Cat owners know for a fact that bad cat breath can be downright awful. It is not that much different from bad human breath, as both are caused by bacteria found in the mouth that breaks protein down and releases the sulfur compounds out into the air. Sulfur smells really bad on its own, which is why breath containing it smells bad as well. The bacterium that causes bad breath with cats is normally associated with a buildup of tartar around the teeth. Tartar is yellow in color, known as a coating of bacteria, food, and minerals. To cure your cat from bad breath, you will need to remove the buildup of tartar. There are several cat foods out there that are designed to reduce the buildup of tartar, many containing enzymes that will literally dissolve it.

You can also give your cat treats as well, as many of them will help eliminate and prevent tartar. If the buildup of tartar is bad, you may need to have your cats teeth professionally cleaned. Once the tartar has been removed, the bad breath will go away. You may be able to clean the tartar off your cats teeth at home. There are several toothpastes available for pets, available in several different flavors. you will need to get a mechanical toothbrush, as the motion is very important for removing tartar buildup. Toothpastes that contain enzymes will dissolve tartar, helping to cure bad breath. If you start early with brushing your cats teeth, you can virtually eliminate any type of tartar buildup that will ultimately lead to bad breath. Some bacteria that lead to tartar can be found in your cats diet. When you feed him, you should always make sure that the food he consumes does not contain a lot of bacteria. If you shop healthy and feed him only healthy foods, it can help his bad breath a great deal.

When you give your pet a treat, make sure that the treat is designed to help with tartar. After your cat has finished eating, you can brush his teeth or rinse his mouth out. This way, you will get the bacteria out of his mouth before it has time to build up on his teeth. Sometimes, cats may have a bad odor in their mouth that does not come from tartar or bad breath in general. In these rare cases, it can be either liver or kidney disease. If you notice bad breath and it is not tartar, you should take your cat to the vet. Even though it may be something to do with tartar, its better to be safe than sorry. Your veterinarian can pinpoint the problem, let you know what the cause is and how you should go about fixing it.

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| ICD9 | ICDO | OMIM | MedlinePlus 003058 | eMedicineSubj | eMedicineTopic | MeshID }} Halitosis or bad breath occurs when noticeably unpleasant odor are exhaled in breathing. Halitosis is estimated to be the third most frequent reason for seeking dentistry aid, following tooth decay and periodontal disease lt;/ref>

General

In most cases (85–90%), bad breath originates in the mouth itself.lt;/ref> The intensity of bad breath differs during the day, due to eating certain foods (such as garlic onion , meat fish and cheese , tobacco smoking lt;/ref> and alcohol consumption and health lt;/ref>lt;/ref> Since the mouth is exposed to less oxygen and is inactive during the night, the odor is usually worse upon awakening ("morning breath"). Bad breath may be transient often disappearing following eating, Tooth brushing ones teeth flossing or rinsing with specialized mouthwash Bad breath may also be persistent (chronic bad breath), which is a more serious condition, affecting some 25% of the population in varying degrees.lt;/ref> Contrary to the popular legend that Listerine coined the term halitosis it actually dates from the 1870s,http://www.merriam-webster.com/dictionary/halitosis Halitosis – Definition and More from the Free Merriam-Webster Dictionary]. Merriam-webster.com. Retrieved on 2011-10-10 although it became commonplace in the 1920s when a Listerine History promoted Listerine as a solution for "chronic halitosis".}
Note that previous editions of Freakonomicsincorrectly described halitosis as a "faux medical term", which this Wikipedia article previously reflected. Halitosiscombines the Latin halitus meaning breath, with the Greek suffix osisoften used to describe a medical condition, e.g., "cirrhosis of the liver". Bad breath is not, however, a modern affliction. Records mentioning bad breath have been discovered dating to 1550 B.C. A mouthwash of wine and herbs was once recommended way of solving the problem.

