Halitosis
kouchu
Breath refers to the odor emitted from the mouth or other air filled cavities, such as nose, sinuses and pharynx. It seriously affects people's social interaction and mental health. Who has reported halitosis as a disease. The survey shows that the prevalence of halitosis in China is 27.5%. In western countries, it is 50%. About 10% to 65% of the world's people have had halitosis.
Cause of disease
Local oral diseases are the main cause of halitosis, but it can not be ignored that halitosis is often the oral manifestation of some serious systemic diseases, and some organic diseases can also lead to halitosis.
pathologic halitosis
① Oral halitosis
According to statistics, 80% - 90% of halitosis comes from oral cavity. Bad breath can be caused by untreated dental caries, residual root, residual crown, bad prosthesis, abnormal anatomical structure, gingivitis, periodontitis and oral mucosal disease. Among them, caries and periodontal disease are the most common related diseases. Food residue and plaque often remain in deep caries cavity and under the overhang of bad prosthesis. Bacteria decompose through fermentation and produce odor. Pulp necrosis or suppurative pulpitis, without treatment can also send out odor; Periodontal disease patients are often accompanied by a large number of dental calculus and plaque. Bacteria in periodontal bags ferment to produce hydrogen sulfide, indole and ammonia, thus producing odor. In addition, periodontal abscess and periodontal bag overflow pus, mostly Staphylococcus aureus combined with periodontal pathogens infection, will also send out odor. The quality and quantity of saliva also play an important role. The decrease of saliva volume and the increase of protein and other organic components reduce the flushing and buffering effect of saliva, which makes bacteria multiply in large numbers, decompose the organic components in saliva, gingival crevicular fluid and food residue, and produce a large number of volatile sulfide, indole and other substances, causing halitosis. Causes of halitosis
② Non oral halitosis
Oral adjacent tissue diseases such as suppurative tonsillitis, chronic maxillary sinusitis, atrophic rhinitis, etc., can produce purulent secretions and odor; Clinical common internal diseases such as acute and chronic gastritis, peptic ulcer acid odor; Halitosis caused by rotten duck eggs is common in pyloric obstruction and advanced gastric cancer; Patients with diabetic ketoacidosis can exhale acetone odor, and uremic patients exhale the smell of rotten apples. In addition, leukemia, vitamin deficiency, heavy metal poisoning and other diseases can cause bad breath.
Physiological halitosis
Short term halitosis may be caused by starvation, consumption of certain drugs or irritant food such as onion and garlic, smoking, and bacteria decomposing food residues caused by reduced saliva secretion during sleep. Bad oral habits and oral hygiene may cause the increase and thickening of plaque on the back of tongue in healthy people. Due to the large surface area of the back of the tongue, there are many nipples, fissures and depressions, which are conducive to the retention of bacteria, exfoliated epithelium of oral mucosa, food residues, etc., serving as a "bacterial storage room", which is conducive to the generation of halitosis. Studies have shown that the degree of halitosis and the amount of volatile sulfide are positively correlated with the thickness and area of tongue coating, especially with the thickness of tongue coating. After removing the tongue coating, the volatile sulfide decreases. This may be because the thicker the tongue coating, the easier it is to form an anaerobic environment, the more conducive it is to the growth of anaerobic bacteria, and thus the more conducive it is to the production of volatile sulfide, resulting in halitosis.
In addition, there is also false halitosis, that is, the patient feels that he has bad breath, but the test result is negative. Can be improved by explanation and psychological counseling.
Looking for the cause
Bad breath is not terrible, as long as you find out the cause is treatable. First of all, we should consider whether halitosis is a source of stomachs or non stomachs. Factors related to halitosis can not be excluded, such as respiratory diseases (nasal cavity, maxillary sinus, pharynx, lung infection and necrosis), digestive system diseases (gastritis, gastric ulcer, duodenal ulcer, gastrointestinal metabolic disturbance, constipation, etc.), parenchymal organ damage (liver failure, renal failure) and diabetic ketosis. Uremia, leukemia, vitamin deficiency and so on, should be the first of these diseases for local or systemic treatment.
If there are oral diseases that may cause halitosis, such as untreated caries, residual roots, residual crowns, bad restorations, gingivitis, periodontitis and oral mucosal diseases, medical treatment should be carried out in time to remove useless residual roots and crowns, remove bad restorations, remove incorrect anatomical structures and treat oral mucosal diseases, For periodontal disease patients, scaling and root curettage and other basic treatment were carried out first, and then periodontal treatment and plaque control were carried out systematically.
Strengthen oral hygiene
Choose the right brushing method, brush at least twice a day, and form the habit of gargling after eating. It's also very important to clean your tongue. Since 80% to 90% of halitosis comes from the back of the tongue, dentists should teach patients to use tongue curette correctly to clean the surface of the tongue. We can also find out the main pathogenic bacteria of patients through in vitro test, and select mouthwash which can effectively inhibit the growth of microorganisms on the tongue surface for local antibacterial. Nowadays, the commonly used mouthwash includes chlorhexidine, hydrogen peroxide, sodium salt, zinc salt, etc. a good mouthwash should be able to maintain the ecological balance of normal oral flora and prevent new diseases caused by flora imbalance. To stimulate the secretion of saliva or to use substitutes, saliva has the functions of antibacterial, bactericidal and oral cleaning. In the treatment, we should also consider increasing the amount and flow rate of saliva, enhancing the movement of tongue, chewing food rich in fiber or chewing gum, etc., which are conducive to reducing halitosis.
