Foetor Ex Ore

FOETOR EX ORE, bad breath from the mouth. In healthy people and those suffering from various diseases, the air exhaled from the mouth has no odor, and sometimes is even aromatic or temporarily has the smell of eaten food or drunk liquid. But very often F. e. o. is found even in relatively healthy people, as well as in many diseases of the oral cavity, pharynx and some other organs that communicate with the oral cavity. In this case, the nature of the odor deserves great attention, by which in many cases one can judge the cause and place of origin of this phenomenon. An unpleasant odor is present in many people after sleep and prolonged abstinence from food and drink, especially if teeth cleaning and mouth rinsing were not performed; this is explained by the decomposition of food residues and secretions from the oral cavity. In smokers in this case, the smell of tobacco is added, which in the absence of F. e. o. is not unpleasant at all. However, even with good condition of the oral cavity and teeth, the exhaled air often has a more or less pronounced smell of indole, explained by the presence in the crypts of the pharyngeal and palatine tonsils of the so-called Dietrich plugs, which are a collection of decomposing epithelium and pus globules. This explains the sensation of bitter and putrid taste and smell in the nasopharynx, which ceases with artificial removal of these plugs; if they are secreted spontaneously, then, falling into the pharyngeal and oral cavity, they temporarily cause a more acute sensation of bitterness and decay. Clearly putrid F. e. o. is often the result of the presence of carious teeth or uncured carious tooth roots. A special F. e. o., unpleasant but not sharp, almost always occurs in febrile patients with acute infections, in particular with typhoid fever. A frequent cause of F. e. o. is alveolar pyorrhea and chronic gingivitis, and the exhaled air has a very unpleasant smell with a tinge of the smell of carrion. This characteristic smell, even more pronounced and in this case similar to the smell of air exhaled through the nose with ozene, is a sign of ulcerative stomatitis, which can be easily verified by examining the oral cavity. The same or with a slightly different shade F. e. o. is characteristic of gingivitis in scurvy. F. e. o. in any case should not be confused with the smell of air exhaled through the nose, which may depend not only on ozene, but also on other processes in the nasal cavity and its accessory sinuses, when these processes are accompanied by putrefactive decomposition of the discharge. The exhaled air sometimes acquires a special smell of volatile substances excreted through the lungs, such as: the smell of ammonia in uremia, acetone in diabetic coma, the smell of wine fumes after consuming large amounts of alcoholic beverages. Putrid, distinctly fecal odor, sharply increasing after coughing, indicates the presence of putrefactive decomposition in cavities located in the respiratory tract and in the lungs, as happens in bronchiectasis, pulmonary cavities and lung abscesses. The same is observed with purulent-putrid accumulations in the pleural cavity, if it communicates with the bronchi (open chronic pyopneumothorax). The exhaled air acquires an even more foul smell of carrion in gangrene of the lungs, as well as in putrefactively decomposing carcinomas in the respiratory tract, and sometimes in the esophagus. Periodically, the patient can spread a hydrogen sulfide or putrid odor, caused by belching during fermentation and rotting processes in the stomach, as well as as a result of the entry of intestinal contents into the stomach by antiperistalsis due to their obstruction.