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Bad Breath Related to Stomach Problems

Posted: December 5th, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

Bad breath caused by stomach problems is not common with the general population, but there have been documented causes when this breath condition comes from the stomach. There are several factors involved in nasty breath caused by stomach problems. Knowing what these factors are can help you identify the underlying issue and what steps you need to take to get rid of bad breath from stomach problems.

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The stomach is where all food ends up to be processed into nutrients that the body can use. Along with food, the stomach also contains bacteria that assist in breaking down the food. However, not all bacteria can be classified as “good”. It’s the bad bacteria that can be harmful and produce bad breath from stomach problems.

Some sources of bad breath from stomach bacteria include:

  1. Helicobacter Pylori are bacteria that cause the common stomach ulcer. This produces the stench, especially when you belch.
  2. Skipping a meal can cause the stomach to send the acids normally used for digestion to the throat, which causes foul breath.
  3. Imbalance of bacteria can also cause bad breath from stomach problems. As mentioned earlier, your stomach has a balance of good and bad bacteria. If more bad bacteria is produced or stays in the stomach, this can be a cause of not so nice breath. An easy way to cure this is to take a daily probiotic supplement either in tablet form or through ingestion of yogurt. This is rich in good bacteria to help restore balance in your stomach.

Other causes of bad breath from stomach problems can originate from your digestive system. It can be caused by the following instances:

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  1. Eating hard to digest food. Food that remain largely undigested go straight to the liver and putrefy there, causing the foul breath due to stomach problems. Sometimes, it also causes an overproduction of stomach acids, which emanate and cause bad breath.
  2. Heartburn is normally due to acid in the stomach flowing up into the throat. This is similar to acid reflux and can be triggered by caffeinated soft drinks or coffee. Foul breath from stomach acid is distinctive.
  3. Nausea can be caused by bad bacteria in the stomach. It is a sign that your stomach may not like something you’ve recently eaten.A foul breath normally accompanies the nausea and may be a signal that you are about to regurgitate your stomach contents.

These are some common causes of bad breath from stomach acids or bacteria. The best way to avoid these is to watch what you eat to make sure your stomach stays healthy.

Article Source: http://www.articlesbase.com/dental-care-articles/bad-breath-related-to-stomach-problems-2349776.html

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Gillian is a bad breath expert and co-creator of the new web-site: http://bad-breath-begone.com

Get lots more info there on Bad Breath and Stomach Problems and also check out her Free 10-part Mini-eCourse, “Naturally Remove the Bad Breath Blues”, it might be all you’ll ever need (and did I mention it was free!!)

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Keeping Bad Breath Away , Cures for Bad Breath

Posted: November 29th, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

Bad breath or Halitosis refers to a noticeable unpleasant odor exhaled while breathing. Such a condition may have a major impact, both personally as well as socially on people who tend to suffer from this condition, or believe that they do. It is believed to be one of the most frequent reasons for seeking dental treatment, apart from tooth decay as well as periodontal disease.

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In most of the cases, bad breath tends to originate in the mouth itself. Also, bad breath intensity differs during various times of the day, mainly because of eating particular foods like garlic, meat, onions, fish, as well as cheese. Apart from that, obesity, smokings, as well as alcohol consumption are other factors related to this condition. As the mouth gets exposed to lesser quantity of oxygen and is primarily inactive during nights, bad breath is generally worse on awakening. It may also be transient, quite often disappearing after brushing, rinsing, or flossing.

As far as bad breath cure is concerned, there are several things that you can do.

Since bacterial deposition in the tongue is one of the major reasons for bad breath, gentle cleaning of the surface of the tongue twice a day is one of the most effective options in regard to bad breath cure. A tongue scraper or tongue cleaner may be used for wiping the bacterial deposition, debris, as well as mucus. You can also use an inverted teaspoon for this purpose. One should avoid using a toothbrush for the same, as it would further spread the microbes in the oral cavity. Apart from that, a little bit of tongue gel or antibacterial mouth rinse on the surface of the tongue would further restrain bacterial growth.

