substance in its composition penetrates the membranes of bacterial cells, increases its permeability, after which lysis and cell death occur.
Regular rinsing of the mouth with chlorhexidine causes a dramatic decrease in the content of sulfur-containing substances in the breath and the organoleptic rating. But with the effectiveness in the fight against bacteria, one should also take into account side effects, namely: discoloration of tooth enamel and tongue, rancid taste in the mouth and short-term weakening of the sensitivity of taste buds.
Essential oils.
With regular rinsing with Listerine, which contains essential oils, scientists have recorded a 3-hour effect on reducing unpleasant odors. At the same time, when considering the quantitative reduction of bacterial plaque, the drug steadily reduces the level of microorganisms by 25% at frequent use within four days.
chlorine dioxide.
Chlorine dioxide (ClO2) is a powerful oxidizing agent that eliminates odors by an oxidative reaction of hydrosulfide, methyl mercaptan and the amino acids methionine and cysteine. With a one-time rinsing with a liquid containing this substance, a gradual decrease in the concentration of oral bacteria occurs.
Rinsing with water and oils in two stages
Rinsing the mouth with water containing oils with cetylpyridinium chloride is the development of the scientist Rosenberg. He proved that the effect this tool consists in the adhesion of oral bacteria to oil drops, and cetylpyridinium chloride becomes the catalyst for the reaction. The effect of the application is observed when rinsing twice a day, in the morning and in the evening, and in terms of indicators it exceeds the effectiveness of Listerine.
Triclosan.
This active substance is generally recognized against most types of oral bacteria and is highly compatible with other elements contained in oral hygiene products. Experiments show that rinsing with a liquid containing 0.15% triclosan and 0.84% ​​zinc gives a more significant reduction in odor than rinsing with listerine. However, the effect produced on hydrogen sulfide largely depends on the accompanying reagents.
Aminofluoride or stannous fluoride.
The combination of amine fluoride with stannous fluoride (AmF/SnF2) provokes odor reduction even with infrequent cleaning.
Hydrogen peroxide.
The use of 3% hydrogen peroxide as an active ingredient in the rinse leads to a sharp reduction (up to 90%) in the breath of volatile sulfur compounds, and the result lasts for 8 hours.
Oxidizing lozenges.
Lollipops, which contain an oxidizing agent, have a weaker effect. Their duration is approximately 3 hours. Such an effect is caused by dehydroascorbic acid, which is formed during the peroxide oxidation of ascorbate, which is contained in lollipops.
Modification of volatile sulfur compounds
Soluble metal salts.
Metal ions show their effectiveness in mastering sulfur-containing gases. Zinc is an ion with two positive charges (Zn++) that binds to doubly negatively charged sulfur radicals, resulting in reduced emissions of volatile sulfur compounds. Similar action is characterized by mercury and copper. Clinically, volatile sulfur compounds inhibit CuCl2; SnF2; ZnCl2.
Experimentally inhibited HgCl2=CuCl2=CdCl2; ZnCl2>SnF2; SnCl2; PbCl2.
Zinc, when compared to other metals, is not highly toxic and does not accumulate to discolor tooth enamel. In practice, the zinc chloride contained in the rinse shows high performance in therapeutic process, the level of sulfur compounds is reduced by 80%, and organoleptic indicators are reduced by 40% in 3 hours.
Rinses containing 0.05% chlorhexidine, 0.05% CPC and 0.14% zinc lactate are more effective in practice than 0.2% chlorhexidine solution in terms of lowering the level of volatile sulfur compounds and organoleptic indicators. An outstanding result is achieved as a result of the conversion of volatile sulfur compounds with zinc, and is "polished" by antibacterial action. The combination of Zn++ and chlorhexidine works great when used together.
Toothpaste.
Practical experiments have proven an improvement in breath freshness for up to 3 hours when using a product that has soda in its composition. Its bactericidal action causes the inhibition of bad breath and converts volatile sulfur compounds into a non-volatile state.
Pastes containing zinc citrate and triclosan, when applied to the back of the tongue, reduced bad breath for up to 4 hours. But it was noticed that when the oils were removed, the activity of the ingredients decreased. When using pastes with triclosan for 7 days, the sulfur level decreased by 41%.
Chewing gum.
When preparing chewing gum, fluorine or chlorhexidine is added to the product, which improves breath freshness. Additives of tea extract have deodorizing properties. At the same time, epigallocatechin is considered to be the main deodorizing agent in relation to tea catechins. When epigallocatechin and CH3SH react, a non-volatile substance is formed.
When chewing for 5 minutes of chewing gum containing 2 mg. acetate Zn ++, a decrease in volatile sulfur compounds was observed by 45%, but the effect was short-lived.
Odor concealers
The line of camouflage products that freshen breath for a short time is very extensive. These include lozenges, sprays, rinses, and chewing gum. Their working effect is based on increased secretion of saliva, which subsequently dissolves volatile sulfur compounds. A similar effect is achieved with plentiful drink or chewing-induced periodonto-parotid reflex, that is, stimulation of the salivary glands during chewing.
Conclusion
Bad breath carries an important social burden and indicates the presence of a disease. A correct diagnosis and preventive oral hygiene contribute to the maximum therapeutic effect. Despite the prevalence of plaque on the tongue, periodontitis and gingivitis, the possibility of serious diseases should not be ruled out. Identification of the true causes of halitosis should occur with the participation of doctors of related specializations and in combination with trial therapy: strengthening oral hygiene, introducing mouth rinses, tongue scrapers and other tools to cleanse the breath.

