Bad Breath Halitosis Forum

If this post helps one person have their bad breath (halitosis) cured then I will be satisfied that I posted this. I promised myself if I found a solution that I would share it with people searching for help. I think that this will help all of you get to the bottom of the problem.
I am currently in my late 30s and I have had this problem as far back as I can remember, I think as far back as age 12 or 13.

It was “manageable” back then with things like chewing gum, mouthwash etc, but it was never “fresh” at any point during the day.
As I have become older, the problem became worse such that it became an issue in social situations with visible reactions from people in the form of sniffling, rubbing of the noses, backing up from me while in conversation, being constantly offered gum. I kept thinking if this getting worse now, how would it be when I am “old”

As everyone knows with this problem, it affects your self-confidence; it is stifling in relationships and makes you more introverted. It certainly can even make you depressed.

My issue was predominantly with oral bad breath but I suspected that I had nasal bad breath too.

At first I thought that this was all related to dental hygiene. I had my teeth cleaned every 6 months, which helped, and then I increased the frequency to every 3 months. What I noticed was a slight improvement in my breath but always feeling that there was something still “back there”, I still had the same reactions from people.

I have always had a large white coating on the surface of my tongue.

BRUSHING TEETH
Did this twice a day with every tooth brush including electric, ultrasound, and manual, with every tooth paste including pure baking soda, (baking soda and lemon)
I even tried after every meal – It did not work

TONGUE SCRAPING
I would do this every morning and night, sometimes after meals, I would remove a large amount of nasty white/ yellow stuff, I would scrape and my tongue would be pink, but there would be still a smell that came from “back there”. THE COATING ALWAYS CAME BACK in about 6 to 12 hours.


DRY MOUTH
I never had a dried mouth. I tried hydrating well; drinking all the time, lemon slices, dry mouth tablets – absolutely no effect


ORAL RINSES
I next started doing research on the Internet. I have tried virtually every mouthwash that is out there – twice daily. I remember going to house parties as a teenager and using the hosts mouth wash while I was in there bathroom to lessen the effects of my bad breath (without much success)

I tried the alcohol-based mouthwashes: not much help (“the front of your oral cavity feels clean), the problem still persists

I tried medical mouth washes “Chlorohexidine”, these are difficult to find and are powerful, oral surgeons use this to sterilize the mouth before surgery – needless to say they are strong, to my disappointment, it did not work

I tried chorine dioxide mouth washes – but still did not work

I tried “oil pulling” an old ayurvedic cleansing and detoxifying procedure, basically swishing for 15 minutes and spitting out the oil –it is interesting to note that the oil pulling with coconut oil as oil pulling has be shown to be as effective as cholorhexidine in studies of bacterial loads (I started now thinking if both did not work, then the problem is not being targeted by oral rinses)

http://www.ncbi.nlm.nih.gov/pubmed/25584309
-It did not work.

I tried gargling with saturated warm salt water, salt – a highly concentrated salt solution should be effective at killing bacteria – still did not work (probably out of all rinses - the most effective)
I tried gargling peroxide solution. Of note, bacteria that create the bad smell in the mouth are often anaerobic bacteria – that is, they do not like oxygen, and oxygen kills them. A peroxide solution – brings oxygen into their environment and should kill them. To my disappointment, it did not work.

CHANGING THE ORAL FLORA
After researching and finding out that different mouths have different types of bacteria based on different things. I decided to try and change mine to a situation where I would have less “smelly bacteria present”
http://www.ncbi.nlm.nih.gov/pubmed/16553730
I tried supplementing with bacteria that is found in people with normal breath. I supplemented with K12 chewing gum, I bought high potency powders and swished it.
-Again to my disappointment, it did not work
I tried different probiotics and it did not work


KILLING THE BACTERIA WITH ANTIBIOTICS
I tried using antibiotics that kill anaerobic bacteria (bacteria that like no oxygen and cause odors in the mouth) – Metronidazole/Flagyl – it did not work
I tried Augmentin – it did not work
I even tried gargling and swishing the antibiotics and then swallowing – Nasty taste- it did not work.
I tried using probiotics after the antibiotics at high doses it did not work.

Fermented foods: such as sauerkraut and yogurts have a positive effect of the good microbial flora in the gut but did not work for me.


VISITING THE PERIDONTIST
I wanted to be sure that I did not have any deep tartar or issues that my dentist missed so I saw a periodontist who GAVE ME 100% ASSURANCE IT WAS NOT FROM MY TEETH – OK, one more thing checked off the list.

