How Nasal Drainage Affects Halitosis

Connections between post-nasal drainage and halitosis

Over the years of treating halitosis, we have found distinct connections between the degree of post-nasal drainage and halitosis. Post-nasal drainage often produces a thick or sometimes runny flow of mucous that travels down the back of one’s throat. Much of it is swallowed but a fair amount of it ends up accumulating on the dorsum or top of the tongue. Usually, this mucous drainage will accumulate most heavily towards the posterior regions of the tongue. Often times post-nasal drainage is noticeable as a thick flow of mucous that forces one to have to swallow or clear one’s throat frequently. Post-nasal drainage can also produce a mild chronic cough because the mucous may trigger a cough reflex when it reaches the larynx.

Chronic post-nasal drainage has been known to also produce a hoarse or raspy voice. Sometimes an individual may not even be aware of the condition because it is mild enough so as to not be noticeable, or the individual may be unaware of the condition because they have had the condition so long that they have either ignored it or have just become accustomed to it. Another strong indicator that one might have post- nasal drainage is if they develop a white or yellowish colored film or coating on the top or dorsum of their tongue. If this film is removed either by a toothbrush or tongue scraper it should stay away for most of the day in someone who doesn’t suffer from post nasal drainage. On the other hand, if one is experiencing post-nasal drainage the film will often return within 2-4 hours following its removal. The only thing that can build up that fast on the tongue is mucous draining from the sinuses.

What causes the post-nasal drainage?

The causes of this condition differ individually but the most common causes are allergies, a deviated septum, sinusitis, or a chronic sinus infection. Many people are not even aware that they have allergies because they are looking for the classic signs of allergies such as sneezing, sniffling, and itchy eyes. These, of course, are the typical symptoms of allergies that most people are familiar with but many people have such mild allergies that they may not recognize the symptoms because all they have is post nasal drainage that may be very mild or intermittent. When the mucus builds up on the tongue it produces what is known as a biofilm. A biofilm is a gelatinous polysaccharide matrix that provides an ideal environment for bacteria to reside and multiply in, and it also provides a protective layer around the bacteria protecting it from outside medications and insults.

Eighty percent of bacteria produce a biofilm and it is one of the most difficult problems to overcome when dealing with bacterial infections. The presence of biofilm in the sinuses is one of the reasons that many people have such long battles with chronic sinus infections. The fact is the antibiotics have great difficulty penetrating the biofilm to gain access to the bacteria, and the infection can continue to linger. This is also coupled with the fact that bacteria have been rapidly developing resistance to the antibiotics being used against them.

The sinus irrigator produces a pulsing action that mechanically breaks up the biofilm and mucous in the sinuses, thus greatly decreasing its presence. As a result of this sinus irrigation there will be a significant decrease in the mucous drainage going down the throat, and also a decrease in the white or yellow film on the tongue. Consequently, there will also be a decrease in the biofilm on the dorsum or top of the tongue. The mucous layer and biofilm layer on the tongue normally contain a lot of anaerobic bacteria that are responsible for producing the odors we recognize when we smell a bad breath odor, and the mucous itself will provide a food source for these same bacteria, thus propagating the condition.

People with deviated septums of the sinus usually have difficulty breathing normally through one side of their noses and often have difficulty obtaining proper drainage from their sinuses. This also can lead to breathing difficulties, a state of constant congestion, post-nasal drainage, and frequent sinus infections. Once again the irrigation of the sinuses and nasal passages with the sinus irrigator will help clear the sinuses, improve drainage, and thin the mucus, thus allowing for improved breathing, drainage, and a healthier environment in the sinuses. The sinus irrigator is also frequently recommended following sinus surgeries to assist with the healing and prevent post-operative sinus infections.

Preventing Halitosis

Moisturizer spray is good, but avoid moisturizing sprays with additives or preservatives such as benzalkonium (which can actually be the root of your problems). Preparations you can make yourself are economical. It’s advised to buy preparations that come with a refillable spray bottle. This allows you to moisturize and clean your nose as soon as you are exposed to diesel bus fumes, smoke, or dust. If the product is expensive or isn’t in a bottle convenient for carrying with you, you are less likely to use it right when you are dry or exposed to irritants. Look for a nasal/sinus moisturizer that contains no irritating additives such as Benzalkonium.

A good sinus moisturizer can be used as desired to promote sinus drainage. Since it’s free of irritating additives, there’s no sting and kids will be comfortable using it.

Tea helps to move the cilia will help the sinus drain. Hot compresses over the nose, above and below the eyes helps restore ciliary function. A Pulsatile Nasal Irrigating device such as the sinus irrigator, performed daily for 2 weeks is often sufficient because the pulsation encourages good ciliary movement. Stagnant mucus is also removed along with bacteria. Oftentimes the key is to simply drink enough water to liquefy the secretions.

Can Coffee Be used Instead of Tea?

There is nothing wrong with coffee, tea is just most commonly known to stimulate cilia movement. Hot coffee is a great alternative to hot tea. Ice drinks slow the cilia, as do most antihistamines. Sometimes patients are taking a large number of different medications and these combine to make the nose dry and prevent proper sinus drain. Here, pulsatile irrigation is probably the best treatment.