Bad Breath Halitosis Forum

I was asked by Austuser regarding tonsils. Most researchers consider the tonsils responsible for about 3-6% of cases of bad breath. There is practically no research on this subject, and little to go on. One researcher presses the tonsils to smell the exudate and thinks that the tonsils are a major cause of bad breath, but others (myself included) differ with him.
Tonsilloliths (tonsil stones) are much more common than I first thought when I started doing research on halitosis almost twenty years ago. They affect perhaps 5% of the population at one time or another. They smell really bad when you crumble them between your fingers, and this often leads people to suspect that they have terrible breath as a result. But I have smelled people with tonsilloliths who don't have bad breath.
Again, I am a microbiologist, not a physician, but having your tonsils out as an adult is not a simple painless procedure, and I would avoid it unless you are absolutely certain that this is the cause of your bad breath. While on sabbatical at U of Toronto in 1990, I met a woman who had had all her teeth removed because she thought her bad breath was coming from them. She still had terrible bad breath when I met her, but it was coming from her tongue.
So my recommendation is to keep your tonsils in place, unless you are convinced beyond any doubt that the odor is coming from them and not your tongue, etc.
Finally, there is a procedure in which the crypts of the tonsils are heat sealed by laser. I don't know whether it works or not, but at least it leaves a good part of your tonsillar tissue intact and is probably better than having them removed.
I wish I could be more helpful.
And finally thanks to all the constructive people out there who realize that in the current state of your site, most academic people are not going to take you seriously. I'm still hoping that you will realize this soon and accentuate the positive. Bad breath is indeed a big problem. But to solve it you need cooperation and discourse, not hate and spite.

So that white gunk on the tongue couldn't be coming from tonsil stones? Or could tonsils cause post nasal drip for some reason?

I don't know what to think of this. I know you've screwed some people, but I do appreciate that we get professional's comments.
Anyway, I had my tonsils operated and it did help my breath a little, took away the awful rottening smell. I still have bad breath, but at least it's not that bad. And that pain is easily manageable with tramadol, it's nothing compared to what we go trough every day.

mel rosenberg wrote:I was asked by Austuser regarding tonsils. Most researchers consider the tonsils responsible for about 3-6% of cases of bad breath. There is practically no research on this subject, and little to go on. One researcher presses the tonsils to smell the exudate and thinks that the tonsils are a major cause of bad breath, but others (myself included) differ with him.
Tonsilloliths (tonsil stones) are much more common than I first thought when I started doing research on halitosis almost twenty years ago. They affect perhaps 5% of the population at one time or another. They smell really bad when you crumble them between your fingers, and this often leads people to suspect that they have terrible breath as a result. But I have smelled people with tonsilloliths who don't have bad breath.
Again, I am a microbiologist, not a physician, but having your tonsils out as an adult is not a simple painless procedure, and I would avoid it unless you are absolutely certain that this is the cause of your bad breath. While on sabbatical at U of Toronto in 1990, I met a woman who had had all her teeth removed because she thought her bad breath was coming from them. She still had terrible bad breath when I met her, but it was coming from her tongue.
So my recommendation is to keep your tonsils in place, unless you are convinced beyond any doubt that the odor is coming from them and not your tongue, etc.
Finally, there is a procedure in which the crypts of the tonsils are heat sealed by laser. I don't know whether it works or not, but at least it leaves a good part of your tonsillar tissue intact and is probably better than having them removed.
I wish I could be more helpful.
And finally thanks to all the constructive people out there who realize that in the current state of your site, most academic people are not going to take you seriously. I'm still hoping that you will realize this soon and accentuate the positive. Bad breath is indeed a big problem. But to solve it you need cooperation and discourse, not hate and spite.

even with no tonsil stones occupying a crypt, by dabbing a cotton swab in there, I can detect a horrid odor..

I'm no expert of course, but it seems more than possible to me that a tonsil crypt is where the worst of the bacteria form, and then may spread to the rest of the mouth throughout the day.. the crypt isn't washed out with saliva and gets very little contact with the outside air coming in..

no matter how clean we clean our tongues, doesn't it seem likely that the nasty stuff existing in the tonsil crypts could just throw some more of that bacteria right onto the tongue??