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Rinsing the mouth with an effective mouthwash is another effective bad breath cure. Although it is just a temporary solution, it is still effective. Depending upon the type of mouthwash and the cause of bad breath, the effects may vary. Mouthwashes usually feature antibacterial agents, such as chlorine dioxide, cetylpyridinium chloride, zinc gluconate, chlorhexidine, and various essential oils, which help in restraining bacterial growth in the mouth.

Chewing gum is another effective remedy. Now dry mouth may increase bacterial growth and result in Halitosis, chewing sugarless gum may help in production of saliva; thereby prevent the mouth from getting dry. This helps in reducing bad breath. Some chewing gums also have anti-odor ingredients, which further aid the cause.

Apart from the above, gargling before bedtime, maintaining appropriate oral hygiene and regular visits to the dentists are some ways, which can help in the treatment of bad breath.

Article Source: http://www.articlesbase.com/health-articles/keeping-bad-breath-away-cures-for-bad-breath-3636160.html

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Do you wish to find out more about an effective bad breath cure? Head to our website for a comprehensive and informative guide on bad breath cures today.

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Common Causes Of Bad Breath

Posted: November 2nd, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

It would be very awkward to open your mouth while worrying about bad breath, especially if you need to talk to a friend or a co-worker in a closed space like an elevator. You may not be alone, as there are a number of factors that can cause it.  

The food that one eats is one of the most common reasons for bad breath. While there are tasty foods that smell really good, getting food particles trapped in your mouth can emit the bad odor. A food that has volatile oils is another bad breath producer. Some examples of these are garlic and onions. While these foods are broken down in the stomach, the volatile oils are carried by the bloodstream. When they reach the lungs, they stay there and the odor pours out with each exhalation; this process continues until the food is completely flushed out of our system. Garlic, onions, and other volatile-oil-rich foods will give you bad breath for up to three days since ingesting the foods.    

Other causes of bad breath lie in your dental health. Not brushing or flossing after every meal will leave food particles in your mouth and teeth where they will be approached by bacteria – the final result is hydrogen sulfide vapors. Good breath isn’t the only thing on the line with dental hygiene, but overall health of your mouth too. Plaque attacks the gums, resulting to bleeding, otherwise known as gingivitis. Tooth decay is another result from plaque. Bacteria can also come from dentures that aren’t cleaned regularly, and those that do not fit properly – causing more bad breath.  

Besides food type, bad breath is commonly caused by dry mouth. Your mouth is kept moist most of the day by saliva. Your cheeks, gums, and tongue will start collecting dead cells when your mouth is dry. When these dead cells start decomposing in your mouth, you get bad breath. Take morning breath for example; your mouth dries up while you’re sleeping, and results to that awful morning breath.

Bad breath is also commonly caused by mucus-related infections. When sinuses discharge mucus to the back of the throat, they start giving off a smell. Besides sinus infections, bronchitis and upper respiratory infections that provoke mucus discharges can cause bad breath for you. While we are not to be blamed for the bad breath caused by infection, we can be blamed for the infection that caused the bad breath. Smoking causes all kinds of complications for the respiratory system. It causes two things for promoting bad breath: It fries your mouth, and gives you periodontal disease. Going on a diet also causes ketoacidosis. During a diet, chemicals breakdown to give that fruity smell that no one appreciates.  

Whatever cause of bad breath you have, the fact remains that there will be discomfort felt by you and whoever you are talking to in close proximity. Changing habits can be enough to cure bad breath, provided that the cause has been identified. Habitual changes can be as simple as carrying a toothbrush and toothpaste if you’ll be having lunch at work; alternatively, you can bring a mouthwash or breath freshener. If you clearly have dental problems, then it’s best to go to the dentist.

Article Source: http://www.articlesbase.com/dental-care-articles/common-causes-of-bad-breath-2226782.html

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Dorothy J. Nichols is a health enthusiast like millions of others suffers from bad breath. Feeling the embarrassment and social isolation from her condition has led her to developing both traditional and conventional remedies for halitosis. You can read more about her bad breath remedies at http://www.forgetbadbreath.com.

