We will refer to this annoying issue – which is already irritating enough – as ‘BREATH ODOR’, which is called as ‘bad breath’ among public. 15% of total patient population, which consults to an ENT specialist in our country, has this breath odor problem. Breath odor is not a problem that starts during childhod; it usually emerges at adulthood. There are 4 main ENT related reasons in regards to this issue.
1. The chronic inflammation called Sinusitis, which inhabits in the cavities of facial bones, causes a yellow-greenish secretion to flow towards adenoid. And since this post pharyngeal drip is inflammated, it releases an unpleasent odor. Treatment: Primarily, treated medically; meaning is, this inflammation is tried to be eliminated by medication. Whereas in advanced sinusitis, ‘endoscopic’ sinus surgery is the solution, since the discharge cannot be treated by medications. Chronic tonsillitis in mouth region causes a viscous tonsil eruption called ‘magma’, which shows itself as breath odor.
Treatment: Removal of the tonsils or shrinking their volume with radiofrequency.
2. Even though, it is not specifically treated within the scope of ENT, suspecting dental and gingival diseases during the oral examination of the patients who consult to ENT doctors is a distinctive sign for breath odor diagnosis. Because dental and gingival diseases might cause breath odor.
Treatment: Problem is detected by ENT doctors and the patient is referred to a dentist, who are the real experts in this area.
3. Stomach and intestinal system related diseases, might involve breath odor problem as well.
4. In some situations, fungal infections on the base of the tongue, might also cause breath odor.
Treatment: Even though, it is not related to ENT areas, during the examination – especially during ‘flexible fiberoptic laryngoscopy’ examination – tongue base, esophageal inlet and larynx and vocal cords should be inspected and the patient is referred to the related department. When the acidic content in the stomach moves up to the back side of the throat via esophageous especially at nights, it irritates the entrance of the vocal cords and the throat (Reflux). This problem is detected by the latest methods. Treatment is started by us, the ENT specialists. We also refer the patient to a stomach and intestine specialist (gastroenterologist). Until here, we have briefly mentioned about the diseases that are related to breath odor. Yet, there are more significant conditions that are seen in adult patients. It is also possible for a breath odor to arise due to tumors located in and around the mouth, throat and lower respitatory system. What we have here is a type of odor, produced by the crater formations that are created by the dead tissues as aresult of not being able to keep up with the tumor growth, which is commonly known as ‘Ulceration’. Of course, for a person, who only have this single symptom - breath odor - it is the last possibility to evaluate; in other words, it should not be counted within the primary reasons. On the other hand, especially in regards to adult patients, if the breath odor is accompanied by one or more other symptoms, such as hoarseness, diffulty in swallowing, pain radiating to ear, blood from mouth and swelling on the neck, then possibility of tumor should be considered and patient must be examined thoroughly. Also, multidisciplinary approach is required. Because, sometimes breath odor might be the indicator of diabetes or lung diseases.