Bad breath is a fairly common problem faced by up to 85% of the population.

But it is worth considering that in about 30% of cases, the pathology manifests itself regularly and indicates the presence of a chronic disease in a person.

Strong breath is most often caused by digestive problems.

To be more precise, in people who have come to the hospital with the phenomenon in question, doctors diagnose problems in the work of the stomach, liver, intestines or oral cavity.

Halitosis, as it is customary to call an unpleasant odor, may be the result of the accumulation in a person in the oral cavity of peculiar harmful bacteria.

Their accumulation, as a rule, is observed on the tongue, between the teeth and around the jaw.

The pathology under consideration is not considered incurable. modern medicine works wonders, so the most important thing is to timely identify the true cause of the appearance of halitosis.

How to independently feel fresh breath or not

As already mentioned, halitosis has various reasons occurrence and does not always indicate a problem with the health of the oral cavity. The reason may lie in elemental microorganisms.

But due to the fact that there is a risk of developing diseases of the internal organs, you should not ignore the regularly appearing bad breath.

Before you panic, you should determine exactly how stale the air exhaled by a person is.

To do this without outside help is quite difficult, because the internal organs have such a structure that a person is not able to simultaneously exhale air through the mouth and inhale it through the nose.

What to do if there is no desire to disturb others with your requests?

There are several effective ways determine the freshness of breath on their own. They are:

1. A person should pick up a spoon and touch it a couple of times with the smooth surface of his tongue. You need to try to move the spoon to the very base of the tongue, because it is there that the smell from the mouth “hides”. The aroma will be indicated by plaque and the smell of saliva.
2. A person can lean his tongue against his wrist and sniff the remaining trace. When the saliva is completely dry, the smell that people around hear will remain on the hand.

It is worth considering that the result obtained is somewhat weaker than the real aroma, because the true smell is concentrated in the depths of the mouth.

Based on the foregoing, it will be easier and faster to simply ask a relative or close friend what smell comes from the breath.

AT last resort, you can get an opinion from a dentist at a scheduled examination.

Symptoms of pathology

If the smell from the mouth could not be caught, then its presence can be judged by the accompanying symptoms that cannot go unnoticed.

These include the following signs:

1. The presence of white plaque in the oral cavity.
2. Dry tongue with yellow coating.
3. Burning sensation in the mouth.
4. Small balls on or near the tonsils.
5. Unpleasant taste in the mouth when rinsing teeth, drinking coffee or tea.
6. A metallic, bitter, or sour taste in the mouth that occurs daily.
7. Unusual behavior of the interlocutor who turns away or moves away during a conversation.

All these symptoms should not be ignored, because they can indicate dental problems. Or, even more unpleasant, on diseases of the internal organs.

Causes of odor in the mouth

Everyone should know that most often bad breath is observed as a result of formation in the oral cavity. white matter located on the back of the tongue.

If we talk about the factors that contribute to the appearance or enhancement of aroma, then there are several of them:

1. The presence of bacteria in the mouth.
2. Favorable conditions for the spread of such harmful microorganisms.
3. Irregular brushing of teeth, tongue and entire oral cavity - places where bacteria accumulate.

