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Wisdom Teeth Extraction Cured My Nasal Bad Breath

Posted: Fri May 23, 2008 9:52 pm
by Cured
Greetings,

For those of you suffering a chronic bad breath from the nose, but do not have sinusitis or crippling allergies, had your tonsils out, but not your wisdom teeth...it may be impossible to believe, but I'd like to suggest that these may be the culprit.

I'm a 26 year-old male who has suffered with chronic halitosis for 6-8 years, with it having gotten totally crippling socially for the least 3-4 years. Now that I've been, by the grace of God, cured (nearly) completely, I feel as though I need to share my experience with fellow suffererers at their wit's end, should it help them at all.

The bad breath I used to suffer from I never really considered a 'halitosis' per se, but it was this cheesy odor that I could many times smell in my nose, and that would grossly offend people whenever I talked. It was so bad in the final years that people 6-10 feet across the room would pinch their noses or peel back, indicating their offense. Sometimes I didn't even need to speak, and people coming up close behind my head or who were close to my face could detect it and would rub their index fingers under their noses: this was with my mouth fully shut. It could be especially bad whenever I bent down or tilted my head back against the back of my neck, or if I took a deep breath in with my mouth closed.

Most of the time it would smell to me like a very pungent cheese, such as parmesan or blue cheese. Another way to describe it would be the odor of stinky feet or sweaty, dirty gym socks. People would sometimes describe it as smelling "like shit" around me. A variation on this odor that I could detect sometimes was a wet stink like the smell of the aerosol that comes out of one's lungs after a deep sneeze.

Originally, I had been told that chronic sinusitis runs in my family (which it does), and that this may be one of its symptoms, so there was little I believed I could do. But as it grew worse and more pervasive over the years I realized I had to do something.

All the comments in these threads about the social humiliation, isolation and depression that one suffers with a condition like this...from colleagues being forced to embarrass you in front of others, to nasty comments behind my back, to angry looks and rude gestures as if I was a dirty person who could help it otherwise, to losing friends with school changes and unable to make new ones, to nervous breakdowns when people would get too close too suddenly, to staying away from social situations and avoiding directly talking at people unless absolutely necessary...to wondering whether I'd ever be able to have a girlfriend or get married...my friends...I've suffered it all just like you have and learned just how cruel and merciless humankind can be.

Worse yet was trying one thing after another and nothing working. Went to my ENT: two sinus CTs were completely negative for any sinusitis. Over the course of an agonizing year and half, we would try everything from:

[remedy (suspected cause)]

-Zyrtec and Allegra (allergic rhinitis)
-tonsillectomy (tonsillitis & tonsil stones)
-antibiotic (Mupirocin ointment mixed w/ Ocean nasal saline rinse) sinus wash (sinusitis)
-aggressive tooth brushing/flossing/Listerine (mouth bacteria)
-tongue scraping with a scraper (tongue bacteria)
-food allergy testing (allergic reaction)
-Nexium (GERD)
-Magic Miles solution (candidiasis)
-nasal endoscopy (polyps or foreign body)
-Guaifed (thick, poor draining mucus)
-Nasarel (steroid nasal spray for improving sinus drainage)

With every visit the ENT would smell my breath and say "I don't smell anything". That combined with trying one thing after another over the months and having high hopes dashed every time...drove me nearly insane. It was a true curse, and when you have this sort of problem, you also drive yourself crazy racking your mind and researching night and day to figure out what it could be and what could cure it. I had gotten into the habit of doing this every night after work, reading up on nasal and oral odors and their causes, searching the net and reading up and down forums like these for any inkling, shred or clue of information from someone else's experience that might help me.

Went to the dentist: teeth and gums check out fine, got the standard cleaning. Asked if it could be a cavity: negative. How about my crown?: negative. Besides suggesting the Magic Miles solution, they were clueless otherwise...

