Tongue and Bad Breath

The connection between the tongue and bad breath has been known for some time - bad breath results from the fact that certain types of bacteria are able to grow on the surface of the tongue while they are not so comfortable in many other parts of the mouth. They are anaerobic bacteria - bacteria that only thrive in the absence of oxygen. They feed on food particles lodged in the mouth, and on dead cells that are naturally sloughed off the inside surfaces of the mouth and sinus cavities. Thriving in airless pockets in the mouth and throat, some of their waste products are gases like hydrogen sulfide that smell bad and cause halitosis. Though the bacteria are found in places where oxygen is scarce, hydrogen sulfide and other gases produced by the bacteria soon mix with air inside the mouth and in the breath. They form the main components of halitosis.

The connection between the tongue and halitosis is easy to understand once you understand the anatomy of the tongue itself. Though its surface may look like simply rough skin, it is actually a busy surface with many deep clefts. The surface of the tongue is covered with elevations of four kinds, all called papillae. Some of these papillae contain taste buds, the receptors that allow us to taste our food. The papillae are shaped like little pillars or mushrooms, set into the surface so that a deep moat surrounds each one. At the base of the papillae, glands secrete fluids to wash the taste buds and clear away food particles. At the back of the tongue lie the lingual tonsils, lymphoid tissue that forms part of the body's defense against harmful organisms. Unfortunately, anaerobic bacteria tend to accumulate in all of these clefts and moats in the tongue and bad breath results.

The surface of the tongue is typically coated with a layer of mucous that contains antibodies, enzymes, and lubricants to make it easier to chew and swallow food. An additional effect of this mucous layer is to cover all the tiny grooves in the tongue - it provides an additional barrier between the anaerobic bacteria and the oxygen present in the mouth. Particularly at the very back of the tongue, there are anaerobic conditions perfect for the proliferation of anaerobic bacteria. This is why many dentists and bad breath specialists recommend that you regularly clean your tongue - to remove the mucous layer and allow oxygen to contact the tissues and bacteria on the surface. Other bad breath treatments aim at delivering oxygen to the back of the mouth to put an end to anaerobic bacteria living on the tongue and halitosis that follows.

It's not clear why some people have a problem with their tongue and bad breath while others don't. All tongues are basically the same but only a few unlucky people have so many anaerobic bacteria colonizing the back of their tongue that a bad odor results. Regardless of the reason, however, the way to tackle the problem is usually the same: get rid of the bacteria that live on the tongue and halitosis will go away. Antiseptic mouthwashes aim to do this. Other mouth washes that contain oil are based on the idea that bacteria will stick to the oil and be carried away. Still other mouthwashes deliver oxygen to the surface of the tongue to kill off bacteria and discourage other bacteria from moving in. Until we know how to prevent the bacteria from making themselves comfortable in our tongues in the first place, these approaches are the best solutions to the problem of the tongue and halitosis.

Tonsils and Bad Breath

Suffers of breath malodor often wonder if there is a connection between tonsils and bad breath. Usually, this is not the case, but in certain circumstances bacteria multiplying at the back of the throat in the tonsil area can cause a bad odor on the breath. This odor has one of two sources: the breakdown of healthy tissues caused by an active infection - pharyngitis - such as strept throat, or the breakdown of dead cells and food particles by anaerobic bacteria that are part of the normal ecosystem of the mouth. This article deals with the second scenario.

To understand the link between tonsils and halitosis, it's helpful to understand what the tonsils are and where they're located. We actually have three types of tonsils in the nasopharynx, the area at the back of the mouth and the top of the throat. The pharyngeal tonsil (also known as the adenoids) lies at the back of the nasal cavity high in the throat. The palatine tonsils are located at the back of the oral cavity and are visible when the mouth is opened widely. Lastly, the lingual tonsils are situated at the very base of the tongue. All of these tonsils are part of the lymphoid system - an important part of the body's defenses against invading and potentially disease causing organisms. The tonsils that most commonly give rise to an association between tonsils and bad breath are the palatine tonsils.

The palatine tonsils lie between folds of tissue called tonsillar pillars. The tonsils are composed of dense lymphoid tissue and each has between ten and twenty little hollows in its surface. The tiny hollows, called tonsillar crypts, collect shed epithelial (skin) cells from the lining of the mouth and throat, white blood cells (pus cells), both living and dead, and oral bacteria - a combination that can easily explain why tonsils and bad breath sometimes go together. Located as they are, in the back of the throat, these crypts have sinus drainage, saliva, chewed food, and cellular debris constantly passing by them. In some people, particularly those who have chronic sinus irritation with post nasal drip, material can build up in the tonsillar crypts, causing the aggregates that are the link between halitosis and bad breath. These aggregates are called tonsil stones or tonsiloliths.

Tonsiloliths are literally little balls of dead cells, debris, and bacteria. The bacteria, inhabitants of tonsils, and bad breath producers, find a ready source of food in the dead and decaying cellular material. Consuming the protein there, they produce foul smelling compounds called volatile sulfur compounds as they multiply. As long as the tonsil stones remain lodged in the tonsillar crypts, the bad odor will be produced; eventually the tonsil stones become large enough to be dislodged and swallowed. Then new ones will begin to form. For people who tend to develop tonsiloliths, the problem of stones in the crypts of the tonsils and halitosis is likely to be continuous over time, and require a regular program to combat breath malodor.