Doctors identify several main reasons that provoke the occurrence of bad breath in a person. It is worth looking into them in more detail.

Non-physiological causes

Food

A large amount of food that a person regularly consumes is considered the culprit of the pathology in question. For example, garlic and onions.

In the process of digestion of food, the molecules that make up its composition must be absorbed by the human body and excreted from it with the bloodstream.

The fact is that many molecules have an unpleasant odor that penetrates through the blood into the lungs of a person. And they leave the respiratory organs during exhalation, provoking strong smell from mouth.

The bad smell that is caused by eating should go away on its own after a few days, when the body gets rid of bad-smelling microorganisms.

It is easy to deal with such a problem - you just need to remove such food from your daily diet.

Tobacco smoking

All people, from time to time, communicate with people who smoke, from which it smells specifically.

A similar phenomenon is observed in connection with pernicious influence on the body of a smoker of nicotine, tar and other harmful substances that are part of cigarette smoke.

Such substances settle on the teeth, oral mucosa and soft tissues: gums, cheeks, tongue. To prevent bad breath smoking person, it is recommended to forget about cigarettes and brush your teeth more often.

Presence of dentures

Dentures can be complete, partial or removable. They are united by the fact that all of them can significantly affect the smell of the mouth.

People who wear dentures can do an experiment to see if their dentures affect their breathing. To do this, a person must remove false teeth, put them in a closed container and leave for a few minutes.

After that, the container should be quickly opened and smelled. A similar smell is heard by the surrounding people from the breath of the owner of prostheses.

It is worth considering the fact that bacteria that settle on the teeth and tongue can also settle on the surface of a removable denture. Which, in turn, also provokes bad breath.

The doctor who installed removable teeth is obliged to tell his patient about the rules for caring for them. Do not think that dentures do not need to be cleaned - this is a mistake.

To prevent bacteria buildup, dentures should be cleaned in the same way as natural teeth, with a toothbrush. After such actions, the prosthesis is placed in a container with an antiseptic, which is recommended by the attending physician.

Diet and fasting

They are very popular among women various diets aimed at weight loss. But it is worth remembering that it is impossible to exclude any products from the diet until the dietitian allows it.

Problems like this can be easily fixed. Enough to give up bad habits and from malnutrition, observe personal hygiene and visit the dentist periodically.

But the pathology under consideration is not always so simple and not dangerous.

Physiological causes

Increased dryness in the mouth

People who don't think they don't have bad breath can't deny that even they don't have fresh breath in the morning.

This phenomenon can be explained by nighttime drying of the oral mucosa. Xerostomia occurs due to the fact that the sleeping body practically does not produce saliva.

The same problem can occur in teachers or lawyers who talk for a long time, so their mouth area is also prone to drying out.

But there are also people who suffer from chronic type xerostomia. In this case, the problem is much more difficult to solve, because the lack of saliva provokes bad breath.

Saliva cleans the mouth of bacteria. When a person swallows saliva, millions of harmful microorganisms and the food that these organisms feed on leave his mouth.

A chronic type of xerostomia may occur after treatment with certain medications.

For example, anti-allergic drugs, antidepressants, tablets that support normal arterial pressure, diuretics, or strong painkillers.

The older a person is, the drier the mucous membrane of his mouth becomes. This is due to the fact that the salivary glands are already working without the previous intensity, and the constituent parts of saliva change significantly.

Periodontal disease

Gum problems are the most commonly cited causes of bad breath. Any dentist can safely say that the aroma from the mouth, which is affected by gum disease, is always very specific.

But it is he who gives experienced doctor the ability to diagnose periodontal disease even without a primary examination of the person who applied to him.

People over 35 are prone to gum disease. To be more precise, than more man years, the more prone to problems with fresh breath.

Periodontium, which is a bacterial type pathology affecting soft tissues and adjacent teeth, should not be started.

An untimely diagnosed problem causes damage to the bone in which the person's teeth are located.

If the patient notices that a crack has formed between his gums and teeth, then he should immediately seek the help of a specialist, because such a gap indicates a rapid progression of the periodontium.

If you do not get rid of the gap, then bacteria that cause halitosis will constantly accumulate in it.

