It is reported that the cause of bad breath is not always found in the oral cavity. Especially when the most common causes, for example, pathology of the oral cavity or stomach, are already excluded, perhaps the source of the unpleasant odor is deeper.
To begin with, we’ll need to learn a little lesson in anatomy to understand what the occlusal plane is. This surface passes through the cutting edges of the first incisors of the lower jaw and tubercles of wisdom teeth, and in the absence of the latter through the second molars. Nature conceived: the occlusal plane should be parallel to the arch of the base of the skull. And if the rule is observed, a bite is correct, a nose breathes well, a back is easy to keep straight, a body is relaxed.
But sometimes having done his job, a dentist realizes that he cannot afford to level the occlusal surface alone, and resorts to an osteopath, a manual therapist for help. And it is all because teeth through the hyoid bone with the muscles that are connected to the scapula, with a cervical spine. If there are problems in vertebrae, the work of cervical occipital muscles is not coordinated, which accordingly affects the position of a jaw and spoils the bite.
If the musculoskeletal system is broken somewhere, all its parts suffer and pass on their problems to the upper departments: the hernia of the cervical region affects the condition of teeth, and even a sore lower back can distort the bite. Imagine you got a tiny pebble in your boot, and you have no way to remove it. You will immediately feel how one shoulder rose above the other, you are skewed. By morning, a neck will ache. And what if you walk with a stone in your heel all your life? Approximately the same pain rises from the lower back to the teeth.
In this case, using special techniques, osteopaths move the bones of the skull a little (do not be alarmed: there are small sutures between them that leave the bones with some mobility), and adjust the cervical vertebrae. After 10-12 treatment sessions, an osteopath and a chiropractor can see an improvement in the spine.
Change for the better will not reach the teeth right away, but gradually the occlusal plane will level out. Then the headaches, which, as a rule, pester such a patient, will pass or diminish. Sleep will improve. The numbness of the fingers will disappear. And even the pressure normalizes.
It is purulent inflammation that often leads to the formation of a bad smell. If it is in the oral cavity, the cause is usually detected quickly. On the other hand, in case of inflammation outside the oral cavity, additional diagnostics may be required to detect the cause of bad breath.
Since the air is exhaled through the nasal cavity, it physiologically communicates with the paranasal sinuses in case of purulent inflammation, the unpleasant odor is mixed with the inhaled portion of air. Sanitation of the oral cavity or treatment of stomach problems in this case will not help, since the source of the odor is outside the oral cavity. Inflammation in the antrum of the maxillary sinus causes recurrent bacterial infections. Quite often, staphylococcus becomes such an “odorless” agent.
Dentists report that brushing your teeth can remove odor only for a short time. In chronic inflammation of the paranasal sinuses, bad breath from the oral cavity is usually not the only problem. Inflammation of the paranasal sinuses causes other symptoms, such as pain in the affected sinus, postnasal syndrome. Thus, for more effective care, the possibility of surgical treatment of inflamed paranasal sinuses should be considered, if conservative treatment methods are not effective. If the inflammation is eliminated, the bad breath usually disappears on its own.
The main goal in the surgical treatment of chronic sinusitis is to normalize the anatomy of the nasal cavity, restore aerodynamics of the nasal cavity and paranasal sinuses. Corrective operations in the nasal cavity are performed with septoplasty, vasotomy with lateroposition. The natural fistulas of the paranasal sinuses expand as a result of pus and mucus can leak out, and the ventilation of sinuses is restored.
Restoring normal air exchange prevents the resumption of inflammation. In addition, as part of the operation, washing of the affected sinus is performed. Pus is removed, which usually immediately eliminates the smell. If after the operation there is no secondary infection, and healing takes place in normal mode, and the symptoms of halitosis disappear completely.
Depending on where the cause of the bad odor from the oral cavity is located, the treating specialist is either a dentist or an ENT specialist. Typically, these specialists work in multidisciplinary clinics in close cooperation, so if the dentist cannot identify the causes of a constantly occurring bad breath from the oral cavity, you should consult an otorhinolaryngologist. In addition to inflammation of the antrum of the maxillary or other sinuses, chronic tonsillitis can cause bad breath. Also, common diseases of internal organs can be a trigger for bad breath, for example, the digestive tract.
