confused about the source of my bb, need help

[bbsufferer]

Hello everybody,

I decided to register on this website and exchange some opinions with people suffering from bb or at least my type of bb. I read many of the posts and the more I read, the more confused I seem to become from the variety of causes to one's bb. To cut the story short, my experience with bb has been as follows:

For as long as I can remember, I have always had an unpleasant taste in my mouth. In fact, when I was a small child my brother used to make fun of me and my bad breath. I guess that played its part and made me conscious about my breath from a very young age. All the way through high school and uni, I have been conscious of this fact and have avoided talking face to face to people. The thing is that I wasn't extremely worried about this until recently, as people would rarely, if ever, make a remark about me having bb. However, I have always known that the bb was there and I am now desperately trying to find a cure for it.

When I first started researching the possible causes of bb, I found that many of these causes were present in my case. To begin with, I had gum disease which I have now brought under control, and by gum disease I mean serious gum bleeding. Btw, forgot to metion that Im 29yo male. Also, my right tonsil has a huge crypt and I can insert the whole tip of a cotton bud in it, this is how I clean it from the gunk that accumulates inside and the tonsil stones. I also have constant post nasal drip and one of the nostrils is constantly obstructed if not completely blocked. Through this website I also found out that wisdom teeth could cause bad breath. In my case my lower right, despite still encased in bone, produces foul odour from the site (upon rubbing my finger or pressing with a cotton bud). There is one other thing that I don't know whether I have it or not, and this is reflux. However, I have a strong reason to believe that I might be suffering from silent reflux due to the constant clearing of my throat, occassional feeling of a lump being stuck there and possibly the unpleasant, at times bitter taste in my mouth.

As you can see, I tick many of the above boxes. Needless to say, my oral hygiene is perfect and my dentist has also confirmed that on many occassions. This, of course, eliminates the possibility that my bb could be caused by gum disease. And here lies the big question. Which of the other possbile causes is the real culprit. Just before I go into more details, Id like to mention that I have asked a few of my friends and family to check my breath by breathing straight into their faces - my mum and one of my best friends. They both said they could not smell anything. My brother also told me he could not smell my breath during any of our conversations. As a matter of fact, they all believe I have developed a paranoya and am worrying too much about it. I am sure many of you guys have been trhough the same type of experience. But I know that this unpleasant taste in my mouth is always there and I can smell it myself. How do I do this? I lick my wrist and wait for 30 odd seconds and then smell the area. The smell is not extremely bad but it is not pleasant either. I also rub my tongue against my upper lip and then sniff if. The smell is not nice and at times can be quite bad. I have taken metronidazole on a few occassions in my life and for completely different reasons. It was the first time I actually realized what it feels like to have a fresh breath all day and all night, even without brushing. But as soon as I finished the course, the nasty taste would come back.

My gut feeling is that my bb and unpleasant taste in my mouth is being caused by a stomach condition and possibly silent reflux. I am more willing to accept this as a possible cause for a few reasons: I have always eaten fast and rather than chewing my food completely I used to drink juice everytime I swallowed my food. Secondly, even though I can detect foul odour from the area of my unerupted wisdom tooth, this cannot really explain the fact why I had bb and unpleasant taste many years before a wisdom tooth could have formed. Also, during many hours of internet research I have learnt that post nasal drip could actually be caused by certain stomach conditions, such as reflux or even candida. Speaking of the latter I also got tested for it by providing a stool sample, and it came back negative. Finally, I have some typical symptoms of reflux, such as constant clearing of the throat and occassional feeling of a lump in my throat. And yes, my tongue is always coated and the only time I saw my tongue turning pink was when I took metronidazole.

Well, thats my story cut short. I could go into much more details about the diet that I am on and the different and alternative medicine methods I have used to try and find out what the reason for my bb is. I would really like to hear your thoughts and share my experience with people who share this particular case of bb. Thanks for reading this long post and hope to hear from you guys soon.

[halitosisux]

Hi there. What age did you have gum disease and how long did it last? How did it start?

[bbsufferer]

Hi and thanks for replying,
My gum disease started at a young age, probably my early teen years. I would brush my teeth and there would always be blood. However, noone ever suggested to me how important it was to floss on a regular basis. I have been doing this and also using interdental brushes for the past 3 years and the improvement has been tremendous. I have some pockets here and there but my dentist told me they were within the limits and one of the pockets is actually between the wisdom tooth and the lower right molar. Forgot to mention that my gum disease is probably genetic, as my mum has it too and it has now developed into periodontal disease.

[halitosisux]

Have you ever considered trying a waterpik type oral irrigation device?

I can certainly relate to your childhood experiences. I never remember brushing my teeth during childhood, so it probably smelled like the standard type of bad breath caused by laziness. I actually didn't care about it at the time though, not one single bit. I couldn't smell anything, so it was like a denial. It wasn't until one day doing my school mock exams that I started noticing whiffs and began to feel aware of the shit taste in my mouth. My nose was always blocked up too up to this point, until my face grew and things opened up a little and I could actually smell things. This, coincidentally, was also when my wisdom teeth started erupting, and my breath really became awful. Ironically, it was also when I became meticulous about my oral hygiene, but by now it was completely futile and no amount of oral care could get rid of the stench in my mouth.