Pathologies of the respiratory organs

Very often, bad breath is associated with diseases of the upper respiratory tract or allergic reactions.

Such pathologies provoke the flow of mucous secretions from the nose to the mouth, through a hole in the soft palate. The accumulation of just such mucus leads to halitosis.

People who have been diagnosed with sinus disease often experience nasal congestion. This phenomenon causes them to breathe through their mouths, which contributes to the drying of the mucous membranes. And what it threatens is described above.

Problems from the field of dentistry

As already mentioned, strong breath is often associated with pathologies in the oral cavity. Such infectious processes how an abscess of a tooth or an elementary growth of a wisdom tooth can cause halitosis.

Untreated caries provokes the appearance of harmful bacteria on the teeth. Therefore, visits to the dentist should not be ignored.

Bowel disease

The human gastrointestinal tract contains a large number of putrefactive bacteria, which release sulfur compounds during the digestion of food. Therefore, problems with the intestines are often the causes of halitosis.

If there are no pathologies in the intestines, then beneficial bacteria work so that the resulting gases are odorless.

When a person is diagnosed with dysbacteriosis, improper digestion is observed, during which fetid fermentation appears.

Intestinal pathologies weaken the sphincters, so gases enter the mouth. In order to prevent this phenomenon, you should get rid of dysbacteriosis, because brushing your teeth alone in this case is not enough.

Diabetes

bile duct dysfunction, hormonal disbalance, sinusitis and polyps in the nose - all these diseases can cause halitosis. Modern diagnostics will be able to identify the source of the pathology and help to deal with it effectively.

Other neglected diseases

If a person's actions aimed at combating bad breath have not led to the desired result, then you should make an appointment with a therapist.

A doctor may suspect a number of such pathologies: diseases of the liver, kidneys, or respiratory system.

stressful situations

Depressive states also provoke the problem under consideration. As soon as the emotional background returns to normal, the pathological phenomenon disappears on its own.

Whatever the reason that provoked bad breath, the phenomenon cannot be started. For an accurate diagnosis, you need additional diagnostics and physical examination.

How is pathology diagnosed?

The process of making a diagnosis should be taken very seriously. The patient is obliged to tell the doctor about any chronic diseases he has.

It has been proven that bad breath is often provoked by food and hygiene factors. That is why a person is forbidden to eat, drink, rinse his mouth and smoke two hours before the examination.

Modern medicine has the following methods of diagnostic examination of the patient:

1. The hedonic method should be carried out by a specialist who is able to study the nature and severity of halitosis, and then evaluate it on a special scale. In this case, the subjectivity of the doctor can be called a disadvantage of the method.
2. The use of a device that makes it possible to measure how many sulfur compounds are in the air exhaled by the patient. AT this case it is necessary to measure the amount of hydrogen sulfide, methyl mercaptan and dimethyl sulfide.
3. Various microbiological studies.

The treatment scheme and, accordingly, its result depend on the accuracy of the diagnosis.

Ways to get rid of bad odor

Due to the fact that bad breath is caused by bacteria, one of the most effective ways to get rid of this symptom is to proper cleaning oral cavity.

Such actions should be taken in order not to feed the bacteria, reduce their number in the mouth, destroy the habitat of bacteria and prevent their reproduction.

It is necessary to clean not only the teeth, but also the gums, because they also accumulate a specific plaque that contributes to the appearance of halitosis.

Regular visits to the dentist

If a person is worried about a strong aroma from the oral cavity, and it is not possible to cope with it on their own, then it is better to consult a specialist.

There are many additional reasons for this. They are:

1. Not everyone knows how to use dental floss. The dentist will tell you how to do it right.
2. Tooth brushing can be hindered by tartar that has grown on them. The doctor will quickly and painlessly remove it.
3. In the event that a person has signs of periodontal disease, then only a specialist is able to prescribe adequate treatment.
4. The dentist will tell you what to do if he does not reveal pathologies in his profile.

Currently, there are a large number of dental clinics, so finding the right doctor will not be difficult.

Proper tongue cleaning

It just so happens that many people never brush their tongues. This is a big mistake, because it is on it that the main amount of harmful bacteria is concentrated.

It often happens that after several procedures, a person notices that the aroma from the mouth does not appear.

The back of the tongue smells stronger than the front. This is because the tip of the tongue regularly cleans itself by rubbing against the hard palate, and there are few harmful microorganisms on it.

