Dr. Achanta Krishna Swaroop
Dentistry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am 53-year-old. I have had severe halitosis since I was a teenager. I have been to so many different doctors and specialists, but no one has been able to help. The smell comes from my nose, so the odor can be smelled when I am not even talking. I had balloon sinuplasty, which made my halitosis worse. I had a hiatal hernia repaired and a LINX implant placed for GERD. It did nothing to help. I had all of my mouth restored with new fillings and dental implants. My gums are healthy. I was tested for SIBO and the bacteria was slightly high. I had tongue rejuvenation which cleaned the film off my tongue, but that too did not work.
Kindly help.
Hello,
Welcome to icliniq.com.
Thank you for your query.
I have studied your SIBO case report in detail (attachment removed to protect the patient's identity), and I am an oral and maxillofacial surgeon. Therefore, I can help you with multiple strategies to combat the bad breath you suffer from your childhood. The problem is that when you have a history of GERD (gastroesophageal reflux disease) or SIBO (small intestinal bacterial overgrowth), in such conditions, the oral cavity tends to have a lot of bacterial fluctuations or pathogens. Because of this, you will be facing bad breath. Also, tongue cleaning will not be of much use, but deep dental scaling will work every six months to flush the harmful bacteria out of the tooth's soft tissues.
I suggest you to follow a few things mentioned below.
Mouthwashing is a definite must, and there is no way out because that is the most effective, or else the bad breath keeps worsening or stinking.
I hope this has helped you. Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I do get deep teeth cleaning every six months. Several years ago, I went to the clinic the dentist asked me to use Chlorhexidine. It worked for a while, and then it stopped altogether. I suspect that the bacteria became immune to it. I still used it for years but never got the same results as I did in the beginning. I use Dioxi Chlor mouthwash twice a day. My dentist remarked how my teeth and gums are excellent. In another clinic, I went to clean my tongue and measured the bacteria in my mouth, which was normal. It makes me think the halitosis is not coming out of my mouth, especially since it also comes out of the nose when I exhale. And I wonder why my halitosis got worse for a while after I had balloon sinuplasty. I am extremely worried about my halitosis.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
But it would help if you did not give up hope. I suggest you to rinse your mouth at least six to seven times a day with very concentrated and lukewarm salt water. Keep doing this till you see a decline or change in your bad breath and you do not need a Chlorhexidine mouthwash to take care of your halitosis. This is because salt is the most potent agent against high bacterial counts. Also, if you shift entirely to a vegan diet or consume more green leafy vegetables and vitamin C-rich fruits or antioxidants, it will help you. This is because the history of GERD (gastroesophageal disease), SBIO (small intestinal bacterial overgrowth), and systemic gut medications can alter your oral flora. I suggest you to follow the following instructions mentioned below.
I hope this has helped you. Thank you.
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Dentistry
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