IS IT MY STOMACH OR LEAKY GUT, DO I HAVE H. PYLORI INFECTION? do I have silent acid reflux?
I tried regular probiotics – no effect.
I tried bentonite clay – no effect.
I NEVER HAD SYMPTOMS OF REFLUX. But I changed my diet around incase I had silent reflux
I started avoiding coffee, spicy foods, oily foods, stopped eating late at night. I started taking a high dose of nexium for 6 weeks
-sadly, no improvements
- I was treated for a presumptive H Pylori infection with antibiotics – no improvement
-Finally I had a gastrointestinal expert to perform an upper endoscopy: no evidence of any refux, or ulcer or herniation
I WAS ASSURED IT WAS NOT FROM MY STOMACH or esophagus.


IS IT MY SINUSES (do I have an infection or post nasal drip)?
I had already tried antibiotics, I never had any symptoms to suggest my sinuses.
-I started with a sinus irrigator and I actually put it into my mouth and faced it up towards the adenoids (you are going to have to do a google image search on adenoids) and irrigated
TO MY SURPRISE, I had little tiny clumps of incredibly smelly material that was released – I would later realize that these are “tonsiliths” or stones
I thought I had found the cure but I still had the same reactions from people with further irrigation (and now no tonsiliths) → my irrigation was not the solution unfortunately.
I started reading about tonsil stones and felt that this might be my problem (although I HAD NEVER REALLY HAD ANY SWOLLEN TONSILS OR CRYPTS that I could see).
I read about an in office ablation of the palatine tonsils (you technically have 3 tonsil – palatine, lingual and adenoids), they would burn the palatine tonsil tissue off. What you need to know about this is that IT DOES NOT GET THE ENTIRE PALATINE TONSIL TISSUE)
Further it leaves the lingual tonsils (which can be a problem) and adenoids (which can be a problem as well) and the remnant palatine tonsil.
After the procedure (which I chose to have the ability to go back to work the next day) left, my breath improved perhaps 20% for a few days and then it was back to normal. THIS LEFT ME VERY DISCOURAGED.
I kept thinking that the problem was coming from my throat, I could tell where it was coming from – BUT I DID NOT HAVE AN EXACT SOURCE. I did more research and about tonsil tissue and found out that they can be A SOURCE OF BAD BREATH WITHOUT ANY TONSIL CRYPTS OR STONES NECESSARILY PRESENT → THIS WAS MY BREAK THROUGH AND WHEN I FINALLY FOUND SOME HOPE. I FELT THAT THE PROBLEM WAS AT THE BACK OF THE THROAT (WHERE THE TONSIL TISSUE IS, THE REASON WHY ALL THE OTHER THINGS DID NOT WORK WAS BECAUSE THE COULD TARGET THE PROBLEM. EVEN THE RINSES COULD NOT PENETRATE THE TONSIL TISSUE AND PERHAPS THAT IS WHY IT REMAINED.

I was almost misled THINKING THAT I DID NOT HAVE ANY TONSILAR TISSUE REMAINING. My palatine tonsils where still partly remaining, the in office procedure cannot remove all the tissue because it is too painful – it cannot go beyond the capsule – there was still tissue there. I ALSO HAD MY LINGUAL TONSILS AND ADENOIDS + THE REMENANTS OF THE PALENTINES.
DON’T LOOSE HOPE IF YOU HAD A LASER TONSILLECTOMY AND YOU STILL HAVE BAD BREATH; → the laser procedure may be effective more for crypts with tonsil stones but not removing all the tonsilar tissue

I researched it further and found that there is significantly high cure rate for bad breath if you have ruled out other sources and you still have your tonsils.

http://www.ncbi.nlm.nih.gov/pubmed/16553730

A lot of ENT specialists may not be aware the tonsils (even without stones and even after laser ablation) can cause bad breath.


Needless to say I had a tonsillectomy (remnant palatine, adenoids and linguals and my problem has be cured.
I cannot tell how this has changed my outlook in life.
I feel “free”. Can talk to people, more outgoing etc.