Among the many misguided things I tried myself (that is, without any physician’s oversight or approval) over the years were:

-gums and mints (which only made the smell more pronounced and worsened the effect)
-drinking vinegar (for sinus stuffiness/mucus flow)
-Centrum multi-vitamin
-L-carnitine supplement (in case it was isovaleric acidemia, which produces an odor like that I complained of)
-Sinofresh sinus spray
-Ocean nasal saline rinse (occasionally w/ baking soda)
-TheraBreath sinus drops
-TheraBreath regular mouthwash
-TheraBreath PerioTherapy mouthwash
-TheraBreath gum
-hydrogen peroxide
-oil of oregano (which is quite possibly the most awful thing mankind could consume)
-swabbing up my nostrils with alcohol swabs
-Tinactin antifungal cream up my nose
-Mupirocin antibiotic ointment up my nose
-Diet changes (including cutting all dairy products)
-Eating yogurt
-Odor Eaters foot powder (in case it was my feet since the odor resembles feet so much)
-Clean & Clear daily face wash (in case it was oily nose pores)
-Acne cream treatment (in case it was oily nose pores)

The last three were more desperate measures, more indicative of how insane my inability to conquer this bad breath was driving me, than anything else. To make a long story short, after my ENT became exasperated with me, after trying another one only to be tried on GERD medication again (which I knew wouldn't work), and after praying the most sincerely about this situation that I ever have, I ran into a webpage during my searches a few days later (see above about my searching) that suggested something I'd could never have dreamed of considering as the source: wisdom teeth.

Wisdom teeth, especially if they're impacted, can cause gum flaps to form around them, and these can trap tremendous amounts of bacteria, which give off all kinds of foul odors. This may result in a localized infection called pericoronitis, which may produce detectable symptoms or not (as in my case). To make matters worse, it may be absolutely impossible to reach the gum pockets and crevices around these teeth with even aggressive, thorough brushing and flossing (as in my case). Think about food debris being back there for years, never being able to be removed properly, and how that will eventually make your breath smell all the time. This was why no amount time, effort or money I spent on my oral and/or nasal hygiene was going to be of any use.

When I ran the idea of extracting my wisdom teeth by my father (a general surgeon), my dentist and the oral surgeon, all except my dentist dismissed any link out of hand, and he was skeptical at best. My oral surgeon offered to extract the teeth, but guaranteed me with snicker by a probability of 99% that it would have no improvement on my breath. But wisdom tooth extractions are so common and harmless, it was certainly worth a shot, especially after the living hell I had been through. Well, I had all four wisdom teeth extracted in late February, and let me say how good it feels to be able to tell an oral surgeon you were glad you didn't listen to him...because it's been nothing short of a miracle. The road to recovery is long and I've had my share of bumps along the way, but in general, the cheesy odor from my nose I used to complain of is completely gone, and people no longer get offended when I'm talking directly to their face, or when they stand close to my head. About three weeks after the surgery I developed two strong odors from my gums (which I could smell through my nose): the first was the footy/cheesy odor that used to bother me, but now magnified by about 1000 times (the release of which indicated to me that I had 'struck gold' so to speak as far isolating the wisdom teeth area as the cause of my bad breath), the second a foul, tooth pulp/root canal-like odor common to invasive dental work. These gave me heartache for a week or two, then died down significantly, with occasional weaker relapses (say once or twice a day every few days) which are getting weaker by the week (as of now, I haven't had the first one for more than a month). The stinky, sneeze aerosol-like odor I isolated to my upper left wisdom tooth/gum area, and that too has disappeared completely over the weeks as that socket closed up. I know I won't be out of trouble completely until the sockets fill up solidly with new gum tissue, but the improvement over my past life has been staggering--by over 90% by my estimate, and I told my oral surgeon that I could feel just by how the odor vanished with the changing of my oral anatomy that my life was never going to be anywhere near the same as it was in the past (this was a month and a half after telling him one week post surgery when I had the stitches out that I still had my fingers crossed inspite of detecting immediate improvement, just due to my being let down big time after my tonsillectomy). I was asked to give recovery at least three good months, a point I've not yet reached, so I am giving myself at least a few more months for my life to return completely to normal. But as I said, the improvement has been real, drastic and lasting.

I'm not putting my story out there as a panacea for all: some of you may have already had your wisdom teeth out, some people's may be totally healthy and not odor causing or impacted at all, and both still may suffer chronic breath. But I share it because I know that during the years I suffered I was desperate for any tip anyone could provide, especially since nothing I was trying was making a dent. If somebody had told me to investigate my wisdom teeth as a possible cause of my foul nose odor, I'd have gotten them out in a heartbeat.

