The assumption that halitosis is primarily a gastrointestinal (stomach) problem is still common among doctors and patients. Foetor ex ore and halitosis are medical terms for bad breath. Both are clinically determined via the presence of volatile sulphur compounds in the breath with a halimeter or with our olfactory organ, the nose.

Problem

Many people permanently suffer from halitosis. Often, the affected person is not aware of it, because for the patient, the smell is always present. And, in case the problem is pointed out, hardly anyone knows what to do about it. In many cases, halitosis occurs only temporarily and a chewing gum or a mouthwash is used as a short-term remedy. Bad breath is often associated with lack of hygiene, which is often not true. Because this is an intimate topic, very few people dare to point out bad breath to others. This is very unfortunate, because once its cause is determined, halitosis can be cured relatively easy in most cases. The risk of halitosis can be reduced to a minimum, i. e. to a short-term matutinal halitosis, by carrying out a good oral hygiene and the procedures listed under "Therapy", provided none of the diseases without oral cause mentioned below are present. The bad breath in the morning disappears after the brushing of the teeth and a small meal. Chewing gum, tooth-paste, and mouthwash containing chlorohexidin, zinc or cetylpyridiniumchloride are prophylactically effective.

Cause

There are different causes.

In 80 % - 90 % of all cases, the aetiology of halitosis can be found in the oral cavity, thus falling into the competence of the dentist or the prophylaxis assistant. The bad smell is caused by bacteria which are degrading substances of the saliva, food residues etc. into gaseous sulphur compounds. That does not necessarily mean, however, that it is caused by a lack of oral hygiene. Food residues can accumulate in recesses such as partly cracked teeth or other hiding places, where they are not accessible for dental hygiene procedures. However, a lack of oral hygiene is increasing the problem, because the retention of food residues is much higher in decayed teeth, gingival pockets, on dental calculus, in defective fillings, under crown edges, and in the interdentia. Only in rare cases, the stomach is the origin of halitosis.

Therapy

The treatment of halitosis consists of eliminating the causes. Usually, this starts with optimizing oral hygiene. Beside the brushing of teeth, this also includes the cleaning of the interdentia by the use of appropriate means. Thorough care is required for the fine gaps along fillings and crowns. There are many different shapes of tongues, some with deep grooves. In those cases, a cleaning of the grooves with a toothbrush or a tongue scraper as well as a rinsing with a suitable solution is necessary. If afterwards can be determined that the halitosis is not caused orally, a clarification with the physician of your choice will be arranged.

Regular control and prophylaxis sessions with a prophylaxis assistant prevent relapse. The prophylaxis assistant will let you know, if you start suffering from halitosis (again). Because a halitosis of the tongue can reinfect the periodontium. Be grateful to your prophylaxis assistant or your friends who brought this problem to your attention. Honesty and discretion are characteristics of a good friendship.