Dr. Rosenberg:
Does having one`s tonsils removed make the throat more susceptible to future bacterial infections?

Dr. Rosenberg, what is your take on acid reflux as a culprit for bad breath?

I'm pretty sure I do not have chronic bad breath (though I get my share of bad days), but I seem to have random bursts of horrible odor emanating from mouth. Usually when I'm talking, though occassionallly it happens when I'm silent also. Simply, the odor is similar to really bad flatulence and I'm pretty darn sure it's not coming from the other end.

I saw an ENT recently and he said that this odor was probably from when I refluxed so that's why I do not have chronic bad breath. I thought I had a bad post nasal drip problem, but he said that mucous wasn't coming from my sinuses but from my throat producing phlegm to protect itself from acid.

He also said my sinuses didn't look that bad, but I know if I go a day without nasal irrigations, I have bits and pieces of pasty white bits when I do irrigate. It goes to light yellow and green if I do not irrigate for a few days

Anyhow, just background to preface my question on acid reflux. What has your experience been when dealing with reflux as a cause?

I floss, brush my tongue and use a proxy brush regularly. My two most recent dentists have complemented me on the fact that I have a very clean tongue and the fact that they hardly had to do any cleaning between my teeth because I'm so diligent with flossing (practically after every time I eat). Yet I can't seem to shake this horrible odor that comes and goes. Sure it's a not a chronic issue but when it pops up when you're a car with people, discussing business in a meeting, on a date, talking to a friend on the train...after two years, it's definitely affected my self esteem.

jc wrote:Dr. Rosenberg:
Does having one`s tonsils removed make the throat more susceptible to future bacterial infections?

I heard that, in some countries in Latin America, physicians are no more removing tonsils for discovering that the absence lof them let our throat susceptible to bacterial infections.

I think tonsils act as bacterial filter or something so if they`re removed then it may cause more harm than good. Maybe Dr. Rosenberg could shed some light on this.

thankyou for the advice.

I already told my ENT that i would not be removing my tonsils, rather i will just be fixing my deviated septum.

I am pretty certain my tonsils dont smell because i swab them with a cotton tip and smell nothing. Only when there is a tonsil stone in there and i swab them do i smell the horrible tonsillolith smell. Once i cough or pick it out, the smell is gone.

I am a mouth breather more often than a nose breather. When i am on my computer or watching tv i breathe through my nose, but when i am active i breathe harder and tend to breathe OUT through my mouth because if i did through my nose i would snot everywhere. I have nasal congestion due to a deviated septum and unknown allergies.

My bad breath is more like my father's. While i dont talk about it with him, he has periodontitis, and his breath is of a yeasty, sometimes fecal smell. I dont have that condition, but if I dont use the probiotic system or tongue cleaner, i can "taste" his kind of bad breath, if that makes sense. But all i need to do is keep up my oral hygene routine and i am fine. I still get self concious so when i am close to people i turn my head or make sure that i dont breathe on them, even though i am probably fine.

I dont like the fact that i have to tongue clean twice a day or before i go out and carry out all these steps before i meet a girl, my friends call me "a very weird boy" lol. But hey, im sure a diabetic doesnt like to prick themselves with a needle 10 times a day so who am i to complain.

thanks again for the advice, im very embarrassed for the site and the picture of you, hope it comes down soon.

mel rosenberg wrote:
Finally, there is a procedure in which the crypts of the tonsils are heat sealed by laser. I don't know whether it works or not, but at least it leaves a good part of your tonsillar tissue intact and is probably better than having them removed.
I wish I could be more helpful.

I had my (palatine) tonsils removed circa ten years ago, to little or no effect. But what about the lingual tonsils? (IMAGE)
Would it be possible to even out that lingual tonsil texture with the help of laser? Surely a lot of bacteria hide back there - I guess it's part of the general area normally referred to as the posterior part of the tongue, though scraping that texture is not very effective at all.

If the main source of the volatile compounds is that far back, I guess nasal air aswell as oral would smell more or less the same..?