The foundation of language touches soft palate so cleaning is not as effective.

There are several effective methods for cleansing the base of the tongue. They are:

1. Have to take toothbrush and as far as possible to carry it through the language. After that, you should begin to gently move towards its tip.
   It is not recommended to press hard on the tongue in order to prevent irritation.
2. It is better to use a paste, which includes substances that protect the mouth from harmful bacteria. It is these components that destroy the fetid odor.
3. The use of a spoon that scrapes plaque on the tongue. To many people, this method seems to be the most effective, because it is not as unpleasant as using special brushes for language. A spoon can be purchased at any pharmacy.
4. Special rinses that are recommended to be used after each brushing of teeth. But it should be noted that rinses alone will not eliminate the problem.
5. Chewing gum and candy has a temporary effect. Sprays for the treatment of the oral cavity are also ineffective.

The ideal option is a combination of all the above methods of brushing your teeth and tongue. But if they do not lead to the desired result, then the matter is most likely in diseases of the internal organs.

How to treat bad breath

Initially, you should contact a dentist who will confirm or exclude the presence of caries or periodontal disease in the patient, disinfect the mouth, and remove plaque.

If the specialist does not find a person dental problems, then send it to the local doctor. The therapist will examine the patient, examine his complaints and prescribe a complete examination of the body, aimed at identifying the causes of an unpleasant odor from the oral cavity.

Due to the fact that halitosis can become a sign of a single ailment, you should make an appointment not only with a therapist, but also with an ENT, who will check a person for polyps and sinusitis.

In addition, it is obligatory to consult other specialists (endocrinologist, urologist, gastroenterologist) who will confirm or refute diseases of the kidneys, liver, pancreas (in particular diabetes mellitus) or the gastrointestinal tract.

The treatment regimen depends on why the aroma formed. Therapy involves the use of various medications.

This includes antibiotics, which should not be drunk until the type of bacteria is identified.

Ways to get rid of bad breath at home

There are several actions that a person who is faced with the problem in question and seeking to get rid of halitosis can do at home. They are:

1. Regular fluid intake. If the body does not have enough fluid, then this is manifested by a decrease in saliva secretion: dry tongue, thirst. And if there is less saliva, then it will not be able to wash off all the bacteria from the oral cavity and eliminate the aroma.
   It is especially important to drink plenty of water for those people who are diagnosed with xerostomia.
2. Rinse your mouth with water. Such a solution for a short period of time will protect a person from smell.
3. Stimulation of salivation. This can be done by chewing food, chewing gum, cloves, mint or parsley.
4. Thorough oral hygiene. This is especially true when a person consumes large quantities food rich in protein. Bacteria lead to the appearance of sulfur compounds after such a breakfast. It must be remembered that meat or fish can provoke halitosis, which causes significant discomfort to a person.
5. Getting rid of worms. Oddly enough, but it is the worms that can lead to halitosis, especially in children.

Parents, instead of panicking at the appearance of a smell from the child's mouth, should give him a drug that will help remove helminths from the child's body.

The most important thing is to detect the problem in time and seek help from qualified specialist(infectionist).

Only after complete examination the patient's body, the doctor will be able to make a final diagnosis and prescribe treatment, if necessary.

Various terms. Dentistry, ozostomy, halitosis, fetor oris are all names for the same phenomenon, which turns into a real problem. And if we are talking about an important meeting, then the situation can become generally catastrophic.

Many are trying to find ways to cope with this scourge. However, chewing gum and spray do not always look appropriate and decent, and besides, they do not solve the problem. To combat the smell, you need to find out the cause.

The reasons

In the first place in the list of reasons - insufficient hydration of the mouth. If you are not drinking enough fluids, then your body cannot produce usual amount saliva. Because of this, the cells of the tongue die, which become food for bacteria. The result is a disgusting smell.

In general, halitosis can be caused by any processes of decay that occur in the mouth.

So, if pieces of food are stuck between your teeth, they will become a delicacy for bacteria, which will be no less delighted that you have not given enough time to hygiene.

It is well known that it is also on the list of the main causes of bad breath, as well as eating garlic and onions. But the diet can also be the cause of such a stench. For example, following strict diets that border on starvation can cause your body to start consuming the fat it has stored up for such a case. This process produces ketones, the presence of which will not be pleasant to smell. Many diseases, and of various types, can cause halitosis. For example, damage to the lungs, liver, kidneys and diabetes. The latter is indicated by the smell of acetone.

