Halitosis: Causes, Types, and How to Prevent Bad Breath

Halitosis

Answer. Volatile sulphur compounds are the main cause of breadth malodor. These consist of hydrogen sulphide, methyl mercaptan and dimethyl sulphide. Various other compounds which are implicated in etiology are putrescine, indole, skatole, butyric acid and propionic acid.

Unpleasant breadth is due to intraoral or extraoral causes which are as follows:

Intraoral Causes

Causes for Physiologic Halitosis

• Mouth breathing
• Medications
• Aging and poor dental hygiene
• Fasting/Starvation
• Tobacco
• Foods and alcohol

Causes for Pathologic Halitosis

• Periodontal infection:
  • Actinobacillus actinomycetemcomitans, P. gingivalis, C. rectus and T. forsythia leads to pathogenesis of periodontitis and production of volatile sulphur compounds. Odor from subgingival dental biofim.
  • As there is increase in the depth of periodontal pocket, the concentration of malodourous chemical increases. Deep pockets also lead to the formation of putrescine and cadavarine.
• Tongue-coating harbors microorganisms
  • Dorsum of the tongue is the primary etiologic factor for halitosis.
  • Since the dorsum of tongue is irregular, it accommodates microorganisms and the food debris.
  • Both desquamated cells and the food remnants entrap over the surface and get decomposed which leads to halitosis.
• Stomatitis, xerostomia.
  • Dry mouth causes volatile sulphur compounds to escape.
  • Number of microorganisms which produce volatile sulphur compounds increase in the saliva.
• Faulty restorations retaining food and bacteria.
• Unclean dentures.
• Oral pathologic lesions: Such as oral cancer, candidiasis, infected extraction wounds, dental abscess and purulent discharge leads to malodor.
• Parotitis, clef palate
• Crowding of teeth: They leads to accumulation of food debris which produces halitosis.

Physiologic Halitosis Extraoral Causes

• Nasal infections: Rhinitis, sinusitis, post nasal drip, tumors and foreign bodies. Crypts of tonsils also lead to accumulation of microorganisms and putrefaction which produces malodor.
• Diseases of gastrointestinal tract: Zenker’s diverticulum, hiatus hernia, carcinomas, GERD and intestinal gas production.
• Pulmonary infections: Chronic bronchitis, pneumonia, tuberculosis and carcinomas.
• Hormonal changes: Hormonal changes occur during ovulation, menstruation, pregnancy and menopause.
• Systemic diseases: Various systemic diseases which contribute to halitosis are liver and kidney insufficiency, diabetes mellitus, renal failure, blood dyscrasias, rheumatologic diseases, dehydration, fever and liver cirrhosis.