REMEMBER, YOU CAN STILL HAVE BAD BREATH FROM TONSILS IF YOU DON’T HAVE TONSILITHS OR STONES – THIS IS IMPORTANT

A lot of ENT specialist wont want to perform this procedure on an adult – it hurts and they patients reasoning (“bad breath”) is not a classic reason to do the surgery (without the presence of stones).
They may even tell you that you don’t have bad breath – this happened to me more than once.
If they do the procedure make sure they give you sufficient and good pain medication – it takes about 10 days to recover.

The purpose of writing this is that you have to be your own advocate because a lot of times if you go to your doctor or dentist or even specialist that may not be able to help you. There is not a lot of training for bad breath, there is unfortunately not that much research and so you will need to help your self.

I spent a lot of money and time. My hope for you is that if you read this you can go systematically through things, you can waste less money and time and get on with a “normal life”.

I am not a blogger, but I promised myself, because of the “pain” of this problem, that I ever get cured; I will share it with people in the hope that they can help themselves. The pain of the procedure was nothing compared to psychological pain of dealing with the problem
Good luck

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Thanks for sharing.
How long have you been cured for now?

To Finallycured25yr,

I feel my situation is very similar to yours, I tried all the other ways too.
Then couple months ago I got laser tonsillectomy on the palatines which removed most of them but there was still some left. My breath improved but I still had a problem. I have seen my surgeon again and asked him to remove the last bits by knife not laser. However he did not agree and said he can do the rest by laser but that means there will still be some left over.

Do you think I should allow him to laser as much as he can off or should I go find a ent surgeon willing to do it the traditional way and cut it with a knife from the bottom of the tonsils. In the past I have seen many surgeons and they have been not willing to take my tonsils off, also I am an adult so the risk of uncontrollable bleeding is increased.

I asked my laser surgeon to check the linguals he said they were fine, I asked him to check my adenoids and that I wanted them removed and he said theres nothing there.they seem fine.

How did they remove your palatine and adenoids with a knife?

How did they perform the lingual surgery? I thought they did that by making a cut from the side of your neck to get to the linguals to operate?

Im from the UK and it is very costly to even get consultation with a surgeon and if they do not agree to remove them then you have to find and pay for another consultation.
Would you be able to tell me details of the surgeon you saw please? you can inbox me if you want

thank you

sun123,
I feel your pain.

I was told by my surgeon that he would perform a classic tonsillectomy on the palantine remenant- that means that he takes it out, shelling it out with the capsule. Every tissue plane has a capsule. I dont think it matters if it is done with cautery or not, it shouldnt be done with a laser because that will just burn the tissue and may leave some behind. It is the tissue that smells (and not necessarily the crypts). The risk of bleeding is about 5%. I think its acceptable based on the problem.
Adenoids are taken out this way too. Linguals are a different story
You need to stop all anti-inflammatories, aspirin, vitamins etc (vitamin E especially).
Do not forget the lingual tonsils and the adenoids.
The linguals were done with coblation. It is difficult to get to the lympoid tissue in the back of the tongue, sometimes they will use a robot (but likely not needed or necessary, it wasnt used on me).
The biggest thing is getting ALL THE LYMPHPOID TISSUE OUT (tonsils and adenoids)
It might be worth it looking at other places in europe to see if you can get a consultation or in the the US. There are options with cash payments that are expensive but likely not prohibitive (guessing 5-8 thousand USD)

Original above should have cited:
http://www.ncbi.nlm.nih.gov/pubmed/20120649

To finallycured25yr,

Why did they remove your linguals? did they have tonsil stones in them? were they infected?

How long did it take for you to recover from the surgery?

All performed by general anaesthetic?

Did they have to do a CT scan first?

How did you convince them to take your adenoids out? what did they see wrong with them?
At our age (adults) they usually disappear to nothing. But I think there must be some layer of tissues or something where the adenoids once were?

Thank You

Did you have nasal halitosis aka extraoral halitosis? Or did the smell only come through your mouth?

Where did you find the info stating that tonsils can be a source of bad breath even without any crypts or stones present? I looked at the studies linked but i couldn't see it. Also how long have you been cured for now?
Thanks

I just wanted to mention the following:

It could be possible that removal of a adenoid was the cure here, as it was stated that using irrigation on that area dislodged stones.

Perhaps lingual can be a cause, but lingual is flushed so often through eating and drinking that it seems unlikely (to me) it would hold debris for too long.

Since they were taken at the same time, you it's harder to pinpoint a true cause.

So for the people on here that have had adenoids and palatine removed, maybe do some harder investigating into the lingual before going to an ENT.

