|
Overcoming
oral odour
Tips
for fresher breath
Science has not completely understood the intricacy of halitosis.
Although the recognition and treatment of halitosis may seem
insignificant in the panthesis of medical conditions, it has
a dramatic effect on a person's life and relationships. Here
are some tips that will help relieve your fear of halitosis
and make you more confident.
*Gently clean the very back of your tongue with a tongue cleaner
(soft bristled small tooth brush may help). Take care not to
damage your tongue. Just sweep the mucus layer away. Practice
helps to overcome the vomitish feeling.
*Eat a good breakfast; it cleanses the mouth, and gets the saliva
flowing.
* Prevent your mouth from drying out. Chewing gum for just a
few minutes can reduce bad breath. Drink sufficient quantities
of liquids.
* Use a mouth wash (Consult your dentist because some can stain
your teeth). The most effective method is to rinse and gargle
just before sleep. This prevents build up of micro organisms
and odour during the night.
* Clean your mouth after eating odorous foods or drinks such
as garlic, onions, curry and coffee. Make sure to clean between
your teeth after eating food or beverages rich in proteins.
* Brush and floss (Ask your dentist how to use dental floss).
* Ask an adult family member or close friend about your breath.
This is the most reliable way to find out if you have halitosis. |
By Dr. Buddika
Dassanayake
Bad breath, medically termed Halitosis [from Latin halitus (breath)
and the Greek osis meaning abnormal conditions] is attracting growing
public attention. It traverses a wide range of scientific fields
including dentistry, medicine, bacteriology, biochemistry, physiology
and not suprisin-gly, psychology. The extent to which this phenomenon
of bad breath has drawn public attention is well reflected in American
market research studies.
According to reports, Americans spend $1.8 billion on toothpastes,
$715 million on oral core gum, $740 million as mouth washes and
other dental rinses and almost $950 million on tooth brushes and
dental floss annually. Significantly, $625 million is spent on breath
freshners which are exclusively aimed at safeguarding fresh breath.
So, where does halitosis come from? According to recent scientific
studies carried out in this area, 85-90% emanates from the mouth,
5-10% from the nose, 3% from tonsils and about 1% from other sites.
Whatever the site of origin it is the result of microbial metabolism
which is not different from the body odours that emanate from a
person's underarms and covered feet.
Our mouth is inhabited by hundreds of bacterial species. These tiny
organisms that particularly depend on proteins for their nutritional
needs produce some truly fetid chemical compounds. Some of the bacteria
that feed on sugars also play a role in producing a malodorous mouth
because sugars are often present as glycoproteins (a combination
of sugar and protein).
Some of the bacteria that are unique in producing halitosis are
Treponema denticola, Porphyronomas gingivalis and Bactriods forsyths.
Scientists have recently found that the microbiota on the tongue
differs from those species living in plaque on teeth and gums. In
otherwise healthy people the very back of the tongue is the source
of malodour rather than teeth or gums. Microbes happily lodge in
the small invaginations found in that area which are poorly cleansed
by saliva.
One might be tempted to conclude that eradication of all micro organisms
on the tongue would be a potential treatment for halitosis. These
bacteria, however, play a protective role. Ordinarily, the tongue
harbours some fungus (candida albicans) in small numbers. This population
is kept in check by the presence of bacteria. When tongue bacteria
are wiped out, the fungus can run rampant. And fungal diseases are
more severe and difficult to control than halitosis. So it is wiser
to keep bacterial population present, but under control.
Other oral sources of bad breath include poor oral hygiene, gum
inflammation, faulty dental work, unclean dentures, food particles
collected in cavities of teeth, and pus produced by oral infections.
Because a steady flow of saliva washes away bacteria and their products,
anything that promotes dryness - mouth breathing, fasting, dehydration,
prolonged talking, stress, radio therapy, salivary gland diseases,
medications and tobacco smoking will aggravate the situation.
Apart from the mouth, the nose and the nasal passages also account
for 5-10% of bad breath cases. Here the odour comes mainly, out
of the nose. Nasal odour may result from inflammation of air cells
in facial bones (Sinusitis) or conditions that impede or block the
nasal secretions, such as an embedded bead in the air way. If a
child suddenly develops an overall offensive odour it is wise to
have a good check up for any blockage in nasal passages.
Suppurated tonsils may account for about 3% of halitosis cases.
Small stones called tonsilloliths grow in the crypts of the tonsils
and consist of partially calcified bacteria and debris. Tonsilloliths
smell foul themselves but don't always cause bad breath. They are
relatively uncommon, and because they do not usually cause any medical
problems, many physicians and dentists have never heard of them.
A lingering mystery is why people tend to be exquisitely sensitive
to the breath quality of their fellows and notoriously bad at smelling
their own. The answer to this may be simply because, we expel air
from our months horizontally and only subsequently breathe in vertically
through our nose, so the chance of getting a representative whiff
is low. Whatever the reason it is difficult for someone to know
if he or she has bad breath without being told. And given the embarrassment
involved, being told is unlikely.
