Opinion

Bad breath, an embarrassing ignored health condition

By Malek Arol Dhieu

Bath breath, which is also medically called halitosis, is a medical condition that lowers self-esteem and affects every day\s life and personal relationships. This condition affects approximately 30% of people around the world. It is associated with a foul oral odor that originates, according to Academy of General Dentistry, in the mouth, throat and tonsils. The bad breath odor is usually caused by a group of anaerobic sulfur-producing bacteria that breed beneath the surface of the tongue and often in the throat and tonsil area. These bacteria occur naturally in your oral environment and are supposed to be there because they assist your digestion by breaking down proteins in to amino acids. Proteins are commonly found in food, mucus or phlegm, blood and in diseased oral tissues. As the bad breath bacteria feast on proteins in your mouth, sulfur compounds are released from the back of your tongue and throat and these bacteria excrete waste as hydrogen sulfide, methyl mercaptan and other odorous and bad tasting compounds known as volatile sulfur compounds. As long as this process of anaerobic bacteria feeding on proteins and excreting volatile sulfur compounds continues unchecked, your breath will become worse and worse. People with chronic recurring bad breath often lose their self-confidence. However, it can be difficult to know if you have bad breath. Family members and colleagues may not tell you. The most common signs and symptoms of bad breath include post-nasal drip, a bitter metallic taste, a white coating on the tongue and thick saliva. Most symptoms of bad breath depend on the underlying causes of bad breath. Many people who suffer from bad breath because of dry mouth can experience difficulty speaking, swallowing (dysphagia), a burning sensation in the mouth or dry eyes. Fever, sore throat, persistent cough and swollen lymph nodes in the neck indicate respiratory tract infections which can also mean bad breath. One of the best ways to find out if you have bad breath is to lick the inside of your wrist, wait for five seconds and then take a whiff. There’re many causes of bad breath but there’re four causes of bad breath that are very common. Dry mouth – a dry mouth provides a perfect environment for anaerobic bacteria reproduction. Long periods of speaking, smoking, drinking alcohol and snoring are a few common reasons why people experience dry mouth. Most people experience bad breath in the morning due to lack of saliva production while they sleep. For healthy individuals, food odors are temporary and normal salivary flow will eliminate it within several minutes, however, those who suffer from dry mouth and lack of saliva find that even minor odors may end becoming long term bad breath problems. Foods- bad breath can be made worse by certain foods such as onions and garlic because they contain smelly sulfur compounds. Dairy, meat and fish contain dense proteins which are used as a food source by the anaerobic sulfur-producing bacteria that cause bad breath. Refined and processed sugars also provide a food source for bacteria. Coffee and juices can contribute to bad breath because they are acidic and provide the bacteria with an ideal breeding environment. Poor dental hygiene- inadequate oral care leads to bacterial buildup on the teeth and gums. This leads to gum diseases like gingivitis and periodontitis, which can cause halitosis because the proteins from bleeding gums and diseased oral tissue provide fuel to odor-causing bacteria. Illness and diseases- individuals suffering from diabetes, lung disease, kidney disease cancer, liver disease, respiratory tract infections or metabolic disorders often experience chronic bad breath due to dry mouth. Sinusitis, pneumonia, bronchitis, post-nasal drip and polyps affect airways and may cause halitosis. Other illnesses including nasal odor, putrefaction from the tonsils, tooth decay, yeast infections of the mouth and gum disease can cause halitosis. Certain drugs such as antidepressants, high blood pressure medications and antihistamines can cause halitosis because they reduce saliva production. Halitosis is diagnosed by performing a rapid strep test or throat swab culture. Both tests involve gently swabbing the back of the throat close to the tonsils with a cotton swab. A lab test can detect a bacterial infection. A viral infection will not show on the test but may be assumed if the test for bacteria is negative. In some cases, the physical findings are convincing enough to diagnose a probable bacterial infection. Treatment will consist of antibiotics to cure the infection if tests reveal bacteria. Antibiotics may be given as a single shot or taken 10 days by mouth. Although symptoms will likely improve within two or three days after starting the antibiotics, it’s important to take all of the medications your doctor prescribes to make sure the bacteria are gone. Some need to take a second course of antibiotics to cure the infection.

The author is a medical student, University of Juba. He can be reached at malengaroldit@gmail.com or +211922332811.     

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