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Top 8 Causes Of Bad Breath And Symptoms

Posted: October 30th, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

Halitosis — known as bad breath to most — is an embarrassing condition that can affect anyone at anytime, and is caused by several factors. In most cases bad breath (halitosis) is caused by the presence of oral bacteria. There can be, however, other factors that influence the odor associated with one’s breath and, in fact, the quality of a person’s breath will ultimately depend on a number of different variables.

1. Dry mouth (xerostomia) is a condition that affects the flow of saliva. This causes bacteria to build up in the mouth and this leads to bad breath. Dry mouth may be caused by some medicines, salivary gland problems or by continually breathing through the mouth instead of the nose. Older people may produce less saliva, causing further problems.

2. Gum disease, most certainly, can cause bad breath, because food trapped in gum pockets can rot and ferment, which releases sulfur products, and increases tartar buildup on the teeth, which also traps bacteria that release sulfur products. Most know that smoking causes bad breath, and that heart problems eventually result from the habit, but few realize that smoking causes gum disease, and that gum disease can cause heart problems.

3. Sinus conditions can have an effect on the quality of a person’s breath. Upper respiratory infections and allergies can create postnasal drip that deposits onto the back portion of a person’s tongue (by way of the oral-nasal pathway found in the area of a person’s soft palate). This discharge often has a foul taste and smell. What’s worse, oral bacteria will feed upon this discharge and create their own smelly waste products thus adding to the problems the person is having with bad breath.

4. The food we eat can adversely affect our breath. Odors from garlic, onions, cabbage, and certain spices may result in halitosis when the suspected food is absorbed into the blood tream after digestion. When the blood has transferred to the lungs, the smell from the food is evident when you exhale.

5. Other medical conditions that cause bad breath include infections in the throat, nose or lungs; sinusitis; bronchitis; diabetes; or liver or kidney problems. If your dentist finds that your mouth is healthy, you may be referred to your family GP or a specialist to find out the cause of your bad breath.

6. Dieting can cause bad breath in the form of a hunger odor, a.k.a. “morning breath,” which goes along with the sensation of hunger. Some evidence leads to the conclusion that this odor is a product of the decomposition and rotting of pancreatic juices, which passes into the stomach while the body fasts. The odor worsens if one skips breakfast.

7. Tobacco also causes its own form of bad breath. The only solution in this case is to stop smoking. As well as making your breath smell, smoking causes staining, causes loss of taste and irritates the gums. People who smoke are more likely to suffer from gum disease and also have a greater risk of developing cancer of the mouth, lung cancer and heart disease.

8. With eating comes digestion, another cause of bad breath. Gasses produced during the digestive process may escape through your mouth, emanating the odor it produces. Poor digestion resulting in constipation and disorders of the bowel may contribute to bad breath again, from the gasses that are produced during this process.

Article Source: http://www.articlesbase.com/diseases-and-conditions-articles/top-8-causes-of-bad-breath-and-symptoms-3480796.html

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Author is an online medical researcher on bad breath cure. Click read more on bad breath cure, bad breath causes and cures.

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7 Causes For Bad Breath In Children

Posted: September 16th, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

Halitosis is an offensive odor which comes from the mouth, nose, or airway. It is also defined as exhaled air containing more than 75 parts per billion of odor-producing volatile sulfur compounds. Halitosis in children is often due to the decomposition of mucus secretions and debris which accumulate on the tongue, in the nose, and between the teeth. The commonly affected areas are the back of the tongue, space between two teeth and even the lining of the gum. Believe it or not, bad breath usually stays for as along as one does not brush his teeth properly. So, it is up to you to teach your child how to maintain proper dental hygiene. Besides consuming certain food items, there are also other causes of bad breath which can occur in your child. This article will provide you a fair insight of what they are.  

1. Oral fungal infection: Children who take antibiotics for a long time may develop a Candida infection in the mouth. Children undergoing chemotherapy, or who are immunosuppressed, are prone to develop oral fungal infections. Such oral yeast infections produce a characteristic sweet odor.

2. postnasal drip is the most common cause of bad breath in children, and may be caused by allergies, recurrent colds or chronic sinus infections.

3. Gut problems used to be blamed, and enemas and laxatives were often given as cures, but in fact these have very little to do with bad breath. Your stomach is shut off from your throat and mouth by a tight ring of muscle at the base of the foodpipe, so it is normally a closed tube. Therefore no odour escapes from the stomach, except if you belch, or regurgitate food (vomit).

