Various Diseases Of Head Are Cause Of Bad Breath
( Originally Published 1936 )
"What causes bad breath? Is there any cure for it?" asks a reader. Bad breath may come from disease of the nose, tonsils, teeth, gums or general constitutional disease.
Atrophic rhinitis, a degeneration of the mucous membrane of the nose, produces the worst forms of bad breath. Fortunately it is not a common disease—fortunately because it is not easy to cure.
Infection of the gums with Vincent's germs is another cause. Popularly this is known as trench mouth. The infection ranges in severity from widespread, acute, painful inflammation of the gums to the presence of the germs in the mouth without perceptible inflammation of any kind. Frequently marginal decay of a tooth allows the Vincent's germs to lodge in a small crypt often unseen. As one of the germs produces a gangrenous decay, the odor which results may be unpleasant.
Of course an ulcerating tooth produces bad breath. Food particles allowed to remain between the teeth ferment and may also be responsible, although in the modern toothbrush-toothpaste era this should be very unusual as a cause.
The tonsils have a thousand crevices and they secrete a fatty mucous secretion which frequently hardens, and there remain lumps of such material in the tonsillar crypts. I believe this is the commonest cause of unsuspected bad breath—the kind your best friend won't tell you about.
Chronic bronchitis, when a good deal of fetid, nummular sputum is brought up, naturally gives the breath an unwholesome odor.
Constitutional diseases as a cause of bad breath are not always considered. Yet it is a fact recently discovered that the salivary glands are organs of excretion. In fact, a test has recently been devised in which the saliva is used to determine how much urea (which should be excreted by the kidneys) is being cast out by these glands, as an index to the amount of kidney damage. The salivary glands take over some of the functions of the kidneys when the latter are incapacitated.
Keeping in mind these various causes, treatment suggests itself. We assume that neglect of ordinary cleanliness is not one of the possible causes. Spraying and cleansing the nose with antiseptic and deodorant oily liquids is just as important as frequent brushing of the teeth. For occasional emergencies, when no definite cause can be found, chewing a five-grain tablet of salol will kill most breath odors.
WHAT HAPPENS WHEN SENSE OF SMELL IS DISTURBED
A physician who was convalescing from a severe attack of influenza felt vaguely that there was something wrong with him, but he could not define it. He was living in a strange world, but he did not know what was strange about it. Finally he realized that he could not smell. The influenza infection had destroyed his olfactory membrane.
He has written up his experiences at some length in a German medical journal.
The sense of smell is used by animals for two purposes—to warn them against enemies or dangerous objects, and to attract them to food and pleasurable experiences.
Human beings have not a very acute sense of smell. But it is remarkable how much we depend upon it. Much more than we realize. A great deal of our happiness depends upon the sense of smell—it stimulates appetite and increases our enjoyment of food. It is particularly involved in making love, as the use of perfumes for purposes of sex allure indicates. The olfactory center is closely connected with the memory, and much of our enjoyment of places—rooms, buildings, barber shops, bathrooms—depends upon the odor which they have. We may be totally unaware of these odors—they work their associations subconsciously.
A man once told me that the smell of fresh linoleum always brought back to him the poignant memories of his first love affair. It was when all this mental furniture was suddenly taken away from him that the physician mentioned above realized what his olfactory sense meant in his life. The sense of smell gradually returned to him, but before it became normal he passed through an intermediate stage in which everything had a woolly, alcoholic, or repulsive odor. He lived in a world of unknown smells and it was a very unpleasant world. Testing himself on familiar objects with well-known smells, such as an orange, he would name in advance the odor he was going to smell, which only made him realize the better how different was the smell which came to him from the object.
Many people lose their sense of smell from influenza, or some other infection. In other cases it is destroyed by the application of chemicals. It usually returns, though it takes 10 months or a year to do so.
Three conditions are described as variations of the sense of smell. Anosmia is loss of smell; hyperosmia is an increase in the sensitiveness to smell; and parosmia is a perversion of the sense of smell. In one case of the latter the patient perceived a constant bad odor, due to ossification of the olfactory membrane in the nose.
Many times the perception of bad odors is due to nose infection, or infection of the teeth, or a plug in the tonsils. It is well known that drugs injected in the veins are quickly smelled by the patient, the drug being carried by the blood stream to the nose. One patient complained of a bad smell which disappeared when an abscess in the bone of the forearm was drained.
Hysterical patients frequently complain of disorders of smell.