Bad breath
Periodontics in Bilbao
Halitosis and its treatment
Bad breath and oral hygiene are directly related. Most cases are of oral origin, due to gum disorders such as gingivitis or periodontitis.
Bad breath is still a difficult topic for patients and healthcare professionals to address. On the one hand, there is the stigma associated with halitosis and, on the other, those who suffer from it are rarely aware of it. The sense of smell, due to its tolerance capacity, adapts and stops perceiving bad breath. In addition, there is halitophobia, which causes some people to become obsessed with bad breath even when the problem is not present.
Gum disease
Causes of bad breath
After many years of experience, at our dental clinic in Bilbao we have seen that around 85% of cases of halitosis are due to an oral cause, 8% to ENT pathologies and the remainder to systemic pathologies. Oral causes are due to the accumulation of volatile sulphur compounds. These contain sulphur which, when mixed with other gases, generate bad odour. They originate from cellular metabolism, either bacterial or from the individual’s own epithelial cells in the oral mucosa, the gingival sulcus, and especially on the back of the tongue. ‘The tongue has a very complex microanatomy in which small crypts form, where bacterial communities nest and produce volatile sulphur compounds through their metabolism,’ explains Ion Zabalegui, a specialist in periodontics and implantology at Zabalegui Dental and Facial Medicine.
Halitosis and oral hygiene are directly related. Most cases of oral origin are due to gum infections such as gingivitis and/or periodontitis, which are caused by bacteria and develop due to inadequate hygiene. Bad breath is also related to a decrease in salivation, known as xerostomia, associated with certain types of drugs, mainly antidepressants. Halitosis can also occur during pregnancy and menstrual cycles. This is because hormonal changes can alter the oral flora and promote the growth of certain bacteria. This means that if there is an underlying problem, bad breath will occur, although in many cases it is temporary. A diet too high in protein also promotes halitosis.
Periodontic treatments
How is halitosis diagnosed?
For diagnosis, an organoleptic analysis is initially performed.. ‘The explorer places their nose about ten centimetres from the patient’s exhaled air and uses their scale of values to measure the degree of bad odour. It is a subjective way of guiding specialists,’ explains Ion Zabalegui. In addition, the appearance of a portable gas chromatograph has helped detect the presence of three gases closely associated with halitosis. in an objective manner. It calculates the quantity and concentrations of these volatile sulphur gases very accurately. Of these three gases, two are directly associated with oral origin. ‘It is very useful in halitophobic patients to show them objectively that they do not have halitosis,’ adds Zabalegui.
Our periodontal treatment in Bilbao aims to restore proper oral health by eliminating the cause of bad breath. The use of interdental brushes, dental floss, tongue cleaners and specific mouthwashes with antiseptics to eliminate bad breath should be complemented with an initial treatment to professionally remove bacterial deposits that have accumulated on the gums and the back of the tongue. Only the most severe cases usually require pharmacological treatment as well.