If you think you might be suffering with reflux, it might be worth trying Zantac for a few weeks. Make certain that you've ruled out helicobacter pylori too and that you take practical steps that are known to help with reflux problems.

Your other issues, like your PND, are likely to be only exacerbating any underlying issues that might be causing your bad breath.

Have a read through this thread:-
viewtopic.php?t=2057&highlight=waterpik

I agree with you that gum disease susceptibility is probably genetic. Possible genetic determinants could be variation in some specific part of the immune system or the specific resulting profile of bacteria which colonize your mouth, unique to every mouth. There is a proven link between certain types of bacteria present in the mouth and gum disease. It might be worth looking into the various types of probiotics which are claimed to help.

For the reasons I've mentioned above, I think we all have a certain susceptibility to having bad breath. Those gum pockets you have might be causing your bad breath, yet the same identical situation in someone else's mouth may be completely harmless to them.

[bbsufferer]

I actually have an oral irrigator - a panasonic one, which I believe is better than waterpik, as I made the comparison when bying it. For some reason I stopped using this, as it didn't make any difference. I will probably resume very soon.

As for the acid reflux, I will visit my GP within the next few weeks and ask for a referral to a specialist ENT. I am pretty sure there is something down there, as during previous examinations doctors have told me my stomach was kind of inflamed. If acid reflux is confirmed, then this could be a possible cause for my bb and funny taste in my mouth. I have also recently started modifying my diet to relieve any possible reflux symptoms. I can notice a slight improvement, but am not sure if it's me or it is really helping. Anyways, will keep trying. There is one thing, however, which I do not understand and it is the exact link between bad breath and reflux. Is it that the latter changes the ph in your mouth to more acidic and therefore creates the perfect conditions for bad bacteria? Or is it something else?Do people with acid reflux have bb coming straight from the stomach or is it through bacteria overgrowth in their mouth/throat? I have noticed that when eating more alkaline foods, such as almond butter, the taste in my mouth improves and the coating on my tongue decreases a lot. What do you think?

And finally my biggest worry - my lower right wisdom tooth. As I mentioned previously, I can detect a foul odour originating from that part of my mouth and more specifically from the area between the 2nd and 3rd molar. My wisdom tooth is still encased in bone from what I can see on the x-rays and yet there is a pocket there which my periodontist confirmed during one of my visits. He also advised me not to touch my wisdom tooth, as it was situated close to to the IA nerve and could possibly result in nerve damage. If this wasn't the case, I would have extracted my tooth ages ago. During many hours of research on wisdom tooth extraction I found out about a new technique which only removes the crown but leaves the roots in place. This has a lower risk of nerve damage, but still, it's not 100% safe. So here I am with the dilemma of whether to remove my wisdom tooth and see if it will make any difference or try everything else first and leave this as a final option. I just don't want to take this chance and find out later that it has not helped and I have put myself in a deeper s**t. I am just not 100% sure that the wisdom tooth can be causing my bb, as it has formed much later than my first bb symptoms. I was also thinking of buying some of these special syringes for cleaning gum pockets and see if this will make a difference. If anyone has used them, some feedback will be helpful. Also, before you had your wisdom teeth removed, were they fully erupted or visible. Mine all seem to be encased in bone, with the lower one having a small cyst/fluid, whcih apparently facilitates extraction, if I ever decide to have one.

Just forgot to mention that I also had a DNA test for my mouth bacteria and the results confirmed higher than usual presence of anaerobic bacteria. The dentist collected the samples from below the gum line, but im not sure whether bacteria was there because of the fact that my mouth produces a lot or simply because this is where they originally came from.

I will stop here and will be looking forward to your input on this. I will also go through the thread you posted above.

[halitosisux]

Hi, yes I've heard that the Panasonic ones are better. I've never used one before, but I did try making my own syringe which wasn't a very effective solution, except for delivering various antibacterial substances where I wanted them to go.

I'm a bit confused why you don't think your irrigator would be suitable for your wisdom tooth pocket, though.

Regarding the acid reflux, have you ruled out helicobacter Pylori? (sorry if you've already mentioned this).

Problems relating to the stomach can manifest in lots of different ways. If you produce normal amounts of acid and this refluxes into your esophagus, you'll tend to suffer with heartburn and discomfort. If you are producing very little acid (which is not easy to find out without going through tests) and you suffer with reflux, you might not even notice it. Also, infection with helicobacter can sufficiently reduce your levels of acid (if you are already not producing much) to cause achlorhydria. This can then result in small intestinal bacterial overgrowth, which can lead to symptoms of IBS and cause bloodborne bad breath.

Infection with helicobacter can also stimulate the stomach into producing more acid as a reaction to try to kill it off. But because the helicobacter is able to survive the acidity it just forms a vicious circle.