Classification

Halitosis has been classified by location of the cause of the malodor and by aetiology The primary subdivision is between Genuine halitosis and pseudo halitosis. Where halitosis is genuine, this can be subdivided according location, for example intra-oral halitosis (within the mouth) and extra-oral halitosis (outside the mouth). Intraoral halitosis is also known as oral malodor and accounts for some 80-90% of genuine halitosis cases. Genuine halitosis can also be thought of as either physiological, or pathological. *Genuine Halitosis **oral malodor (intra-oral halitosis) **Extraoral halitosis ***Extra-oral Blood borne halitosis ***Extra-oral non-blood borne halitosis ****Upper respiratory tract (ENT) causes ****Lower respiratory tract causes ****Gastrointestinal halitosis *Pseudohalitosis **delusional halitosis **olfactory halucinations/neurosensory disturbance

Cause

Tongue

The most common location for mouth related halitosis is the tongue lt;/ref> Tongue bacteria produce malodorous compounds and fatty acids, and account for 80 to 90% of all cases of mouth-related bad breath.lt;/ref> Large quantities of naturally-occurring bacteria are often found on the posterior Dorsum (biology) of the tongue, where they are relatively undisturbed by normal activity. This part of the tongue is relatively dry and poorly cleansed, and the convoluted microbial structure of the tongue dorsum provides an ideal habitat for anaerobic bacteria which flourish under a continually-forming tongue coating of food debris, epithelium postnasal drip and overlying bacteria, living and dead. When left on the tongue, the anaerobic respiration of such bacteria can yield either the putrefaction smell of indole skatole polyamine , or the "rotten egg" smell of organosulfur compounds (VSCs) such as hydrogen sulfide methyl mercaptan Allyl methyl sulfide and dimethyl sulfide

Cleaning the tongue

The most widely-known reason to Tongue cleaner is for the control of bad breath. Methods used against bad breath, such as mints, mouth sprays, mouthwash or gum, may only temporarily mask the odors created by the bacteria on the tongue, but cannot cure bad breath because they do not remove the source of the bad breath. In order to prevent the production of the sulfur-containing compounds mentioned above, the bacteria on the tongue must be removed, as must the decaying food debris present on the rear areas of the tongue. Most people who clean their tongue use a tongue cleaner (tongue scraper), or a toothbrush.

Mouth

There are over 600 types of bacteria found in the average mouth. Many of these can produce high levels of foul odors when incubated in the laboratory The odors are produced mainly due to the breakdown of proteins into individual amino acids, followed by the further breakdown of certain amino acids to produce detectable foul gases. For example, the breakdown of cysteine and methionine produce hydrogen sulfide and methyl mercaptan respectively. Volatile sulfur compounds have been shown to be statistically associated with oral malodor levels, and usually decrease following successful treatment.lt;/ref> Other parts of the mouth may also contribute to the overall odor, but are not as common as the back of the tongue. These locations are, in order of descending prevalence: inter-dental and sub-gingival niches, faulty dentistry work, food-impaction areas in between the teeth, abscess s, and unclean dentures Scully C, Rosenberg M. Halitosis. Dent Update 2003 May;3 Oral based lesions caused by viral infections like Herpes Simplex and HPV may also contribute to bad breath.http://www.healthcentre.org.uk/dentistry/oral-herpes.html Oral Herpes Dentists] UK Health Centre

Gum disease

There is some controversy over the role of periodontitis in causing bad breath. However, advanced periodontal disease is a common cause of severe halitosis. Waste products from the anaerobic bacteria growing below the gumline (subgingival) have a foul smell and have been clinically demonstrated to produce a very intense bad breath. Removal of the subgingival calculus (i.e. tartar or hard plaque) and friable tissue has been shown to improve mouth odor considerably. This is accomplished by subgingival scaling and root planing and irrigation with an antibiotic mouth rinse.lt;/ref>lt;/ref>

Nose

The second major source of bad breath is the nose. In this occurrence, the air exiting the nostril has a pungent odor that differs from the oral odor. Nasal odor may be due to sinus infection or foreign bodies

Tonsils

In general, putrefaction from the tonsil is considered a minor cause of bad breath, contributing to some 3–5% of cases. Approximately 7% of the population suffer from small bits of calcium matter in tonsillar crypts called tonsillolith that smell extremely foul when released and can cause bad breath.lt;/ref>

Esophagus

The lower esophageal sphincter which is the valve between the stomach and the esophagus may not close properly due to a Hiatal Hernia or GERD allowing acid to enter the esophagus and gases to escape to the mouth.http://emedicine.medscape.com/article/930029-overview Gastroesophageal Reflux] Steven M Schwarz 2009 May 13 A Zenker's diverticulum may also result in halitosis due to aging food retained in the esophagus.

Stomach

The stomach is considered by most researchers as a very uncommon source of bad breath (except in belching . The esophagus is a closed and collapsed tube, and continuous flow (as opposed to a simple burp) of gas or putrid substances from the stomach indicates a health problem—such as gastroesophageal reflux serious enough to be bringing up stomach contents or a fistula between the stomach and the esophagus—which will demonstrate more serious manifestations than just foul odor. In the case of allyl methyl sulfide (the byproduct of garlic s digestion), odor does not come from the stomach, since it does not get metabolized there.http://www.webmd.com/news/19991127/garlic-bad-breath-king Why Garlic Is the Bad Breath King]. Webmd.com (1999-11-27). Retrieved on 2011-10-10.

