Interstingly, the rise in chronic halitosis (bad breath) has less to do with personal hygene and more to do with a certain medical trend: specifically the removal of the tonsils. As recently as the Baby Boomer generation, doctors were yanking tonsils out right and left at the slightest inflammation. With the rise of hi-powered antibiotics that have made such surgery largely unnecessary, more people still have their tonsils. Thing is, behind the tonsils is a breeding ground for actinomyces, that white, solid, pus-looking crud everybody hacks up from time to time. It's perfectly safe, but it stinks to high-hell. For persons with small tonsils and large cavities (known as "crypts") behind them, this decrepid matter "colonizes" in a manner that causes chronic halitosis that, often times, is unknown to the actual person.

Solutions in dealing with it:
1) Having your tonsils removed.
2) Keeping the crypts cleaned out regularly with a water pick, a sterile swab, etc.
3) Regimens of antibiotics such as Clindamycin as necessary.

Department of Otolaryngology, Trinity College, Dublin, Ireland.

Although actinomyces has been identified in between 1.77% and 37% of resected tonsils its possible role in recurrent acute tonsillitis has received little attention. A histological and bacteriological study of 129 pairs of tonsils from patients with recurrent acute tonsillitis showed actinomyces to be present in 29.5%. The organism, however, was also present in 40% of tonsils from 10 patients with no history of tonsillar disease. In neither of these groups was there any specific evidence of tissue reaction to actinomyces nor was there a male preponderance as in clinical actinomycosis. The presence of actinomyces in the tonsil was not favoured by the concurrence of beta-lactamase producing bacteria. These data indicate that actinomyces does not have a causal role in recurrent acute tonsillitis.

PMID: 8877183 [PubMed - indexed for MEDLINE]

This concludes my "way more information than you ever knew existed" entry of the month.