Here are a few more tips I learned from my ordeal and its resolution that may be helpful (though be aware I am not a medical or dental professional):

-Chronic bad breath that is more or even exclusively detectable to you or others through your nose rather than your mouth can easily fool you into believing it must originate from your nasal passages or sinuses (it sure fooled me, hence all my desperate measures putting stuff up my nose), when that is rarely ever the case. For a long time I argued with my ENT about the effectiveness of non-nasal treatments since I swore the odor came from my nose. He would continue to insist that most breath odors originate in the mouth. It turns out he was right, even though he failed to identify the oral source, ultimately. The reason the odor was more detectable in my nose was simply that the position of the wisdom teeth in the mouth is close to the nasal openings. This is also true with the upper, rear surface of the tongue. There are very few truly nasal sources of halitosis. The only remotely common ones are a foreign object or sinusitis, and both of these can be cleared up relatively quickly. If the odor persists after this, it isn't from your nose or sinuses. Some have suggested allergic rhinitis as a cause of nasal halitosis: I'm very doubtful of this.

-If you have had chronic bad breath for months or years that doesn't let up even an inch with more aggressive tooth brushing, mouth washing (Listerine, chlorhexidine etc.), flossing, or tongue scraping, or nasal irrigation and antibiotics in the case of noses, it's almost impossible that any magic gum or wonder herbal supplement or the like is going to be the cure, and more likely than not you have a problem that requires some sort of surgical intervention. The reason is some part of your anatomy is formed in a way that is either trapping something it shouldn't be or preventing its proper cleaning or both. Luckily all the procedures that can fix bad breath can be done on an outpatient basis and even without insurance cost at most a few thousand dollars. It's a worthier effort to put time and money into these procedures rather than spend a lifetime of income in misery, trying one snake oil cure after another. Based on my experience, these are the main types of surgeries that have good potential for curing otherwise totally incurable bad breath, ranked in order of most likely to resolve your problem first:

-tonsillectomy
-impacted wisdom teeth (or even 2nd molars if they're impacted) extraction
-corrective gum surgery (to repair gum structures and get rid of bacterial pockets causing odor)
-FESS (surgery to allow better sinus drainage)
-deviated septum repair

-Bad breath originates in the mouth, so that's where one should keep his or her attention. While it's true that certain hormone deficiencies and organ diseases can give one a chronic breath odor, these are usually easily identifiable and not the type of odors (fruity breath, fish breath etc.) members here suffer from anyway. In my experience, the further you get down the digestive tract from the mouth (i.e., esophagus, stomach, colon) the less likely the area to be the source of the odor.

-Most websites and books will tell you that bad breath is caused mainly by bacteria on the upper, rear of the tongue. But what they don't tell you is that this refers mostly to acute bad breath, not chronic bad breath lasting months and years, and certainly not the kind that doesn't improve with tongue scraping. Some can get post-nasal drip and have mucus on the back of the tongue, but it gets swallowed sooner or later in a few minutes. And while bacteria breaking down food on the tongue thrive on no oxygen, one eventually has something else to eat or drink again and they die again. The point is that the mouth is too active a place for these bacteria to be causing bad breath 24/7, especially if one is brushing and using a tongue scraper.

-As someone who regularly sees a dentist and did not have gum disease, but who detected no less than 3-4 distinct foul odors from different areas of his gums after having wisdom teeth extracted, I've come to conclude that our gums are a very underappreciated source of chronic bad breath. Our gums act like a sponge for everything we eat and drink and the bacteria that feeds on it. They are quite possibly the single nastiest body tissue capable of producing bad breath. Insidiously trapped bad breath unleashed suddenly from bacterial pockets and growths in your gums can knock people dead on their noses from the far end of a hallway, 10-20 feet away: something no sinusitis nor tongue dorsum could ever do. Consider your gums as the probable origin of your halitosis especially if the bad breath odor you detect strengthens or worsens when you try to chew on gums or mints or other hard foods. Respect the gums. Fear the gums. Keep the gums happy.

That's the end of it, more or less. I've tried to be as thorough and detailed as possible so that someone may benefit from my experience. Anybody wishing to contact me privately with further questions etc. can use the e-mail feature on the site.

Good luck, my friends!

Posted: Sat May 24, 2008 12:00 am
by sweets07
thank you for sharing this great story. i am so very pleased that you have made it to the other side of this horrible experience called halitosis.

i have pockets behind my wisdom teeth that i can stick my tongue in, so i will consult my dentist which i haven't seen in about a year.

Posted: Sat May 24, 2008 1:53 am
by Jimi Stein
nice post, I am glad you ar almost cured, I only have one wisdom toosh that has no pockets.

