Pathological bad breath (Halitosis) is quite common today, including in civilized societies, and it is a cause of social embarrassment. The social problems it causes have taken precedence over biological issues. In fact, if bad breath did not create a social problem, it might not even be considered a disease, and efforts would not be made for its treatment.
WHAT ARE THE CAUSES OF BAD BREATH?
Bad breath can originate from both pathological and non-pathological factors, caused by volatile molecules from oral and non-oral sources. Despite the multifactorial nature of bad breath, in 90% of patients, the source of bad breath is the oral cavity, while 9% is attributed to non-oral causes such as the respiratory system, gastrointestinal system, or urinary system. In 1% of patients, the cause of bad breath is related to diets or medications.
Especially in periods when saliva flow is reduced, the underlying cause of bad breath is often certain bacteria found between the papillae on the back surface of the tongue. These are primarily anaerobic Gram-negative bacteria (which do not require oxygen) and all bacteria release volatile sulfur compounds (VSC). The three main chemical gaseous components are Hydrogen sulfide, Methyl mercaptan, and Dimethyl sulfide.
IMPORTANCE OF BAD BREATH ANALYSIS
When examining bad breath, the most decisive response we seek from our patients is their assessment of their own bad breath. During the initial visit of patients complaining of bad odors, we conduct a comprehensive anamnesis followed by collecting breath samples using special apparatus. We analyze these samples using Gas Chromatography (Oral Chroma) to measure the levels of Hydrogen Sulfide, Methyl Mercaptan, and Dimethyl Sulfide. The analysis of these three main volatile compounds greatly illuminates our understanding of the bad odor and allows us to manage treatment effectively.
Specifically, Hydrogen Sulfide and Methyl Mercaptan are the main contributors to bad odors from the mouth and upper respiratory tract, while Dimethyl Sulfide alerts us to changes in blood biochemistry or infections in the lower respiratory tract.
ORAL CAUSES OF BAD BREATH
Some of the oral causes of bad breath (Halitosis) include Periodontitis, Gingivitis, Aphthous lesions, Dental abscesses, Traumatic ulcers, Herpetic infections (viral), Fungal infections, Oral cancers, Xerostomia (dry mouth), poor oral hygiene, and consequently the coating of the dorsal surface of the tongue with plaque.
Dr. Dt. Filiz KOLBAKIR
