Post by Arun Nagrath on Nov 3, 2011 19:03:56 GMT
From Archive 17/01/09
Question for Arun re odorous bacteria in mouth
Hi Arun,
In the video post in my blog entitled, Halitosis case on UK TV programme "embarrasing illnesses" they talk about an odorous bacteria from the mouth that grew in a culture that the doctor was able to kill with antibiotics.
They don't say what the name of the bacteria is, which antibiotic they used to kill it, what dosage was used, and for how long. Would you please give us this missing information.
Also, would you tell us what your opinion is about this localized infection, or micro-organisms imbalance in the mouth? Do you believe it could be that easy to just take some antibiotics and the halitosis is gone? Yet, this is what they claim in this program...
Mpdela
[REPLY FROM ARUN MSN POST 10/4/2008]
Maria, you are right to be sceptical about the role of a miracle antibiotic to treat halitosis. However, there are many different causes of halitosis and so it is possible that an antibiotic may provide TEMPORARY relief to the patient in the video. For instance there is the case of Maggs who is a lady who attended our meetup and comes from North England. Maggs (uses her name freely on these sites) complains of very strong breath odour which she has had for 20+ years. Her father also had this and in her case it does look like there may be a more obvious genetic link.
Maggs has a white tongue coating like most halitosis sufferers but has the unusual symptoms of being able to smell as well as taste her own faecal breath! I believe this is quite rare and most halitosis sufferers can not smell, let alone taste their own breath. She has once been told by an Ear/Nose/Throat specialist that she has a slightly hairy tongue - when I looked at her tongue I could not see any huge enlargement of her tongue papillae (these trap the tongue plaque) but these were possibly twice the normal length.
Anyway, let me get to the point. Maggs's powerful breath odour completely vanishes when she is prescribed metronidazole, which is an antibiotic used to treat anaerobic infections. Anaerobic bacteria means bacteria that live without oxygen and these bacteria are usually exceptionally smelly. I must point out that her breath odour only vanishes for about 4 days even if she were to continue with the antibiotics. Presumably the bacteria very quickly become resistant. However, this 4-day window is sufficient for her to enjoy social events such as weddings and parties. Her specialist informed Maggs that she should not use these antibiotics more than once or twice a year since it will stop working otherwise. The dose prescribed can vary slightly but a usual dose might be 400mg 3 times a day (every 8 hours) for 5 days.
Now, before you all rush out to try to buy metronidazole (a prescription antibiotic) over the internet, I would like to point out that Maggs also has a recent diagnosis of secondary Trimethylaminuria (Fish Odour Syndrome) so there is a little uncertainty about where the antibiotic may be exerting it's effect. Trimethylaminuria (or TMAU) often results in anaerobic bacterial overgrowth in the intestine and metronidazole is sometimes prescribed to keep this growth in check.
Anyway, I guess what I am saying is that for the small proportion of halitosis patients in which an antibiotic is effective, that antibiotic will be metronidazole (kills anaerobic organisms in tongue plaque and in the gut). Alternatively, some halitosis patients have a treatable acute infection (acute means short-term as opposed to chronic which means long-term). This infection may be in their gums or their sinuses etc and will completely disappear after a short course of a broad spectrum antibiotic such as amoxycillin 500mg 3 times a day or a cephalosporin such as cephalexin 500 mg 3 times a day or ciprofloxacin 500mg twice a day, all for a week. Obviously, these are all prescription antibiotics and will be prescribed by an Ear/Nose/Throat doctor, dentist or other physician only if needed.
As for the name of the bacteria that cause halitosis. Well many species have been found largely in people with breath odour eg Solobacterium Moorei. However, these may or may not be producing the actual odour!
But for a moment, I would like to shift the attention away from the mouth altogether and focus on areas far removed from the mouth itself! Why? Well guys, I don't really believe the tongue plaque is the full story, and would like to make my point by an interesting Case Study. This is what doctors and pharmacists do on the wards, we look at Case Studies.
