Dr. Hazenfield -- Ear, Nose, and Throat Doctor in Hawaii

Halitosis

Hugh N. Hazenfield, M.D., F.A.C.S.

Halitosis (or bad breath) is an obvious social problem with many potential deleterious consequences, including job security, friendships, and even effects on love life.  If you suffer from halitosis, even your best friends or spouse may be hesitant to tell you.  Once the cause is found, it is usually treatable!

• Causes of halitosis:

  Potential causes of halitosis include the following in approximate descending order of frequency:

   

  • Gastroesophageal reflux disease (See my webpage "Reflux Disease" on the navigation menu below for further information.)

  • Laryngopharyngeal reflux disease

  • Hiatal hernia

  • Chronic cryptic tonsillitis (foul-smelling food debris and bacteria in the tonsils)

  • Chronic sinusitis

  • Infected Tornwaldt's bursa (infected pocket in throat behind the nose)

  • Dental and periodontal disease

  • Chronic lung disease (usually in elderly individuals)

  • Cancers of the nose, throat, and voice box

• Evaluation:

  The evaluation of halitosis is usually first by an otolaryngologist and possibly a dentist.  Further evaluation may require  a pulmonary medicine physician and/or a gastroenterologist.

   

  • Otolaryngologist: 

    The otolaryngologist will evaluate the upper aerodigestive tract, including the nose and openings to the sinuses, the mouth, the throat, the part of the throat behind the nose,  and the larynx, or voice box.  Most causes are found in these areas.

     

  • Dentist:

    The dentist will evaluate the teeth and gums.

     

  • Gastroenterologist

    The gastroenterologist may be consulted to help evaluate and treat a hiatal hernia or gastroesophageal reflux.

     

  • Pulmonary medicine physician

    A pulmonary medicine physician may be consulted to evaluate chronic lung disease.

   

• Treatment:

  Treatment depends upon the cause of the halitosis, but it is usually medical.  Medications and/or dietary changes may be all that is required.  Occasionally, surgery might be required to remove the offending tonsils or properly drain the sinuses.