Halitosis, bad breath, fetor ex ore or smelly mouth all are related synonyms. As the mouth is worse than the anus, it is no wonder that the teeming millions experience this embarrassing but often unrecognised offensive holocaust by our own systems.

Hollywood heartthrob, Oscar winning actor, Clark Gable of the immortal film, 'Gone with the Wind', was notorious for halitosis. In the west, divorce is legalised for bad breath. Let alone human beings, animals particularly lions and bears share this obnoxious trailblazer on equal footing with homo sapiens. Hippocrates in his treatise penned on halitosis.

It is paradoxical that this abhorrent diaspora regurgitates in bizarre and varied modalities. Sometimes the partner feels the nausea and incumbent romps scot free when other times the companion is unaware while the harbinger bears the brunt (parosmia). Then it happens that the predator and the prey are equally exposed which does called perceived halitosis comprise about 80-90% of cases.

The causative factors are so abundant that it may be difficult to put them in order within the post of this page but a clarion call must be made at this juncture that the most outstanding and outlandish account is attributed to the greatest enemy of mankind — the microorganisms. Any part of the oral cavity — back of the tongue, gum, teeth on being infected — the metabolites of the organisms make sulfur compounds emitting noxious gas which is the primary halitosis.

On the other end of the spectrum is a long list of significant conditions — loose dental outfits, anaemia, cancer, liver disease, sinusitis, Vincent's angina, salivary tumour, lung abscess, purulent bronchitis, gastroeosophageal reflux disease (GERD) and many more.

Secondary to some other diseases — diabetic ketoacidosis, renal failure, gastrointestinal system disorders may also give rise to halitosis. Onion and garlic are known culprits. Though there are kits like Haliometre, Gas Chromatometre, BANA test to measure the degree of smell but more often than not the aroma of halitosis is self-evident.

The niggling question is how to address this nuisance? It is easy to say to remove the cause. But on the ground, especially dealing with the primary cause, disinfecting the mouth is not possible, nor permissible. In the majority of cases, medical science particularly dentists have surrendered to this social menace.

Brushing the teeth three times a day meticulously comes first. Flossing, tongue brushing, gurgling, mouth washing with antiseptic, proper hydration has a role to play. Nowadays some deodorant inhalers provide a temporary respite. Avoidance of alcohol, smoking has been credited with permanent relief occasionally.

Treating the infection is of paramount importance. Food menu should be kept in focus. Caries, gingivitis, loose dentures, plaques are combated by the dentist.

For secondary halitosis, the incumbent is taken over by the concerned specialist. Though difficult, some wonderful results have been achieved by addressing the root cause of the dilemma.

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