This story concerns an Asian girl who has attended our meetups and lives in the North of England. Let us call her M, because I have not seen her use her name freely on these boards (by the way confidentiality is important on these boards guys so please think before you post up any member's name or picture). Okay on to the case...
M suffers from a most unusual kind of breath odour. It is intermittent halitosis. Did you know that such a thing even exists? Well I can assure you that it does! Most of the time M will have no breath odour then all of a sudden, without any warning, she will get the most unbelievable faecal breath odour that fills a huge room very quickly. This odour may last for perhaps 20-30 minutes and then vanish as quickly as it had come! The reason that M knows this is that she gets feedback from other work colleagues who she has asked to help her. I personally feel her odour probably lasts much longer than this but the people around her rapidly loose the ability to smell her, which is what happens when you try out a new perfume or aftershave.
She tends to get this odour around 2-3 times a day (she doesn't know for sure because only her work colleagues will confide in her). Now, tell me guys, do you really believe that this odour could be originating from her mouth? Ofcourse not! She has no odour one minute then wham the odour is there full force!
This is not consistant with the picture of a bacterial infection in the mouth because I know of no bacteria that can multiply quintillion fold in the space of a minute or even die off that quickly in only a minute. M has not tested positive for Trimethylaminuria and naturally those of you who do have TMAU will say that this might be a false negative. Well I am tired of hearing all that so let me tell you something even more interesting:-
I have met both Maggs and M and could never smell either of them despite spending the whole day with them on several occassions! Neither of them have been able to detect my odour either. Now let me tell you that human olfaction is pretty specific in it's inability to smell certain smells due to something called accomodation. For instance, when you have been wearing a fragrance for 10 minutes you can't smell it any more but you can still smell everything else perfectly, right? So this goes to show that me, Maggs and M must all be producing the exact same chemical in our odour! This is despite having totally different symptoms altogether!!!
1 Maggs has secondary Trimethylaminuria and tongue plaque and gets continuous faecal breath, which she can taste and smell. She has no body odour.
2 I have continuous faecal breath and body odour that varies with diet. I tested negative for TMAU. I have tongue plaque. I can't taste or smell my breath
3 M has tested negative for Trimethylaminuria. She has intermittent faecal breath (which may come 2 hours after eating?), she can't taste or smell her breath odour. She has no body odour.
Okay, where am I going with all this? Firstly, we don't all have the same symptoms but there seems to be a common metabolic pathway which is defective!I believe that for many of us who suffer halitosis on these sites, the actual origin of the odour is a site far removed from the mouth!! (my own belief is that there is some intestinal involvement). I believe the odorous chemical is passed round the body in the blood stream and is excreted from the lungs (these people will not have tongue plaque) or in the breath (these people will have tongue plaque) or in the undearms etc (if there is no breath odour there will be no tongue plaque). I believe the tongue plaque, where present, will act upon the already smelly metabolites excreted in the saliva making them even smellier.
As many of you know, we are running a questionnaire for odour sufferers in conjunction with a consultant specialist in metabolic medicine. Soon the survey will end and all the results will be compiled and analysed and fed back to the group. I will then be introducing my CASE STUDIES investigation which will look in a very detailed way at each and every one of your odour conditions. Each participant will enter their detailed odour information into a database on a website which will be linked to this one. In this way, you will also be able to look at everyone else's case (what affects their odour, what helped etc) as we go along! The aim of this exercise will be to try to elucidate what helps your particular breath or body odour condition because this is where I am going with the case study investigations.
At the moment nobody is in a better position to research what helps most of us than we ourselves! I hope you will all participate in the case studies because each case is just part of a jigsaw and when we have all the cases together we will have completed the jigsaw and finally made the condition researchable for scientists.
At the moment, these conditions are difficult to research scientifically using analytical chemistry etc. I believe this is because we are dealing with a collection of different enzyme-related conditions each producing different symptoms but nevertheless sharing the same metabolic pathway.