Systemic diseases

There are a few systemic (non-oral) medical conditions that may cause foul breath odor, but these are extremely infrequent in the general population. Such conditions are:lt;/ref>lt;/ref> # Fetor hepaticus an example of a rare type of bad breath caused by chronic liver failure # Lower respiratory tract infection (bronchial and lung infections). # nephritis and renal failure # Carcinoma # Trimethylaminuria ("fish odor syndrome"). # Diabetes mellitus # metabolism conditions, e.g. resulting in elevated blood dimethyl sulfide (Dimethylsulfidemia .lt;/ref> Individuals afflicted by the above conditions often show additional, more diagnostically conclusive symptoms than bad breath.

Halitophobia (delusion halitosis)

One quarter of the patients seeking professional advice on bad breath suffer from a highly exaggerated concern of having bad breath, known as halitophobia delusion l halitosis, or as a manifestation of Olfactory Reference Syndrome These patients are sure that they have bad breath, although many have not asked anyone for an objective opinion. Halitophobia may severely affect the lives of some 0.5–1.0% of the adult population.lt;/ref>

Diagnosis

Self diagnosis

Scientists have long thought that smelling ones own breath odor is often difficult due to acclimatization although many people with bad breath are able to detect it in others. Research has suggested that self-evaluation of halitosis is not easy because of preconceived notions of how bad we think it should be. Some people assume that they have bad breath because of bad taste (metallic, sour, fecal, etc.), however bad taste is considered a poor indicator.lt;/ref>lt;/ref> For these reasons, the simplest and most effective way to know whether one has bad breath is to ask a trusted adult family member or very close friend ("confidant ). If the confidant confirms that there is a breath problem, he or she can help determine whether it is coming from the mouth or the nose, and whether a particular treatment is effective or not.lt;/ref> One popular home method to determine the presence of bad breath is to licking the back of the wrist let the saliva dry for a minute or two, and smell the result. This test results in overestimate as concluded from research, and should be avoided. A better way would be to lightly scrape the posterior back of the tongue with a plastic disposable spoon and to smell the drying residue. Home tests that use a chemical reaction to test for the presence of polyamine and sulfur compounds on tongue swabs are now available, but there are few studies showing how well they actually detect the odor. Furthermore, since breath odor changes in intensity throughout the day depending on many factors, multiple testing sessions may be necessary.

Professional diagnosis

If bad breath is persistent, and all other medical and dental factors have been ruled out, specialized testing and treatment is required. Hundreds of dental offices and commercial breath clinics now claim to diagnose and treat bad breath. They often use some of several laboratory methods for diagnosis of bad breath: # [[Halimeter]] a portable sulfide monitor used to test for levels of sulfur emissions (to be specific, hydrogen sulfide in the mouth air. When used properly, this device can be very effective at determining levels of certain VSC-producing bacteria. However, it has drawbacks in clinical applications. For example, other common sulfides (such as mercaptan are not recorded as easily and can be misrepresented in test results. Certain foods such as garlic and onions produce sulfur in the breath for as long as 48 hours and can result in false readings. The Halimeter is also very sensitive to alcohol, so one should avoid drinking alcohol or using alcohol-containing mouthwashes for at least 12 hours prior to being tested. This analog machine loses sensitivity over time and requires periodic recalibration to remain accurate.lt;/ref> # [[Gas chromatography]] portable machines, such as the OralChroma, are currently being introduced.lt;/ref> This technology is specifically designed to digitally measure molecular levels of the three major VSCs in a sample of mouth air (hydrogen sulfide methyl mercaptan and dimethyl sulfide . It is accurate in measuring the sulfur components of the breath and produces visual results in graph form via computer interface.lt;/ref> # [[BANA test]] this test is directed to find the salivary levels of an enzyme indicating the presence of certain halitosis-related bacteria.lt;/ref> # [[beta-galactosidase|β-galactosidase]] test salivary levels of this enzyme were found to be correlated with oral malodor.lt;/ref> Although such instrumentation and examinations are widely used in breath clinics, the most important measurement of bad breath (the gold standard) is the actual inhalation and scoring of the level and type of the odor carried out by trained experts ("organoleptic measurements"). The level of odor is usually assessed on a six-point intensity scale.lt;/ref>