It could be possible that removal of a adenoid was the cure here

I guess we will never know if it was the Palatine, Lingual, Adenoids or some combination of the three but I suspect it was the Adenoids. My story is very similar to this one. I did everything on that list plus I had my wisdom teeth extracted and a root canal tooth removed. I also had my Palatine tonsils removed BUT not the Lingual or Adenoids.

A while back, there was a thread created by 9YearsToFindCure.
viewtopic.php?t=6255
He ultimately found the cause of his bad breath to be the Adenoids. After removing them, he was immediately cured. Others followed and found their cure as well. I was ecstatic! I was all ready to schedule an Adenoidectomy, but shortly after, a string of other people had the surgery without much success. I went into a deep depression and put my surgery hopes on the back burner.

This story has renewed my hopes!

Thank you finallycured25yr for sharing!

I got my palatine tonsils and adenoids removed at the same time about 3 months ago. The bb only went away for the 10 days I had to take my post-op antibiotics. The very next day when my antibiotic cycle was done, the bad breath returned. This makes me believe it's a gut/bacterial dysbiosis.

Another key clue I discovered was that the source of this smell is from my tongue. If I take my finger and rub my gums, my finger has no smell. If I rub my tongue, then my finger smells.

Anyone else experience this? Test it out for yourself. What do you think this means?

Wow this is basically my story except my bad breath only developed the past 2-3 years. I began irrigating my nose again recently and tiny stones were coming out--i had never heard of tonsil stones or see them on my tonsils. No matter what i do, or try i could never get rid of my bad breath, even briefly but i couldn't smell my breath by scraping my tongue or licking my hand etc. Anyhow, i have my surgery this upcoming Wednesday to remove my palatine and adenoid tonsils along with a deviated septum...up until this point i was already preparing myself for disappointment, had a lot of doubt and contemplating if i would really be able to keep going if this wasn't my cure...but reading your post truly put some hope back into me and i'm trying to stay positive and optimistic from here forward. Thank you so much for sharing!!

whatdidido,

Good luck. Please provide feedback after the operation (good or bad). I will anxiously wait for the results. Thank you.

n123
I had to be my own advocate; I basically had to convince them to do it. I did the research and I felt that I knew what needed to be done. I needed to REMOVE ALL THE POTENTIAL SMELL GENERATORS
I really started thinking about linguals after I researched this site - take a look, they are in Virginia
http://www.fauquierent.net/halitosis.htm
I had a feeling it could be my adenoids too after irrigating that area and smelly material returned. Also, I got a lot of information from this web site. It is relatively painless procedure so I though I would remove this tissue as a "bonus" since I was already going to be going under anesthesia
It took me 10 days to recover.
It was done with General anesthesia
No CT scan - I don’t know how much benefit it would have been (if the saw something I would want it out, if they didn’t see anything, I would want it out)
I just asked the doctor to remove it (I asked politely - he said "yes you have a little bit of tissue there, we can do it, I would nicely insist on it). He did not really see anything wrong with it. Remember that the tissue can seem "normal" but it still smells.
Adenoids usually get smaller with time, but in some people they are still there or have remnants - if you think that this is a source, I would say go for it. It is a safe area, it is painless, you are under anesthesia (that is chance to get rid of a potentially smelly tissue even if it contributes only 10% to the smell)
I think I had nasal halitosis too (when I would get in an elevator and not breathe out of my mouth, I could sense similar reactions to people standing close by)


Corpsebreath
I think this is an area that is still being understood, but from talking to other people- They refer to the "finkelstein test" Involves pushing on the tissue and smelling the material (even in the absense of stones), if it smells the tissue may be contributing.

Stinkbomb
I am glad you have renewed hope - I think there is always an answer to a problem --> this has been one of the hardest problems to find a solution to.

Bear44.
I am assuming that you still have your lingual tonsils. I have no comment if it is your gut other than trying high potency probiotics at high doses and try using chlorophyll tablets (I
Read below and lingual tonsils as the cause (they are lymphoid tissues and can smell - I would really look into it and consider getting it removed, if it was really from your stomach, I don’t understand why the smell would discriminate and only go to your tongue and not the rest of your mouth)
http://www.fauquierent.net/halitosis.htm

whatdidido
Sounds like you have something that can be addressed and so I would be optimistic too.

This is such an informative post! I have an ENT consultation booked for Tuesday next week.

How long has it been since your operation?