Arun
Question for Arun re odorous bacteria in mouth
Hi Arun,
In the video post in my blog entitled, Halitosis case on UK TV programme "embarrasing illnesses" they talk about an odorous bacteria from the mouth that grew in a culture that the doctor was able to kill with antibiotics.
They don't say what the name of the bacteria is, which antibiotic they used to kill it, what dosage was used, and for how long. Would you please give us this missing information.
Also, would you tell us what your opinion is about this localized infection, or micro-organisms imbalance in the mouth? Do you believe it could be that easy to just take some antibiotics and the halitosis is gone? Yet, this is what they claim in this program...
Mpdela
[REPLY FROM ARUN MSN POST 10/4/2008]
Maria, you are right to be sceptical about the role of a miracle antibiotic to treat halitosis. However, there are many different causes of halitosis and so it is possible that an antibiotic may provide TEMPORARY relief to the patient in the video. For instance there is the case of Maggs who is a lady who attended our meetup and comes from North England. Maggs (uses her name freely on these sites) complains of very strong breath odour which she has had for 20+ years. Her father also had this and in her case it does look like there may be a more obvious genetic link.
Maggs has a white tongue coating like most halitosis sufferers but has the unusual symptoms of being able to smell as well as taste her own faecal breath! I believe this is quite rare and most halitosis sufferers can not smell, let alone taste their own breath. She has once been told by an Ear/Nose/Throat specialist that she has a slightly hairy tongue - when I looked at her tongue I could not see any huge enlargement of her tongue papillae (these trap the tongue plaque) but these were possibly twice the normal length.
Anyway, let me get to the point. Maggs's powerful breath odour completely vanishes when she is prescribed metronidazole, which is an antibiotic used to treat anaerobic infections. Anaerobic bacteria means bacteria that live without oxygen and these bacteria are usually exceptionally smelly. I must point out that her breath odour only vanishes for about 4 days even if she were to continue with the antibiotics. Presumably the bacteria very quickly become resistant. However, this 4-day window is sufficient for her to enjoy social events such as weddings and parties. Her specialist informed Maggs that she should not use these antibiotics more than once or twice a year since it will stop working otherwise. The dose prescribed can vary slightly but a usual dose might be 400mg 3 times a day (every 8 hours) for 5 days.
Now, before you all rush out to try to buy metronidazole (a prescription antibiotic) over the internet, I would like to point out that Maggs also has a recent diagnosis of secondary Trimethylaminuria (Fish Odour Syndrome) so there is a little uncertainty about where the antibiotic may be exerting it's effect. Trimethylaminuria (or TMAU) often results in anaerobic bacterial overgrowth in the intestine and metronidazole is sometimes prescribed to keep this growth in check.
Anyway, I guess what I am saying is that for the small proportion of halitosis patients in which an antibiotic is effective, that antibiotic will be metronidazole (kills anaerobic organisms in tongue plaque and in the gut). Alternatively, some halitosis patients have a treatable acute infection (acute means short-term as opposed to chronic which means long-term). This infection may be in their gums or their sinuses etc and will completely disappear after a short course of a broad spectrum antibiotic such as amoxycillin 500mg 3 times a day or a cephalosporin such as cephalexin 500 mg 3 times a day or ciprofloxacin 500mg twice a day, all for a week. Obviously, these are all prescription antibiotics and will be prescribed by an Ear/Nose/Throat doctor, dentist or other physician only if needed.
As for the name of the bacteria that cause halitosis. Well many species have been found largely in people with breath odour eg Solobacterium Moorei. However, these may or may not be producing the actual odour!
But for a moment, I would like to shift the attention away from the mouth altogether and focus on areas far removed from the mouth itself! Why? Well guys, I don't really believe the tongue plaque is the full story, and would like to make my point by an interesting Case Study. This is what doctors and pharmacists do on the wards, we look at Case Studies.