4. If the child is experiencing anything like tooth decay, he can exhale bad breath. In cases when the decay has not yet reached the root of the affected tooth, the cause of bad breath would be hard to find, as the child would not experience pain, but due to the constant detrimental activities of the bacteria upon it, he may still have bad breath.

5. Children who do not properly brush or floss their teeth and tongues are more likely to experience bad breath, resulting from bacteria feeding on stagnant saliva and food particles in their mouths. Food particles can get trapped in the crevices of the tonsils of children who do not brush their teeth at least twice a day. Otherwise known as tonsillar stones, this condition is another reason for foul breath in children.

6. Gingivitis and periodontitis are the most common inflammatory diseases which cause halitosis. The resulting foul odor is very distinct. Gram-negative bacteria such as Veillonella, Fusobacterium nucleatum, and Porphyromonas gingivalis hide in diseased periodontal tissues, and produce foul gases.

7. Anything that dries the mouth makes bad breath worse, because saliva cleanses the mouth. Tricyclic antidepressant drugs (such as amitriptyline) reduce saliva. Alcohol, alcohol-containing mouthwashes, heavy exercise and fasting can all result in a dry mouth and worsen a bad breath problem.

 

Article Source: http://www.articlesbase.com/diseases-and-conditions-articles/7-causes-for-bad-breath-in-children-3406300.html

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Author is an online medical researcher on bad breath cure. Click read more on bad breath cure, bad breath and stomach problems.

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How To Cure Bad Breath Naturally – The Secret To A Fresh Smelling Breath Always

Posted: September 1st, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

Bad breath otherwise known as halitosis is one common issue people deal with. Finding the right cure can be overwhelming since there are lots of options to choose from. That is why, it is important to identify first what is the cause before thinking about how to cure bad breath.

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Generally though, the most common cause of this problem is simply bad oral hygiene. To keep yourself feeling fresh all day and not worry much about your breath especially when you are in front of people, there are some simple ways you might want to consider.

Your Mouth Should be Kept Clean at All Times. Meaning, you need to brush your teeth at least twice a day and floss them regularly. By flossing, you can remove bacteria and food trapped in between your teeth and gum line. Be sure you floss after brushing, otherwise halitosis may be developed.

Clean your Tongue. Aside from brushing your teeth thoroughly, it is just as important to clean your tongue because bacteria that are left on the tongue can also cause bad breath. Brush you tongue after brushing your teeth.

Wet your Whistle. This means you have to avoid getting your mouth dry. Saliva has its natural antibacterial action that can help clean your mouth. Additionally, it also helps wash away food particles that can give your mouth a terrible odor.

Rinse your Mouth. After eating and it is impossible to brush your teeth just yet, simply rinse your mouth. Using plain water can help a lot in removing food particles that are left in your mouth.

Avoid worrying too much about how to cure bad breath. There are simple things you can do address this oral concern.

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The Most Common Causes of Bad Breath

Posted: August 16th, 2010 | Author: Rupert | Filed under: Causes of Bad Breath | Tags: , , , , , , , , , , , , , , , , , | No Comments »

Bad breath is a common health problem which greatly affects the day to day activities of so many people. The offensive odor from the mouth is unpleasant to those who come in close contact with bad breathers.

The problem will be doubled by psychological trauma leading to depression. The sufferers from this problem will be isolated from the society. This can even lead to marital disharmony.

Literally speaking all human beings are bad breathers. Oral cavity contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrefies them. This process results in the formation of offensive gases like hydrogen sulphide, methyl mescaptan, cadaverin, skatol causing bad odor. Most of us control this by regular brushing, tongue cleaning and gargling. Even after maintaining cleanliness in the mouth some individuals suffer from offensive smell due to various causes which has to be diagnosed and treated properly.

Here are the most common causes of bad breath.

1) Poor oral hygiene:

If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offensive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken in-between meals can also produce bad breath because of improper cleaning.

Bad breath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva has got some antibacterial properties which help to keep the mouth clean. Saliva contains oxygen molecules which are needed to make oral cavity aerobic. So the reduction in it’s quantity during sleep makes a favorable condition for anaerobic bacteria.

