conditions bad-breath

RECND560

Bad Breath

Condition:Halitosis
Other:Bad Breath
ICD-10 Codes:R19.6

Summary

Top 3 natural treatments for bad breath:

1. proper oral hygien
2. antimicrobial berbs
2. digestive enzymes

Naturopathic Treatments

Topical
• salt-water gargle
• flossing
• tongue scraping
• sodium bicarbonate (gum or toothpaste)
• nasal irrigation (post-nasal drip)

Specific foods
• green tea
parsley

Botanicals
• ginseng (Panax ginseng) - when associated with H. pylori
antimicrobial tincture - eliminates bacterial sinusitis, tonsilitis, H. pylori, etc.
- sage (Salvia officinalis)
- purple cone flower (Echinacea purpurea)
- thyme (Thymus vulgaris)
- goldenseal (Hydrastis canadensis)
• magnolia bark extract
bitter herbs - ensures proper digestion
• digestive enzymes

Supplements
• chlorophyll

Conventional Treatments

• mouth wash containing cetylpyridinium chloride, chlorhexidine, chlorine dioxide, or zinc;
• dental treatment (e.g. for gum disease)
• cleaning the tongue surface

Signs & Symptoms

• foul mouth odour
• may resemble the smell of volatile sulfur compounds

DDx

• abscess (e.g. peritonsillar, gingival)
• pharyngitis
• adenoiditis
gingivitis
sinusitis
• rhinitis
• bronchiectasis
• stomatitis

Pathogenesis

• unpleasant odors detected on exhale
• may be the result of:
- bacterial infection
- food (e.g. garlic, cheese, fish)
- dental problems
- dry mouth
- tobacco products
- mouth/nose/throat conditions (e.g. postnasal drip)
- other diseases (e.g. GERD, kidney disease, liver failure)
• usually a temporary condition that can be reversed with proper dental hygiene (e.g. brushing, flossing), especially of the tongue
• the tongue is the ideal breeding grounds for anaerobic bacteria and the most common source of halitosis since it produces offensive compounds and fatty acids; the posterior dorsum tends to be poorly cleaned, dry, and exposed to food remnants, dead cells and post-nasal drip

Diagnostics

• physical exam (throat, mouth, nose)
• subjective history
• diet review
• determine if secondary to e.g. post-nasal drip

Diagnostic Tests
• third party sniff test
• halimeter
gas chromatography
• BANA test
• B-galactosidase test

References

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MASSON H. [Chlorophyll A in the treatment of halitosis and body odor; results;drugs]. Ann Otolaryngol Chir Cervicofac. 1951;68(8-9):739-44. UndeterminedLanguage. PubMed PMID: 12986476.

MASSON, LEVIER. [Considerations on the use of chlorophyllin inotorhinolaryngology; study on its deodorizing action in halitosis]. Rev Laryngol Otol Rhinol (Bord). 1951 May-Jun;72(5-6):397-408. Undetermined Language. PubMedPMID: 14865411.

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Greenberg M, Urnezis P, Tian M. Compressed mints and chewing gum containingmagnolia bark extract are effective against bacteria responsible for oralmalodor. J Agric Food Chem. 2007 Nov 14;55(23):9465-9. Epub 2007 Oct 20. PubMedPMID: 17949053.

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Young A, Jonski G, RÖlla G. Inhibition of orally produced volatile sulfurcompounds by zinc, chlorhexidine or cetylpyridinium chloride--effect ofconcentration. Eur J Oral Sci. 2003 Oct;111(5):400-4. PubMed PMID: 12974683.

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