Causes of Bad Breath: Sinus Problems
People tend to think that bad breath is caused by poor oral hygiene, but sometimes the cause of bad breath is not oral and has nothing to do with poor personal care habits at all. Sometimes the cause of bad breath is sinusitis.
What Are the Sinuses?
Sinusitis is a condition of inflammation of the paranasal sinuses. The paranasal sinuses are four air-filled pockets above and below the eyes, two on each side of the nose. We tend to pay attention to our sinuses only when they cause us pain, but they are very important to general health. They cushion the brain stem and upper spinal cord against damage from blows to the face. They add warmth and moisture to air as it is inhaled, and they protect the roots of the teeth from rapid changes in temperature as air is breathed in through the nose. And as anyone with a stuffed up nose can attest, the sinuses add resonance to the voice. Stuffy sinuses cause a distinctive change in the tone and timbre of speech and singing.
We don’t just have paranasal sinuses. We also have frontal, maxillary, ethmoid, and sphenoid sinuses in other locations in the skull protecting other parts of the brain. It’s just the paranasal sinuses that are involved in sinusitis and the bad breath it causes.
What Is Sinusitis?
The inflammation that we call sinusitis (or more precisely, rhinosinusitis) can be caused by infection with bacteria, fungi, or viruses. Sinusitis can also result from the inability to drain into a nose that is blocked by polyps or a deviated septum. The sinuses are connected to the nose by tiny openings known as ostia. The open space behind the ostia develops as the head develops.
An infant may have sinuses that only large enough to accommodate three or four cells. The sinuses may not grow large enough to be detected on an X-ray or MRI until a child is nearly twelve. Even in adults, the sinuses only contain about 15 ml (1/2 of a fluid ounce) of air. The sinuses are always relatively small spaces with very small outlets to the nose.
The sinuses are lined with goblet cells that make mucus to catch dust and germs. They are lined with tiny hairs known as cilia that twitch 6 to 15 times a second to move the mucus toward the ostia for drainage. If an autoimmune disease destroys these hairs, or they are damaged after inhaling a toxic chemical, or if the goblet cells are forced to create large amounts of mucus to isolate an infection, the sinuses clog up. Pain and bad breath follow shortly behind.
What kinds of infections cause sinusitis? In adults, sinusitis most often results from infection with Staphylococcus bacteria. These are the same bacteria that can cause impetigo when they are transferred through mucus to the face.
In children, sinusitis most often results from infection with different kinds of bacteria such as Haemophilus influenzae and Streptococcus pneumoniae that cause ear infections. Children’s sinuses are small enough that they often do not experience sinus pain, but the sinuses can be reservoirs of the bacteria that can infect the middle ear, and vice versa.
And it isn’t just infection that can cause sinusitis. Other sources of sinus inflammation include:
- Breathing in cold air. Cold air can stun the cilia that propel mucus out of the sinuses into the nose.
- Breathing in dry air. Dry air reduces the production of mucus but can cement the cilia in place.
- Swimming. Swimming in contaminated water can flood the sinuses with so many bacteria that both infection and allergic reactions occur at the same time.
- Dental procedures. Root canal work can disturb and inflame the sinuses.
Also, sinusitis can be caused by the common cold. About 90% of people who catch colds develop sinusitis.
Why Does Sinusitis Make Your Breath Smell Bad? And What Can You Do About It?
Any kind of sinusitis traps mucus in the sinus chamber. Bacteria feed on the mucus, and release the amino acids cysteine, cystine, and methionine. These amino acids are converted into hydrogen sulfide (the chemical that causes rotten egg odor) and methyl mercaptan (the chemical that causes sewer gas odor). Every time your blow your nose, the chemicals are released into the air. Making matters even worse, hydrogen sulfide and methyl mercaptan themselves can also destroy tissues in the sinuses and add produce still more decay.
Brushing and flossing and gargling mouthwash really don’t work when the cause of bad breath is sinusitis. But some other methods do.
- A neti pot is a great way to get rid of the mucus that can make your breath smell bad. Water is poured in one nostril so that it flows out the other, carrying what is usually a distressing display of mucus and other secretions along with it. This is probably the best thing you can do to relieve sinus-induced bad breath.
- Making sure you stay hydrated also helps relieve bad breath. You can’t drink enough water to make sinusitis disappear, but avoiding dehydration helps keep mucus thinner so it drains more easily. Just 5 cups (1200 ml) of water a day is enough to prevent dehydration.
- Using a vaporizer or room humidifier also helps keep the sinuses moist so they can more easily expel mucus.
- Cough syrup sometimes helps sinusitis. The ingredient guiafenesin loosens secretions so they are more easily expelled.
There are also things you should not do for sinusitis. Decongestants can dry out the lining of the sinuses so that the opening is made even smaller. Antihistamines that put you to sleep can also put the cilia in the linings of your sinuses to “sleep” so that they don’t expel mucus. And blowing hard to try to clear your sinuses just won’t work. You may pop tiny blood vessels—and the bruising will make your nose even stuffier.
