Halitosis

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I'm pretty sure everyone has come in contact with someone whose breath was unpleasant at one point in our lives. In fact, I'm pretty sure all of us have had bad breath at some point in our lives.
Halitosis is the term used to describe bad breath in the medical field. It is usually not serious and quite easy to remedy.

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The major cause of halitosis is bad oral hygiene. Food particles left over time are a major cause as well. But it's also easy to get rid of it, regular brushing of teeth, flossing or hydration takes care of the problem.
But what happens when your case is persistent? What happens when no matter how many times you brush or floss, or how many gallons of water you drink, your breath just stays bad?! Well, that was the case of a patient that walked into the ENT clinic.
He was a 29 year old male, complained of bad breath for the better part of 2 years, going into its third. He had done all the dentists could advice. No matter how potent or expensive the toothpaste or mouthwash or even procedure, the bad breath was there to stay.
He was then referred to the ENT clinic. Now, after taking a precise history, it was narrowed down by the consultant. The patient said even when his mouth was closed and he put a finger in front of his nose and breathed out, he could perceive that bad odor.
I believe this was helpful in eliminating a dental cause and helped us focus on more difficult possibilities. The paranasal sinuses.

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There are air-filled pockets on the skull, they are called sinuses. The sinuses have various functions but their major functions are in the lightening of the skull and humidification and warming of inhaled air.
If there is an infection of the sinuses, if there's a fluid collection in the sinuses, it would serve as a rich medium for bacterial growth. This could present as a persistent type of halitosis.
This was the diagnosis in the case if this patient. To confirm diagnosis, an image of the sinuses would be paramount. Imaging techniques that could aid include a simple x-ray, MRI and CT scans. Well, we start at the basics, we requested an x-ray of the paranasal sinuses.
With experience, practicing medicine gets easier and one becomes unphased even by the most absurd cases. The treatment plan is simple. Treat the cause.
The patient had sinusitis, that's an infection of the sinuses, which was treated with appropriate antibiotics. The halitosis is subsiding and is expected to completely resolve by month's end.
So, not every case of bad breath is on oral hygiene. If you have or know someone with such condition, please do well to visit your doctors, this isn't one of the things we should sweep under the rug.
This was a rare case, and an uncommon cause of halitosis. Common causes are usually dental cases and usually resolve with prescribed antimicrobial toothpastes and mouthwash.
Other non-dental causes of halitosis are allergies, respiratory tract infections, diabetes, gastrointestinal problems, liver and kidney diseases. Some drugs have been implicated as well.
I advice we do our bit and uphold proper oral hygiene and prevent bad breath in ways we can. And if one is going to have it, know you did your bit. Now, what's your bit?
Regular brushing of teeth, regular visit to your dentists, proper hydration, eat more fruits and vegetables and quit smoking bro!

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I believe the major complications of halitosis lie in the social stigma. It, for starters, messes with one's self confidence and renders one insecure, destroys preexisting relationships, I mean, how do I kiss my girl with all that bad breath?!

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I employ us to take our dental health more seriously before it weighs on our mental health.

Referencing

https://www.medicalnewstoday.com/articles/166636#diagnosis

https://www.webmd.com/oral-health/guide/bad-breath



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6 comments
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So, there is no treatment for paranasal sinuses halitosis? So, how do patients with such abnormality manage it?

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There is. We manage the cause, in this case, the sinusitis, using appropriate antibiotics. Drainage of abscess if there are abscesses is mandatory as well.

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Nice chill write up.. Check up Zenker's diverticulum in your so are time and pericoronitis.

I think I have a post on pericoronitis already

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