Ironically, billions of dollars are spent on breath freshening products
annually, most probably by individuals, who do not have a problem
but merely fear they do. An extreme version of this common belief
is the phenomenon of "Halitophobia".
(Prepared from "Scientific American")
Answering some questions, raising
some more
This book is the latest ad dition to the expanding literature on
the history of western medicine in Sri Lanka. Earlier work on the
subject includes Vanderstraatten 1975, Wijerama 1947, Dias l980,
and Uragoda 1987. Of the various studies undertaken so far, the
monograph by Kamalika Pieris comes closest to a sociology of medical
profession in Sri Lanka. Following the lead given by Kamalika Pieris,
one has to venture into the history of medical profession in Sri
Lanka in order to configure the significance of past personalities
that continue to figure in the contemporary urban landscape and
social history of Sri Lanka. This includes towering figures in the
history of the medical profession in Sri Lanka, including Sir Marcus
Fernando, E.M. Wijerama, E.V. Ratnam and Senaka Bibile.
The period covered in this book requires some comment. The story
begins in 1843, the year in which the first batch of qualified Sri
Lankan doctors returned to the island, after completing their studies
in the famous Bengal Medical School in Calcutta that served as an
important training ground for Sri Lankan doctors prior to the establishment
of the Colombo Medical School in 1870. Kamalika Peiris' account
of the history of the medical profession ends in 1980 on the declared
grounds that the private sector in health care reached new heights
since that year. Not everyone will agree with this periodicasion,
but nobody can dispute the fact that the western medical profession
in Sri Lanka took its distinctive shape during the period under
consideration.
The book consists of 9 chapters. The first two chapters deal with
the origin and development of western medical profession in Sri
Lanka. The key areas explored include development of medical education,
increased popularisation of western medicine and establishment of
a legal framework for western medicine. In British Ceylon two contrasting
agencies, namely military and missionaries, played an important
role in introducing western medicine to the island. It would be
useful to explore further what distinctive impact it had on the
nature of western medicine introduced to the island and how it was
perceived by the public.
Chapter 3 investigates the development of professional organisations
and trade unions within the western medical profession in Sri Lanka.
The focus is on the origin and development of the Sri Lanka Medical
Association (SLMA) and Government Medical Officers Association (GMOA),
with the former as a professional association committed to promotion
of western medicine and the latter as a trade union representing
the interests of western medical practitioners in government service.
The development of professional organisations must be seen as an
important aspect of professionalisation of any occupational group.
From this point of view, the development of GMOA as a powerful pressure
group can be seen as an important landmark in the professionalisation
of western medicine in Sri Lanka.
Chapters four and five cover the development of western medicine
in government and private sectors. The focus is on development of
specific institutions, medical services and categories of health
workers ranging from medical officers to apothecaries. The first
hospitals in British Ceylon mainly catered to well-defined imperial
interests such as military, British residents and plantation communities.
The health services for the rest of the population were mainly dictated
by frequent outbreaks of epidemics such as small pox, cholera, plague
and malaria. How this situation finally gave way to a well-developed
welfare state with free and at the same time quality health care
available for a vast majority of population in the country is not
fully examined in the monograph.
Even though this book is primarily devoted to the study of history
of western medicine in the country, chapter 6 titled "Modern
versus traditional health care" provides a useful diversion
into the relationship between western and indigenous forms of medicine
within the Sri Lankan context. On the whole the analysis centres
on how ayurveda, including deshiya chikitsa, is gradually eclipsed
by western medicine. The author attributed this trend to perceived
and empirically demonstrated greater effectiveness of western medicine
in the treatment of specific ailments and in the control of devastating
epidemics affecting the country.
Chapters 7 to 9 deal with important sociological issues relating
to the professionalisation of western medicine in Sri Lanka. Since
the latter part of the 19th century, ascendance to the western medical
profession has been a primary goal of social mobility. In the early
period Dutch Burghers and Jaffna Tamils were highly over-represented
in the medical profession in Sri Lanka. Among the Sinhalese, the
Karawa caste obviously had a privileged access to the medical profession.
Following the development of a free education system since 1940s,
this situation gradually gave way to a more open pattern of recruitment
and greater access to the profession for hitherto excluded sections
of society.
The author Kamalika Pieris and Visidunu Publishers must be congratulated
for bringing out this important volume. It can be a useful guide
to medical practitioners, historians and social scientists alike.
As a sociology of the medical profession, it answers some important
questions but even more importantly it raises some issues that require
further research.
(The reviewer is Professor of Sociology at the University of Peradeniya
and currently Executive Director of the Centre for Poverty Analysis
in Colombo).
|