This story concerns an Asian girl who has attended our meetups and lives in the North of England. Let us call her M, because I have not seen her use her name freely on these boards (by the way confidentiality is important on these boards guys so please think before you post up any member's name or picture). Okay on to the case...
M suffers from a most unusual kind of breath odour. It is intermittent halitosis. Did you know that such a thing even exists? Well I can assure you that it does! Most of the time M will have no breath odour then all of a sudden, without any warning, she will get the most unbelievable faecal breath odour that fills a huge room very quickly. This odour may last for perhaps 20-30 minutes and then vanish as quickly as it had come! The reason that M knows this is that she gets feedback from other work colleagues who she has asked to help her. I personally feel her odour probably lasts much longer than this but the people around her rapidly loose the ability to smell her, which is what happens when you try out a new perfume or aftershave.
She tends to get this odour around 2-3 times a day (she doesn't know for sure because only her work colleagues will confide in her). Now, tell me guys, do you really believe that this odour could be originating from her mouth? Ofcourse not! She has no odour one minute then wham the odour is there full force!
This is not consistant with the picture of a bacterial infection in the mouth because I know of no bacteria that can multiply quintillion fold in the space of a minute or even die off that quickly in only a minute. M has not tested positive for Trimethylaminuria and naturally those of you who do have TMAU will say that this might be a false negative. Well I am tired of hearing all that so let me tell you something even more interesting:-
I have met both Maggs and M and could never smell either of them despite spending the whole day with them on several occassions! Neither of them have been able to detect my odour either. Now let me tell you that human olfaction is pretty specific in it's inability to smell certain smells due to something called accomodation. For instance, when you have been wearing a fragrance for 10 minutes you can't smell it any more but you can still smell everything else perfectly, right? So this goes to show that me, Maggs and M must all be producing the exact same chemical in our odour! This is despite having totally different symptoms altogether!!!
1 Maggs has secondary Trimethylaminuria and tongue plaque and gets continuous faecal breath, which she can taste and smell. She has no body odour.
2 I have continuous faecal breath and body odour that varies with diet. I tested negative for TMAU. I have tongue plaque. I can't taste or smell my breath
3 M has tested negative for Trimethylaminuria. She has intermittent faecal breath (which may come 2 hours after eating?), she can't taste or smell her breath odour. She has no body odour.
Okay, where am I going with all this? Firstly, we don't all have the same symptoms but there seems to be a common metabolic pathway which is defective!I believe that for many of us who suffer halitosis on these sites, the actual origin of the odour is a site far removed from the mouth!! (my own belief is that there is some intestinal involvement). I believe the odorous chemical is passed round the body in the blood stream and is excreted from the lungs (these people will not have tongue plaque) or in the breath (these people will have tongue plaque) or in the undearms etc (if there is no breath odour there will be no tongue plaque). I believe the tongue plaque, where present, will act upon the already smelly metabolites excreted in the saliva making them even smellier.
As many of you know, we are running a questionnaire for odour sufferers in conjunction with a consultant specialist in metabolic medicine. Soon the survey will end and all the results will be compiled and analysed and fed back to the group. I will then be introducing my CASE STUDIES investigation which will look in a very detailed way at each and every one of your odour conditions. Each participant will enter their detailed odour information into a database on a website which will be linked to this one. In this way, you will also be able to look at everyone else's case (what affects their odour, what helped etc) as we go along! The aim of this exercise will be to try to elucidate what helps your particular breath or body odour condition because this is where I am going with the case study investigations.
At the moment nobody is in a better position to research what helps most of us than we ourselves! I hope you will all participate in the case studies because each case is just part of a jigsaw and when we have all the cases together we will have completed the jigsaw and finally made the condition researchable for scientists.
At the moment, these conditions are difficult to research scientifically using analytical chemistry etc. I believe this is because we are dealing with a collection of different enzyme-related conditions each producing different symptoms but nevertheless sharing the same metabolic pathway.
Arun