By the way, by the smell you can determine what diseases are. So, if your breath smells like rotten eggs, this is the smell of hydrogen sulfide, indicating rotting proteins. If abdominal pain, belching and nausea appear along with it, this may indicate an ulcer or gastritis. A metallic smell indicates periodontal disease, in which the gums can bleed. The smell of iodine indicates that it has become too much in the body and you should immediately consult an endocrinologist.

In the presence of putrid smell should think about possible diseases stomach with low acidity. In the case of dysbacteriosis, intestinal dyskinesia and its obstruction, there will be a smell of feces. A bitter smell hints at trouble with the kidneys. Sour indicates gastritis hyperacidity or an ulcer.

Caries, tartar, periodontitis, gingivitis, pulpitis lead to an unpleasant odor. Even dentures can affect the freshness of breath, because without proper care they become a breeding ground for bacteria that produce waste products - sulfur compounds. Hence the nasty smell.

Bacteria are also very comfortable on the tongue, in the areas between the teeth and along the gum line. In the presence of diseases, cavities may occur when the gums pass into the teeth, the so-called periodontal pockets, where they live and breed with pleasure anaerobic bacteria. Only a dentist can clean them.

Diseases of the nasopharyngeal mucosa are also a common cause of odor, as well as all diseases associated with the ENT organs, as a result of which pus is formed. With such diseases, a person is often forced to breathe through the mouth, which leads to increased dryness in it.

Often bad breath occurs in the morning. The reason is simple: less saliva is produced during sleep, resulting in dry mouth. The less saliva, the more bacteria in the mouth, the more unpleasant the smell. In some people, this phenomenon, which is called xerostomia, becomes chronic.

How to know about smell

There are many ways to find out that bad breath is coming from your mouth. The worst option would be a message about it from another person. However, there are ways to determine this yourself, but not everything is so simple. After all, a person usually does not perceive his own smell. The problem lies in the structure human body. When a person does not want to feel something unpleasant in the air around him, he, as a rule, begins to breathe through his mouth, which makes it impossible to smell from it. However, there are proven options.

Covering your mouth with your palms and breathing into them will not help: you will not smell any. Better look in the mirror at your tongue. He shouldn't have white coating. You can lick your own wrist and sniff it. Run the spoon over your tongue so that saliva remains on it, wait for it to dry, and see if the smell remains.

Solutions

Remember that there is no way to completely and permanently eliminate bad breath. You will have to constantly monitor yourself and take appropriate measures.

• Consume.
• Buy a tongue scraper. Considering that it is the tongue that is the habitat of a huge number of bacteria and this is the most common cause of a bad smell, it is recommended to use a scraper regularly.
• Use dental floss. A considerable amount of bacteria collects between the teeth, on stuck pieces of food.
• Eat proper food. Apples, berries, cinnamon, oranges, green tea, and celery are at the top of the list of foods to help eliminate bad breath. Bacteria are very fond of protein and it is after eating it that they emit a particularly unpleasant odor. Therefore, vegetarians have almost no problems with bad breath.
• Use mouthwash. Rinse your mouth every day for 30 seconds, after which you should not smoke or eat for half an hour.
• There is nothing more pointless than chewing gum when you have bad breath. If there is a need to chew something, then you can choose dill, cardamom, parsley, cinnamon stick or anise for this. This is an essential aid for the production of saliva.
• Use herbal infusions. Since ancient times, people have been using natural remedies in order not to exude an unpleasant odor. So, in Iraq, cloves were used for this purpose, in the East - anise seeds, in Brazil - cinnamon. If we talk about our country, then this is St. John's wort, wormwood, dill, chamomile.
• To minimise fetid odor, you can drink a cup, rinse your mouth with water, and the taste in your mouth will decrease if you chew a coffee bean.
• Have breakfast with oatmeal porridge, which promotes salivation, because saliva is natural remedy mouth cleaning and disinfection.
• If you don't have a toothbrush handy, at least rub your teeth and gums with your finger. At the same time, you will not only reduce the unpleasant odor, but also massage the gums.
• Rub your gums with a walnut. From this, your breath will acquire a nutty flavor, and the oral cavity will receive the vitamins contained in the nut.