Yes gums might be the big factor but how to cur it I dont know, my gums are healthy no pockets at all

Posted: Sat May 24, 2008 3:14 am
by perrymason
thank you for sharing :)

I have a nasal odor (but I have post nasal drip) and i'm pretty sure my soft palate + throat are the sources of BB. Interesting post, thanks again for posting.

Posted: Sat May 24, 2008 3:45 am
by Jimi Stein
but they guy has some good thoughts, if the bb was coming from throat we would smell the same from nose as from mouth I think

Posted: Sat May 24, 2008 10:52 am
by Snobuni
Sorry to be dim, but the two big holes behind our teeth in the top of our jaws are our salivary glands aren't they? I've got unerrupted wisdom teeth in my top jaw, but I don't think I have pockets or skin flaps, what do these look like? :)

Posted: Sat May 24, 2008 1:56 pm
by spygirl
Cured, I am happy for you. One less lonely people in the world at last. I'll pray for you.

Btw, why is your oral surgeon 99% skeptic about the procedure working for you? Have they done any form of xray on your mouth pre-extraction? The reason I ask is because I have a wisdom tooth that is a little impacted I think. However, after xray my ortho said it is not the cause of my bb.

Posted: Sat May 24, 2008 3:59 pm
by greenman
interesting, i had all 4 molars removed at once which was greatly painful =[ and laying in bed one day I had the most painful acid reflux in my life. water couldn't bring it down, so i just slept through it, a few days later i notice my bad breath comes and goes. eventually it seems contained.

now i still do feel it, it's like my insides can't get enough air, i realized smoking has a part in this so that i quit which isn't easy and i may switch to dip tobbaco but maybe not =]

the things i do now is, i drink water only through a straw, i drink all liquids only through a straw which helps drain upper regions of my nasal/throat? I'm not sure but i feel it, it feels clogged and if i drink water through a straw i can make it feel less unclogged.

Posted: Sun May 25, 2008 4:36 am
by Cured
Snobuni wrote:Sorry to be dim, but the two big holes behind our teeth in the top of our jaws are our salivary glands aren't they?
Salivary glands are something else entirely. But wisdom teeth are the last four teeth, the very furthest back along each row. When you have them extracted you will be left with four 'holes' (empty sockets) where the teeth used to be. This is what I was referring to.
I've got unerrupted wisdom teeth in my top jaw, but I don't think I have pockets or skin flaps, what do these look like? :)
It largely depends on the angle the wisdom teeth have descended with. Every person's is different from the next.

Posted: Sun May 25, 2008 7:11 am
by Cured
spygirl wrote:Cured, I am happy for you. One less lonely people in the world at last. I'll pray for you.

Btw, why is your oral surgeon 99% skeptic about the procedure working for you? Have they done any form of xray on your mouth pre-extraction? The reason I ask is because I have a wisdom tooth that is a little impacted I think. However, after xray my ortho said it is not the cause of my bb.
spygirl wrote:Btw, why is your oral surgeon 99% skeptic about the procedure working for you? Have they done any form of xray on your mouth pre-extraction? The reason I ask is because I have a wisdom tooth that is a little impacted I think. However, after xray my ortho said it is not the cause of my bb.
Thanks for your kind words and sentiments! Likewise I pray for each of you...

To answer your questions, the oral surgeon did take a pre-extraction panoramic x-ray of my whole mouth when I went in for my official evaluation (the visit prior to surgery). My wisdom teeth were moderately to severely impacted.

The oral surgeon was virtually sure that the extraction wouldn't improve my breath for two main reasons:

A) teeth don't inherently cause odor, so logically speaking, keeping or removing them should not affect breath odor.

B) In his long experience he had seen people wishing to remove their wisdom teeth to cure all kinds of ailments, from migraine headaches to you name it. In short, my proposal was a stretch for him to hear, because I don't think he listened to me effectively about the unique nature of the halitosis that I was complaining of. In his mind he was thinking of more the acute bad breath that everyone suffers from periodically.

I tried to explain in as much detail as possible about why this bad breath was anything but normal or common (ie, my reasoning was that this was an uncommon bad breath and so would probably require an uncommon solution), and only at this point did he finally relent, but only reluctantly (again, probably because he was thinking more in terms of the common bad breath everyone gets...in which case I'd have agreed with him that extracting teeth wasn't going to cure that kind of breath).

