What Causes Bad Breath? Sometimes It’s a Weird Kind of Stones!
The accumulated wisdom of helpful advice on how to control halitosis seems pretty straightforward. Brush, floss, and use mouthwash. Brushing and flossing are what you need to do keep your moth healthy and to avoid bad breath and mouth odors.
Or maybe controlling bad breath really boils down to diet and lifestyle issues. Don’t eat garlic and onions. Chewing garlic and onions and eating other stinky foods are what causes odors in your mouth.
Or maybe it’s really all about oral hygiene. Make sure to remind your dentist and dental hygienist to remove scale and plaque to stay on top of all the symptoms of tooth decay and damage. Clean your mouth to keep your gum tissue in good health. Avoid periodontal diseases by seeing your dentist twice a year, or at the first sign of bleeding gums. Stop smoking tobacco in any form and especially don’t let cigarette tar accumulate on your tongue and teeth, avoid tongue piercing and keep sinus infections under control.
But sometimes the real cause of overwhelming mouth odor isn’t any of these things. It can be a medical condition for which medications don’t really provide a good solution. There isn’t a nutritional supplement that works very well, either.
Sometimes the cause of bad breath is not periodontal disease or particles of food you don’t wash away. Really difficult halitosis is often caused by tonsil stones. And the world might not know this except for the extended efforts of a blogger and lay expert named Meghan Swann.
All through her childhood Meghan Swann suffered recurrent colds, and flu. She had so many bouts with sore throat she lost count.
But one time when she was a teenager her sore throat felt different. The back of mouth was sore, but the pain seemed to be coming from inside the deep tissue of her throat. It was something more akin to a muscle ache than to strep throat. She had a feeling that something was stuck in her throat, but coughing didn’t bring relief.
So Meghan pressed hard on the back of her throat and sulfurous, smelly mass passed out. It was about the size of a small pebble or a piece of gravel and it smelled terrible. Ms. Swann developed a personal ritual that anytime she felt a “sore throat” coming on, she’d take a cotton swab and press out the debris. But her condition continued for years and years.
A couple of years ago, when Meghan had reached age twenty-five, Meghan’s mother commented that she had heard of a something like Meghan’s condition called tonsillolithiasis, which is a technical term for tonsil stones. These are collections of dead cells and mucus that accumulate in crevices in the back of the mouth.
Bacteria feed on the dead cells and the process of digestion gives rise to a quite noticeable bad smell. They accumulate pockets of debris and digestive waste products that start smaller than the size of a pin and that can grow from the size of a pencil eraser to about 1 inch (25 mm) across. The decay process can be aggravated by eating lots of sugary foods and by diabetes. But before Meghan started searching on the Internet, she did not know that she was not the only person who had the condition.
A typical posting on a site for rare conditions like wrongdiagnosis.com might read, “Whew. So I’m not the only person on earth who gets rocks falling out of the back of her throat. I’m not such a weirdo after all. Finally I know what caused and continues causing my fearsome halitosis.” Another poster might write, “I thought I could have cancer, but I really had bad breath!” The fact is, tonsil stones are getting more and more common.
Until about 1980, it was common for children who got recurrent sore throats to have operations to have their tonsils removed. Now, under the pressure of insurance rules and risk of malpractice liability, it’s rare for a child to undergo the operation.
Doctors prefer to handle sore throats with antibiotic treatment, even when breathing and swallowing are impaired. And antibiotic drugs are a “whole body” remedy, with various potential side effects in lungs, liver, and kidneys. In children, antibiotics frequently cause skin reactions. In women, how well antibiotics work may be influenced by hormone levels. One of the side effects of antibiotic therapy for tonsillitis, however, is the formation of tonsil stones.
Antibiotics dry out the mouth, creating tiny crevices in which dead cells can accumulate and from which infection can spread to living tissue. And even otolaryngologists often fail to realize that the stinky smell in the bad of the mouth isn’t the due to the decay of particles of yesterday’s cold pizza left behind by poor oral hygiene, it’s actually a tonsil stone. That’s despite the growing number of reports about tonsil stones in the medical literature, including a study reported in 2008 from the Brazilian state of Minas that found that 75 per cent of children and teens who have tonsillitis that has not been treated by surgery have bad breath caused by tonsil stones.
Tonsil surgery, of course, gets rid of this kind of bad breath for good. You don’t get tonsil stones if you don’t have tonsils. But nobody likes to go under the knife. For his patients who wish to avoid (or cannot have) surgery, Dr. Lee A. Zimmer of the University of Cincinnati recommends this simple tonsil care regimen anyone can do at home:
1. Rinse twice a day with a mouthwash that does not contain alcohol (because alcohol dries out the mouth and causes cracks), and
2. Rinse the back of your mouth at least once a day with a cleaning jet of high-pressure water from oral irrigation products such as a WaterPik.
3. Chew gum. The saliva released by chewing gum, especially gum sweetened with xylitol, flushes bacteria away.
Oxygenating sinus sprays and mouthwashes may also prevent problems, since the bacteria that cause the odor are killed by exposure to oxygen. All oxygenating remedies will probably help.
It’s always possible that surgery would be the best way to handle this problem. As of the date of this article, however, Meghan Swann is still getting good results from her tried-and-true oral health maintenance routine: When you feel the stones, push them out.
