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Halitosis (Bad Breath)

Bad breath can usually be cured. Bad breath can be caused by food rotting in the mouth, stomach acid regurgitating up to the mouth and infections releasing chemicals that smell. Your doctor should look for white dots on your tonsils, that are often pieces of food that your saliva has turned white. You can remove them by gargling after every meal or by rubbing a Q tip against your tonsils.

If you have belching and burning in your chest or abdomen, you may have acid backing up from your stomach (1,2). Your doctor can order a blood test for helicobacter, the germ that causes stomach ulcers. If it is positive, you can often be cured by taking antibiotics (metronidazole or clarithromycin with omeperazole) for one week. Another cause is an infection in your mouth, teeth, gums, throat or esophagus. Your dentist should look for an infection and order a throat culture. If it grows out bacteria that cause disease, your doctor can cure you by prescribing the appropriate antibiotic. However, more than 30% of the time, the cultures do not grow out a bad germ (3), and you still should be treated with antibiotics. There are so many different germs in your mouth that it is impossible to tell whether a germ that is found there is causing the odor or is a normal inhabitant of your mouth. A 5 mg pilocarpine pill before each meal, or chewing gum, can increase saliva and help wash down food before it is fermented in your mouth

1) NA Alsomal, KE Coley, PC Molan, BM Hancock. Role of Helicobacter Pylori Serology in Evaluating Treatment Success. Digestive Diseases and Sciences 1993 (Dec);38(12): 2262-2266.

2) WM Wang, CY Chen, CM Jan, LT Chen, DS Perng, SR Lin, CS Liu. Long term follow up and serological study after triple therapy of Helicobacter pylori associated duodenal ulcer. American Journal of Gastroenterology 89: 10(OCT 1994):1793-1796. Conclusions: We conclude that seroconversion, which usually occurs after 1 yr, indicates complete eradication of H. pylori. Furthermore, we suggest that the success of the eradication of H. pylori can be judged without endoscopic examination, 8 months after treatment by triple therapy, according to the fall of IgG titers or seroconversion. Re-elevating IgG titers may be a warning of the possibility of relapse or reinfection of H. pylori.

3) H Benaryeh, G Horowitz, D Nir, D Laufer. Halitosis: An interdisciplinary approach. American Journal of Otolaryngology 19: 1(JAN-FEB 1998):8-11. Results: The patients were found to suffer from otolaryngological disorders (26%), dental problems (23%), oral discomfort (18%), and gastrointestinal pathology (10%), or several of the above. 

Checked 7/9/18

January 1st, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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