2) Food habits:

The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favor bad breath. Meat, fish, milk products, eggs, cakes, nuts, pear can cause bad breath. Some food articles can produce particular type of smell which may be unpleasant. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away, a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food. Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.

3) Biofilm:

There is formation of a thin sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteria are seen .The thick coating on the tongue is always associated with bad breath. Even a thin biofilm can make anaerobic condition favorable for bacterial proliferation.

4) Dental caries:

This is a destructive process causing decalcification with destruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli. Food particles are deposited inside these cavities and are putrefied by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrefied completely. Caries are common in schoolgoing children and in those who do not maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.

5) Gingivitis:

Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling, pain and discharge. If the condition becomes worse the infection spread towards periodontal area leading to continuous discharge called pyorrhea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis. All these conditions can produce offensive smell.

6) Gum retraction:

When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps between the teeth and gum. This will provide shelter for the food debris and bacteria causing bad breath.

8) Ulcerative lesions and coatings:

Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria, viruses, food allergies or due to autoimmune disorders. Apthous ulcer is the commonest among ulcerative lesions. Others are herpes, fungal infections, vincents angina, infectious mononucleosis, scarlet fever, diphtheria, drug reactions. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating (candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth and tongue. It is considered as a precancerous condition. Offensive breath is associated with these conditions.

9) Diseases of the salivary glands:

Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavorable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity. Some times the salivary duct is obstructed by stones or tumors. Cancer of the salivary gland is associated with offensive odor. In suppurative parotitis purulant discharge into the mouth causes bad breath.

10) Tonsillitis:

Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques and tonsillar fluid:

If bad breath persists even after maintaining proper oral hygiene there is possibility of this condition. Serous fluid secreted from the folds of tonsil is very offensive. Some patients complain that they hawk some cheesy materials from the throat, which are very offensive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteria. In such conditions tonsillectomy gives noticeable relief from bad breath.

12) Pharyngitis and pharyngeal abscess:

Pharynx is a fibro muscular tube which forms the upper part of the digestive and respiratory tract. Inflammation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offensive discharge of pus in to the throat.

13) Dentures:

Denture users may complain about bad smell due to lodgment of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:

Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasant for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these cause offensive smell.

15) Smoking:

Smokers always have bad smell. It can also produce lesions in the mouth and lungs causing bad breath. Smoking increases carbon dioxide in the oral cavity and reduces oxygen level, causing a favorable condition for bacteria. Smoking reduces appetite and thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose and ear:

Bad breath is occasionally seen in sinusitis (infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the Eustachian tube (passage from middle ear to the throat) can also cause offensive odor. Chronic rhinitis (infection of mucus membrane of nose) and foreign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:

Mostly all diabetic patients suffer from bad breath. Coated tongue, ulcers and coatings in the mouth, increased sugar level in tissues are responsible for halitosis. Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:

Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis, AIDS produce bad smell.

19) Fasting and dehydration:

Dry mouth favors bacterial activity. So any condition which produces dryness in the mouth makes the breath offensive. Even though the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:

Bedridden patients suffer from offensive breath due to thick coating on the tongue. Water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favors anaerobic bacteria to become active.

21) Diseases of stomach and esophagus:

Eructation of gas and food produce unpleasant smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis, gastric ulcer and cancer of stomach.

22) Intestinal diseases:

Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative colitis. Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis.

23) Diseases of lungs:

Lung diseases like pneumonia, lung abscess, chronic bronchitis, bronchiectasis, tuberculosis, lung cancer can produce bad odor during expiration.

24) Liver disorders:

Liver diseases like hepatitis, cirrhosis, can cause halitosis. Gall bladder diseases with vomiting also causes unpleasant odor.

25) Psychiatric patients:

Bad breath is common in psychotic patients due to poor hygiene, irregular food habits, less water intake and.

26) Somatisation disorder:

This is a psychiatric disorder characterized by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain, nausea difficult respiration, bad smell. This condition is diagnosed after detailed examination of the patient with all investigations. Since this is a psychiatric disorder it has to be managed with a psychological approach.

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