Then there's silent reflux, where vapours from the stomach rise upwards and cause damage to delicate tissues. This stimulates the mucous membranes, including those in the sinuses into producing more mucus and causing congestion. Silent reflux can only really be diagnosed vaguely from these symptoms. There is no heartburn or pain, which is why it's known as silent.

There are numberous ways in which all of this can lead to bad breath. First of all, if you are achlorhydric, then stomach contents can rot very quickly and whiffs of stench can rise up your esophagus, even without burping. If you are experiencing acid reflux, then this can rise up into your throat and affect your oral pH and alter the ecology in your mouth and throat leading to bad breath. It's possible that silent reflux may also alter the pH in your mouth and throat (and sinuses), leading to bacterial problems.

Regarding wisdom teeth, the one that was causing my problems was not just impacted, it was quite literally growing out of the rear of my mouth at a 45degree angle. It was about 70% erupted. If you look in your mouth and move your jaw around and try to imagine a tooth there moving in that area and what a trap this creates for bacteria and debris. That's why the smell from mine was so bad. Maybe that's the only time a wisdom tooth can create enough odour to cause bad breath.

I'm also not totally sure what you mean by encased in bone. Do you mean it's under the gum still? or do you mean it hasn't erupted? It's difficult for me to say. Wisdom teeth impactions can affect adjacent teeth and gum. They can cause decay, cysts, and very painful abscesses and infections.

I've never heard of this crown extraction technique before. This sounds like a viable option for you. Without knowning what it all looks like it's hard to say, but if your teeth are fairly well erupted, could the gum around them be trimmed away? Flaps of gum around impacted wisdom teeth can be trimmed away like this.

Like you, I had my doubts about whether my wisdom tooth was causing my bad breath or whether I had bad breath for other reasons which was causing the situation with my wisdom tooth to smell. And just like you, I had my doubts because I know I had bad breath before my wisdom teeth appeared. Also, the failure of my tonsillectomy to cure my bad breath a few years earlier, further compounded my negativity. I could not face the prospect of removing this tooth and finding out I still had BB. I ended up delaying it for years. It was actually easier for me to live with BB than it was to live knowing that I had completely run out of options and ideas. But I did it in the end after a number of wakeup calls and fortunately it went in my favour for a change.

There's no other option really, the only hope of dealing with this nightmare is by trial and error, establishing priorities and logically working your way through them in the order of the most likely, until you get lucky. My advice to you is to try various irrigation methods on this wisdom tooth first (and any other pockets) to see what's possible. In the meantime, focus on ruling out your stomach issues, and then perhaps consider removal whichever teeth your dentist thinks are contributing to the production of this odour you are able to detect.

[bbsufferer]

Halitosisux, a big thank you for all the useful info above!

I completely forgot about the helicobacter pylori, and honestly this never crossed my mind. Is this a pretty routine test I can request from my GP? I remember one of my flatmates had it once and they put her on antibiotics.

As for the wisdom tooth, it's totaly unerupted from what I can see in my mouth, not even a small piece is visible. Also, on the x-ray one can clearly see it is not above the bone line. But still there is a pocket there, which was confirmed by my periodontist. Anyways, will start irrigation with hydrogen peroxide, which I purchased a few weeks ago. For everyone else reading this, guys please use food grade hydrogen peroxide only, as this is the purest form and without any stabilizers and toxic materials. Especially for those who decide to mix it with water and take it internally.

On a purely different note, I just had half a pot of natural biolive yogurt and it refreshed the taste in my mouth quite a bit. You also mentioned certain probiotics that could be taken orally and to establish a beneficial oral flora. Do you have anything particular in mind that you can recomend?

Once again, many thanks and looking forward to your response.

[halitosisux]

You're welcome. Yes, very routine GP request. You can even get yourself a blood testing kit for £5 from most pharmacies. These are accurate if you feel curious to know quickly.

It sounds like your wisdom tooth might be horizonatally impacted. If so, then it's the same as any other tooth, but instead of growing upwards, it's grown on it's side because it didn't have enough room and it impacted into an adjacent molar. And even though it looks all sealed off from the outside world, the gum covering it will be so thin that the gum margin around the adjacent molar will be letting in bacteria and debris. There could be decay going on, both of the impacted wisdom and molar. And yes, as you point out, the whole area underneith is one big pocket where bacteria are getting in.

This impaction also creates stresses on both teeth which can lead to cracks and lead to decay inside the teeth. Irrigation probably wont make a lot of difference here, and infact might even irritate the situation. The last thing you'll want is for the bacteria to get in any deeper because you'll easily end up with a very painful infection. But it's worth irrigating the rest of your gums and just keeping this wisdom tooth area as clean as you can with saltwater rinses.

I've never tried these expensive oral probiotics like Bliss K-12 or the other ones which are supposed to help if you are susceptible to gum disease. I think they all offer money-back guarantees, so it might be worth giving a few of them a try. Good luck!

[bbsufferer]

As I mentioned previously, my gut feeling is that there is a stomach condition that contributes to my problem. Getting tested for H.pylori is first on my list. Will keep you posted on my progress. Thanks for your help so far.