Prevention

At least twice a year you need to visit a dentist for prevention and diagnosis. As in the case of other diseases, diseases of the teeth and oral cavity are best prevented or treated at an early stage, when they are almost invisible and an experienced eye of a specialist is required to recognize them and take timely action.

But the most important thing is to carefully monitor the oral cavity. Dentists say that by the way a person looks after his teeth and mouth, we can talk about how attentive he is to his own health.

Almost everyone has experienced halitosis - bad breath. Bad breath can cause discomfort when communicating with the opposite sex or colleagues. Moreover, chronic halitosis indicates the presence of problems in the body and sometimes very serious ones. Despite these reasons, many do not consider the presence of bad breath, which, by the way, they may simply not notice, as a serious reason for contacting a specialist.

What is the reason?

No one is immune from bad breath. For example, in the morning, stale breath is characteristic even healthy person and is considered the norm. And explained morning halitosis, incidentally, ordinary physiology. At night, salivation is minimal, and bacteria accumulate in the oral cavity, whose vital activity is the cause of the smell. The easiest way to eliminate this cause is to go to the bathroom and brush your teeth.

Another cause of bad breath is also not directly related to human health - it's food. It's no secret that after eating garlic or onions, the eater does not leave a repulsive aroma for a long time. Moreover, neither chewing gum nor a toothbrush will help eliminate it.

Why is this happening? A number of products, such as the aforementioned onions and garlic, contain sulfur components, which, when ingested, are absorbed into the blood and are carried throughout the body.

During the day, breath odor can also increase, which is associated with drying of the oral mucosa. Saliva is a natural humectant and mouth cleanser, and a lack of it can cause discomfort. However, it can be eliminated by drinking plain water more often. It will freshen your breath and remove the unpleasant aftertaste.

Things are different if you are accompanied by chronic halitosis. In this case, it will no longer be possible to cope with the problem with one toothbrush. A timely appeal to a specialized specialist, such as a gastroenterologist or an otorhinolaryngologist, will help to establish the real causes of the problem and eliminate them. Bad breath can be caused by diseases of the gastrointestinal tract: chronic inflammation of the stomach or inflammatory bowel disease, cholelithiasis. Inflammation of the tonsils, pharyngitis, adenoiditis or sinusitis, even the common cold, can also lead to halitosis.

But more often than not, the cause of bad breath is much more prosaic. Insufficient hygiene oral cavity, according to dentists, this is the first and most common cause of halitosis. Unfortunately, despite the high development of civilization and medical technology, people forget to brush their teeth regularly or brush their teeth for 30-40 seconds instead of the prescribed 3 minutes, do not use such devices as a tongue scraper and dental floss. As a result, a huge amount of bacteria can accumulate in the oral cavity, especially on the tongue (many people never clean it), which emit a bad smell with impurities, most often hydrogen sulfide.

Failure to follow the basic rules of oral hygiene often leads to caries or inflammatory diseases such as stomatitis, gingivitis, periodontitis. These ailments can also be accompanied by an unpleasant odor.

Get rid of the smell really

Given that in most cases, bad oral hygiene is caused by poor oral hygiene, you need to take better care of your teeth and gums and start using dental floss and a tongue scraper regularly. Unfortunately, it is almost impossible to clean all plaque and stone with a toothbrush on your own: for this, it is better to contact a specialist.

In general, one of the main rules healthy teeth and gums is a regular visit to the dentist, which is neglected by many. The doctor may early stages put correct diagnosis and prevent the development of inflammatory diseases, common feature which is bad breath.

If the dentist nevertheless revealed the presence of inflammatory processes in the oral cavity and prescribed treatment with potent chemical preparation, then in the complex it is desirable to use a rinse aid. Can be useful drugs with such natural ingredients like oak bark, chamomile flowers, sage leaves, arnica herbs, herbs peppermint. Together they have a wide range and have an antiseptic and anti-inflammatory effect. When a course of chemical treatment prescribed by your dentist (in combination with which you use natural remedy for rinsing) is completed, it is recommended not to stop rinsing immediately in order to consolidate the result.

In any case, whatever real reason the appearance of bad breath, you need to be attentive to your health, contact specialists in a timely manner, including for a preventive examination, and carefully follow the basic rules of oral hygiene.