The causes of breath odour are not entirely understood. Most unpleasant odors are known to arise from food debris trapped in the mouth which is processed by normal mouth microbiology; there are over 400 types of bacteria found in the average mouth. Several dozen of these can cause trouble when allowed to flourish or are genetically disposed to overpopulate. Large quantities of these naturally-occurring bacteria are often found on the posterior of the tongue, where they are undisturbed by normal activity.
The rough surface of the tongue dorsum provides an ideal habitat for some bacteria, which flourish under a continually-forming tongue coating of food debris, dead cells, and hundreds of thousands of bacteria, living and dead. When left on the tongue, such bacteria can yield either a putrescent smell polyamines, or the "rotten egg" smell of volatile sulfur compounds (VSCs) such as hydrogen sulfide, methyl mercaptan and dimethyl sulfide, depending on the bacteria type. It is generally these compounds which, when mixed with mouth air and exhaled, produce unpleasant breath.
Other causes of chronic bad breath may be:- periodontitis (gum disease)
- helminthiasis, (intestinal parasitic infections)
- diabetes
- kidney failure
- sinusitis
- tonsillitis
- gastroesophageal reflux disorder (GERD)
- trimethylaminuria, (TMAU)
- hormonal changes
- a wide variety of prescription drugs (especially when taken on a longterm basis)
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