And sometimes dentists, manipulators and osteopaths send a patient to a psychotherapist to learn relaxation techniques. Have you noticed how at the moment of nervous tension some people play with nodules, the way they “chew” stress?
It turns out that the habit is not harmless. When a person clenches his teeth tightly during stress, he harms not only them, but keeps his gums and jaw in the wrong position. Unfortunately, it is difficult for a person to control the situation when he hears an insult or the situation at work gets out of his control, facial and chewing muscles react involuntarily.
However, the psychotherapist is not the last link in this chain. In advanced cases, you will need the help of a neurologist, physiotherapist.
If nasal breathing is impaired, the patient lives with his mouth open. A tongue is not in place, the jaw rushes forward, the head is tilted. A cranial vault, neck muscles, and a spine itself experience the wrong load. The shoulders are at a different level. A man is hunching. It is difficult for a chiropractor to correct posture. He needs the help of a dentist and an ENT specialist to achieve free breathing.
If the trouble lay in a curved septum of the nose, after an operation a patient feels that now he not only breathes better, but can straighten his shoulders. It is understandable – through a curved septum, a person pulled his nose with difficulty, his pulmonary muscles felt tension. When the situation improved, a patient immediately felt relief, the posture straightened. Then the dentist will easily build the correct occlusal plane.
The muscles of a mouth should always be relaxed, the upper and lower teeth should not be compressed. Do not close them, since there should be a distance of 1-3 mm between them. Remember this position? Have you noticed how smooth your back has become? Try not to grit your teeth spontaneously, whether you are watching TV, reading a book, or driving a car. The most difficult thing is to remember this rule when clarifying relationships with colleagues in the office of the boss.
It would be nice to ask your spouse if you grit your teeth in a dream. If a patient strains his jaw even at night, you can buy a mouth guard in the pharmacy, which you should put on before bedtime. And after a few nights, a person will feel comfortable in the morning. The muscles will release the jaw; it will rest overnight.
If, even after the mouthpiece, the patient feels stiffness and tension, it is possible to relax tired muscles with the help of auto-training sessions. Choose the exercises that suit you best. For someone, a minute relaxation in between work is enough, and someone will have to devote 10-15 minutes to classes in the morning and in the evening. But in case of an autogenous training, pay attention to proper breathing. When the exercises become a habit, a posture will be better, and a bite is more correct.
Of course, over the years, the occlusal surface changes. If a tooth fell out, its violation is obvious. Fortunately, the continuity and integrity of the dentition will be restored by an experienced prosthetist.
But often a person does not notice a defect. In fact, the fangs and lower front teeth were worn out and changed the front bite, lateral occlusion on the left and right. A doctor suggests a patient to build up the worn-out part with filling materials or crowns, but he does not understand why such “pampering” is necessary: they didn’t fall out, do not stagger, there is no caries … It seems that a doctor persuaded a patient to make a necessary restoration. But a dentist does not calm down – he sends the patient to the manual technician, ENT specialist, neurologist. And rightly so! Do not be lazy and get examined by these doctors.
In this situation, some features of the actions of patients in the absence of an oral pathology should be considered. If the consultation with the dentist does not reveal inflammation in the oral cavity, consultation with an ENT doctor is necessary. At the initial examination, several chronic diseases of the ENT organs can be detected that can contribute to bad breath from the oral cavity: tonsillitis, sinusitis, nasal polyps, rhinitis, etc.
In the case of sinusitis, an endoscopic examination of the nasal cavity may be required. In addition to the general diagnosis, the doctor may prescribe another examination: CT scan, X-ray (panoramic image), etc. As a rule, in the presence of a persistent unpleasant odor, conservative therapy is ineffective. Therefore, surgery should be considered as the most optimal solution to this problem is endoscopic sinus surgery.
‘Dentists often send their patients who cannot sit in the dental chair for a long time to me as a chiropractor and reflexologist. It is difficult for a person with a sore back to withstand manipulation, which requires even a few minutes of immobility. As for tension in the masticatory muscles, acupressure, the introduction of homeopathic remedies to acupuncture points are very helpful in this problem.’
Alex Carson, Professor, Doctor of Medical Sciences, Head of the Department of Pain Syndrome Therapy at the Scientific Center for General Medicine.
Chewing gum should not be kept in the mouth for more than 10-15 minutes. If you go beyond the limit, teeth, gums and jaws begin to work beyond measure. Posture goes bad.