Management

Chronic halitosis is not well understood by most physician and dentist , so effective treatment is not always easy to find. The following strategies may be suggested: # [[Tongue cleaner|Gently cleaning the tongue surface]] twice daily is the most effective way to keep bad breath in control; that can be achieved using a tooth brush, tongue cleaner or tongue cleaner to wipe off the bacterial biofilm debris, and mucus. An inverted teaspoon may also do the job. Scraping or otherwise damaging the tongue should be avoided, and scraping of the V-shaped row of taste bud found at the extreme back of the tongue should also be avoided. Brushing a small amount of antibacterial mouth rinse or tongue gel onto the tongue surface will further inhibit bacterial action. # Eating a healthy breakfast with rough foods helps clean the very back of the tongue. # [[Chewing gum]] Since dry-mouth can increase bacterial buildup and cause or worsen bad breath, chewing sugarless gum can help with the production of saliva and thereby help to reduce bad breath. Chewing may help particularly when the mouth is dry, or when one cannot perform oral hygiene procedures after meals (especially those meals rich in protein . This aids in provision of saliva, which washes away oral bacteria, has antibacterial properties and promotes mechanical activity which helps cleanse the mouth. Some chewing gums contain special anti-odor ingredients. Chewing on fennel seeds, cinnamon sticks, Mastic (plant resin) gum, or fresh parsley are common folk remedies # [[Gargling]] right before bedtime with an effective mouthwash (see below). Several types of commercial Mouthwashes have been shown to reduce malodor for hours in peer-reviewed scientific studies. Mouthwashes may contain active ingredients that are inactivated by the soap present in most toothpaste . Thus it is recommended to refrain from using mouthwash directly after toothbrushing with paste (also see mouthwashes, below).lt;/ref> # Maintaining proper [[oral hygiene]] including daily Tongue cleaner Tooth brushing flossing and periodic visits to dentist and hygienist . Flossing is particularly important in removing rotting food debris and bacterial plaque from between the teeth, especially at the gumline. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by your dentist). # [[Probiotic]] treatments specifically Streptococcus salivarius K12 has been claimed to suppress malodorous bacteria growth, however well designed randomised control clinical trails are needed to assess this.lt;/ref> Certainly there is more evidence for mechanical tongue cleansing and to a lesser extent specific antimicrobial mouthwashes.

Mouthwashes

There has not been a single documented medical case of successfully cured chronic halitosis using any of the currently available mouthwashes. However, a 2008 systematic review determined the efficacy of antibacterial mouthrinses for treating bad breath.lt;/ref> Mouthwash s often contain antibacterial agents including cetylpyridinium chloride chlorhexidine (which can cause temporary staining of the teeth), zinc gluconate essential oil , and chlorine dioxide Zinc and chlorhexidine provide strong synergistic effect.lt;/ref>lt;/ref> They may also contain alcohol which is a drying agent. Other solutions rely on odor eliminators, such as oxidizing agent to eliminate existing bad breath on a short-term basis. A new approach for home treatment of bad breath is the use of oil-containing mouthwasheslt;/ref> and two-phase (oil:water) mouthwashes.lt;/ref> Essential oils have been found effective in reducing halitosis, and are being used in several commercial mouthwashes.

Traditional remedies

According to traditional Ayurvedic medicine, chewing areca nut and betel leaf is a remedy for bad breath.lt;/ref> In South Asia, it was a custom to chew areca or betel nut and betel leaf among lovers because of the breath-freshening and stimulant drug properties of the mixture.Both the nut and the leaf are mild stimulants and can be addictive with repeated use. The betel nut will also cause tooth decay and dye ones teeth bright red when chewed. Both areca nut and betel leaf chewing, however, are recognised risk factors for squamous cell carcinoma (oral cancer)."Betel chewing causes cancer". Science and Development Network. August 12, 2003.] WHO | IARC Monographs Programme finds betel-quid and areca-nut chewing carcinogenic to humans]

Research

In 1996, the International Society for Breath Odor Research (ISBOR) was formed to promote multidisciplinary research on all aspects of breath odors. The eighth international conference on breath odor took place in 2009 in Dortmund, Germany.

See also

* Periodontitis * Dental caries * Tooth abscess * Postnasal drip * Oral hygiene * Toothbrush * Tongue cleaner * Mouthwash * Toothpaste * Trimethylaminuria * Dimethylsulfidemia

References

Category Symptoms and signs Digestive system and abdomen Category Oral hygiene