Bad Breath Halitosis Forum

Halitosisux,

Here is my response to your thoughts on tongue coating being caused by dead skin particles shed from the papillae which are then decomposed by fungi.

I think there are three possible main causes of the white tongue coating that so many bad breath sufferes have:

1) Some problem in the sinuses, such as a mild infection or irritation, that causes post nasal drip. That dripping mucus whould hit the back of the tongue, and if it produces bacteria, that could easily spread forward on the dorsal surface of the tongue.

2) The anaerobic bacteria on the surface of the tongue are themselves producing the white coating as a protective layer to keep the oxygen and the antibacterial components in the saliva from getting to them. This is why I think we have to do tongue scraping, not because the coating has an odor, but because it might be protecting the anaerobes.

3) The tongue coating might be caused by some problem in the intestines. This could be an overgrowth of the wrong kind of intestinal bacteria or some other problem (parasites, spastic colon?) This would manifest itself in some kind of abdominal distress, such as bloating, cramps, irregular bowel movements, loose stools, etc.) I don't know the mechanics of how chemicals can move from the intestines to the mouth, but you have mentioned it might be done through the saliva.

Here is why I have a problem with the tongue shedding theory: If the papillae are shedding cells, then that would be a normal process for all human beings. The dead cells would be washed away by the saliva and the chewing of food. In all probability we would not even be aware of it. And if there were a fungus in the mouth, that would be a very serious health problem which could be diagnosed by a doctor. Fungi are very dangerous; they can spread and in the wrong part of the body they can kill you. So I think that if BB sufferers had fungi in their mouths, this would have been discovered a long time ago and be recognised as a known medical problem.

Additional comment: We don't know for sure that there is a link between tongue coating and bad breath, and there are other causes of bad breath.

As far as the connection with tongue coatings and BB are concerned, there's either a reason that causes a tongue coating which results in having BB, or there's a reason that causes BB which results in having a tongue coating. Or, by coincidence, there's a reason that happens to cause both.

Consider that its very common during religious fasting to quickly end up with a heavily coated tongue and bad breath, the accepted reason being the combined effect of lack of abrasion that would normally have taken place from chewing food, and the effects of mild dehydration from going without food (and the water contained in food). When a person is sick, this is basically the same reason why a tongue coating tends to develop.

With a tongue coating in place the anaerobic bacterial activity beneath that coating will increase resulting in an increase in the production of foul chemicals, leading to a degree of bad breath.

Of course it's possible that intestinal/digestive problems related to intolerances, infections or infestations or possible enzyme deficiencies can lead to the production of foul smelling chemicals inside the intestines, similar or even identical to those produced by oral bacteria, which find their way into the mouth via saliva and mucus, the same pathway that occurs with TMAU and other bloodborne odours.

As we've discussed before, fungi are part of any microbial flora. The mouth, intestines, vagina and the skin for example. The presense of fungi in these areas is one thing, the invasion of tissues due to temporary flora imbalance (as commonly occurs during a course of antibiotics or to a newborn child) or immunodefficiency is another.

Regarding PND, obviously, if there is foul smelling post nasal drip/discharge from a sinus infection or irritation, then this foulness is going to lead to some degree of tongue odour and bad breath. But, lots of people have odourless PND and no BB, so I think this type of clear odourless PND may be purely an exacerbative factor in cases where BB is due to other causes.

And then we need to consider that some people have coated tongues, but they dont have BB. This could signify so many different possibilities, ranging from immunological differences to differences in bacterial profiles. It may simply signify that chronic type-1 BB type of odour production has nothing whatsoever to do with oral bacteria, but that the odourous chemicals are being produced elsewhere and they find their way into the mouth as has already explained.