Please shed some light on this, Prof Rosenberg.

Yours,
Karl

dude the professor aint commin back. hes the only one Jimmi left as a monkey on the front page after "toning" it down. i almost laughed out loud, this place is too funny

I've just been busy with other matters.
What you refer to as the lingual tonsils (or posterior tongue dorsum) is the major site of bad breath, according to Grapp (1933) and most researchers since then . I'm not in favor of scraping there or anywhere on the tongue, rather, I recommend gently sweeping the mucus from there, if you can get that far back with a plastic tongue cleaner. Harsh scraping is just going to damage the tongue. But by gently removing the debris and mucus, you are removing their source of nutrition and putrefaction. Other options for cleaning that area are gargling right before bedtime, and making sure to eat rough foods, particularly at breakfast.
No one has done any research to check whether people who have had their tonsils out have less bad breath statistically than those who haven't, and to see whether the size of the tonsils (or other parameter) is related to bad breath. It's a project well worth doing.
Yes, if the odor is from the back of the tongue, some small component may be from the nose, but the large majority is going to be from the mouth, particularly during speaking. I think that what happens is that the air travels over the surface of the tongue when speaking, and furthermore the movement of the tongue adds to the level of molecules released. That is why when checking someone's breath we also ask him/her to count aloud to see whether that increases the odor. Sometimes indeed it does.

Thank you for the advice re: not being to harsh in the cleaning of posterior tongue dorsum. I don't think this is very well known; people are just told to "brush the tongue as far back as possible". Would you say it would be (at least theoretically) possible to use laser in order to even out that surface in order to stop it being a bacterial hiding place..? I'm sure many patients suffering from severe halitosis would consider such an operation even if it may have drawbacks... ...what's your thoughts?

Speaking from personal experience, I do get frequent comments on something smelling when I'm not even talking. Not always a bad stench. For example, if I've gargled with a mint flavour rinse, people around me will ask 'is someone here chewing some super strong gum', or if I've eaten certain foods I get the 'did someone let one off' etc etc. I guess this means the air passing by that general area gets sufficiently mixed up with the VSC:s to make it a very noticeable smell even when nose breathing... .

You know the smell that spreads around certain people who have just been to the dentist? They smell of 'dentist' for hours after they've been, even when they're not talking. I guess it's similar to that, albeit odours of a more offensive character

I hope we can agree that there is no mouth wash out there which can give certain severe cases more than very temporary relief, so a more radical approach would be welcome. Is laser too far fetched..? Any other ideas ?

Thanks very much for your time.
/Karl

Larc400 wrote:Thank you for the advice re: not being to harsh in the cleaning of posterior tongue dorsum. I don't think this is very well known; people are just told to "brush the tongue as far back as possible". Would you say it would be (at least theoretically) possible to use laser in order to even out that surface in order to stop it being a bacterial hiding place..? I'm sure many patients suffering from severe halitosis would consider such an operation even if it may have drawbacks... ...what's your thoughts?

Speaking from personal experience, I do get frequent comments on something smelling when I'm not even talking. Not always a bad stench. For example, if I've gargled with a mint flavour rinse, people around me will ask 'is someone here chewing some super strong gum', or if I've eaten certain foods I get the 'did someone let one off' etc etc. I guess this means the air passing by that general area gets sufficiently mixed up with the VSC:s to make it a very noticeable smell even when nose breathing... .

You know the smell that spreads around certain people who have just been to the dentist? They smell of 'dentist' for hours after they've been, even when they're not talking. I guess it's similar to that, albeit odours of a more offensive character

I hope we can agree that there is no mouth wash out there which can give certain severe cases more than very temporary relief, so a more radical approach would be welcome. Is laser too far fetched..? Any other ideas ?

Thanks very much for your time.
/Karl

I am sort of convinced that it's dryness in sinuses that is the cause of your bb, you were a smoker. It could be a conncection. about dentist -When you are at dentist the mucuos being affected and more dryer, maybe the protective mucuos that prevent odour from tounge dissapear becose of the whole dryness. but of course it's just my thoughts. But convinced thoughts btw answer my pm