Dentists and ENTs, though they have a basic experience with typical breath odors, most likely cannot well handle the exceptional case that many to most bad breath sufferers here are (would we be here otherwise?). Cases like ours tend to fall between the cracks in the training and study of even the best breath-related professionals. It became clear to me after several visits to my ENT and dentist and thorough discussions with them that although they were happy to keep trying conventional treatments according to their training and knowledge, that they hadn't the foggiest idea what was causing it or how to really attack it, and that they might very well exhaust every avenue and still fail to resolve it (my ENT just about did!).

It's also worth bearing in mind that my case was especially insidious in the fact that the odor seemed never to be detectable, much less bothersome, anytime I went to see them (and believe me, you have no idea how up the wall this drove me, and how much it contributed to my depression). This made it impossible to identify even if they could have identified it. I believe my ENT once was able to detect it, since he said he detected an odor, before promptly misdiagnosing it as tonsillitis (leading to my tonsillectomy). But he could never detect anything after that, though it remained ever-present to me and everyone else around me.

In any case, had I left my fate in the hands of dentists and ENTs I know I'd still be suffering today. But for me my life grew so miserable that wasn't an option.

Posted: Sun May 25, 2008 11:05 am
by Larc400
Hi, great info O:)

May I ask:

1) When you used to floss in the area round your wisdoms, was there a detectable smell?

2) Did the back of your tongue also have an aroma (i e when sticking a few fingers back there, letting them dry and then checking the odour)?

Thanx!

thank you

Posted: Sun May 25, 2008 10:49 pm
by sean1979
Thank you for telling us your story. I would've never thought of my wisdom teeth being the culprit of my problem, but the logic makes so much sense in my situation. I have taken out my tonsils last year and it has helped tremendously but not 100%. I have since felt hopeful and positive about being cured completely, but never did I think 1 second about my wisdom teeth having anything to do with bad breath. I always thought maybe the tonsillectomy wasn't done completely right or that my ent specialist was not meticulous when observing my sinus, nose, and throat areas.

I have always wondered why my nasal discharge or mucous did not smell if the smell was coming from my nose. Sometimes my stubborness and hope get in the way of my logic. If something inside your nose doesn't stink, then nose is not the problem. If something inside your mouth stinks, there is something wrong with your mouth. Now that I read your story, I am going to stick by this fact. I am going to definitely get my wisdom teeth out. Thank you for your story. I haven't been this confident about a possible cure since my tonsillectomy.

Posted: Sun May 25, 2008 10:51 pm
by sean1979
I forgot to ask. How many of you still have your wisdom teeth? If you don't, have you had your tonsillectomy? How many of you have taken out your wisdom teeth and tonsils?

Posted: Mon May 26, 2008 4:54 am
by Cured
Larc400 wrote:1) When you used to floss in the area round your wisdoms, was there a detectable smell?
In general, no, there was no odor. In the last few months before I had them extracted, however, I recall an instance or two where during flossing I yanked the floss from my UL wisdom tooth very hard and that produced the stinky water, sneeze aerosol-like odor I described in my original post.

At that time, however, I believed it was released from whatever ailment I falsely thought my nose had. It was a very quick release that was only detectable for a split second and that I couldn't ever reproduce a second time.

Of course it later turned out the odor was in fact from around that UL wisdom tooth (see my post).
2) Did the back of your tongue also have an aroma (i e when sticking a few fingers back there, letting them dry and then checking the odour)?
No, it did not. I often tried the touch-dry-and-sniff test on various parts of my mouth and it never produced any detectable odor.

Re: thank you

Posted: Mon May 26, 2008 6:35 am
by Cured
sean1979 wrote:Thank you for telling us your story.
You're very welcome! It's something I felt obligated to do because of the potential it had to help others who were suffering from my same case or a similar one.
sean1979 wrote:I always thought maybe the tonsillectomy wasn't done completely right or that my ent specialist was not meticulous when observing my sinus, nose, and throat areas.
I'm glad to hear that your tonsillectomy helped tremendously, because it sure didn't change anything for me. I had gotten my hopes up so high and endured ten days of excruciating post-op pain and sleepiness from the oxycontin in order to get rid of my problem, only to realize slowly and painfully over the weeks that followed that it wasn't diminishing in the least and that it wasn't going to go away.

Sometimes the adenoids too can trap food debris and swell up with bacteria and pus and cause odor much along the same lines of the tonsils. These might be another avenue to investigate in case you didn't have them out with your tonsils. My ENT checked on my adenoids during the tonsillectomy and told me afterward that I naturally had no real adenoidal tissue to speak of.

Good luck and hope you'll be better...