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Suggest Treatment For Bad Breath
Question: So to inform you to the best of my abilities:
I have been quite worried about this situation for some time now as it has not seemed to dissipate on its own or through 2 courses of antibiotics.
A month and a half ago I had a XXXXXXX sized red boil on my face that I could not pop and that slowly receded leaving a small scar near the bottom of my ear. When it was mostly receded, I started to feel a pressure and slight itchy feeling in that area of my neck/throat. I have had a swollen lymph node directly below my ear on the back of my jaw. After a round of Omnicef, It was ultrasounded and came back as 4x5x15mm and the bilateral node directly inder the other ear for comparison was 5x5x11mm. Radiologist said minimal bilateral lymph nodes, unspecific and suggested a clinical follow up. The bloodwork came back all within normal ranges, including my thyroid hormones. So a week after bloodwork I followed up with a different doctor at the same clinic, she prescribed Sulfameth/trimethoprim for 10 days. The itchy sensation went away, but the lymph node stayed swollen. Since I have finished the antibacterial, the itchy/pressure feeling has come back and I have realized that my tonsil on the same side as the large lymph node is also swollen and slightly red. I cannot see any white bumps or odd growths on the tonsil. Anyways, my coworker complained about my breath being very bad today. This has never happened before and we were at least 3 or 4 feet away from eachother... I grabbed a cue-tip and decided to rub the back of the inflamed tonsil to try and remove possible tonsil stones. I noticed the cue-tip was slightly yellow after I had done this and smelled very strongly. I did the same on the other tonsil and there was no yellow and not much of a smell.
I included pictures of the tonsil. I made the mistake of googleing swollen lymph node and unilateral swollen tonsil, and now I am incredibly stressed fearing all the malignancies people referred to. I have not had a noticeable fever or sore throat. The tonsil does ache however.
Thank you for any help you can give, I am sincerely thankful whether good, bad, or neither.
I have been quite worried about this situation for some time now as it has not seemed to dissipate on its own or through 2 courses of antibiotics.
A month and a half ago I had a XXXXXXX sized red boil on my face that I could not pop and that slowly receded leaving a small scar near the bottom of my ear. When it was mostly receded, I started to feel a pressure and slight itchy feeling in that area of my neck/throat. I have had a swollen lymph node directly below my ear on the back of my jaw. After a round of Omnicef, It was ultrasounded and came back as 4x5x15mm and the bilateral node directly inder the other ear for comparison was 5x5x11mm. Radiologist said minimal bilateral lymph nodes, unspecific and suggested a clinical follow up. The bloodwork came back all within normal ranges, including my thyroid hormones. So a week after bloodwork I followed up with a different doctor at the same clinic, she prescribed Sulfameth/trimethoprim for 10 days. The itchy sensation went away, but the lymph node stayed swollen. Since I have finished the antibacterial, the itchy/pressure feeling has come back and I have realized that my tonsil on the same side as the large lymph node is also swollen and slightly red. I cannot see any white bumps or odd growths on the tonsil. Anyways, my coworker complained about my breath being very bad today. This has never happened before and we were at least 3 or 4 feet away from eachother... I grabbed a cue-tip and decided to rub the back of the inflamed tonsil to try and remove possible tonsil stones. I noticed the cue-tip was slightly yellow after I had done this and smelled very strongly. I did the same on the other tonsil and there was no yellow and not much of a smell.
I included pictures of the tonsil. I made the mistake of googleing swollen lymph node and unilateral swollen tonsil, and now I am incredibly stressed fearing all the malignancies people referred to. I have not had a noticeable fever or sore throat. The tonsil does ache however.
Thank you for any help you can give, I am sincerely thankful whether good, bad, or neither.
Brief Answer:
It is not related to cancer...
Detailed Answer:
Hi
Thanks for posting the query and an elaborate history. I have gone through the history and also examined the image thoroughly. I will try my best to help you with this problem.
1. Bad breath can be due to various reasons such as infected tonsils, caries tooth, tonsillolith, acid reflux, sinusitis, etc. After compiling all the information giving you, I am of the opinion that the bad breath in your case may be because of the caries tooth of the left last lower molar and the inflamed tonsils.
The reason behind the foul smell of the qtip when used over the left tonsil is because, your left tonsil is bigger compared to that of the right with more number of crypts. Hence the accumulation of the food material will be more on the left rather than the right. The accumulated food material with bacteria acting on it gives a foul smell.
2. Secondly, the tonsils and the posterior pharyngeal wall still looks red and inflamed indicating the residual infection. This could also contribute to the foul smell.
3. The caries tooth on the left lower molar can also cause bad breath.
4. Do not worry! Neither your history suggests of any indications towards cancer nor the photograph and the blood reports. Let me make it very clear to you that cancer of the tonsils are not seen in your age.
My honest suggestions to you are:
1. Drink plenty of warm water
2. Use povidone iodine throat spray or gargles for a week or ten days, to reduce the inflammation and bad breath.
3. If you have any problems related to the acid reflux, it has to be treated with proton pump inhibitors.
4. Consult your dentist for a complete evaluation.
5. Avoid chilled food and beverages/smoking/coffee/alcohol if any.
Hope I have answered your query; I will be available for the follow up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
It is not related to cancer...
Detailed Answer:
Hi
Thanks for posting the query and an elaborate history. I have gone through the history and also examined the image thoroughly. I will try my best to help you with this problem.
1. Bad breath can be due to various reasons such as infected tonsils, caries tooth, tonsillolith, acid reflux, sinusitis, etc. After compiling all the information giving you, I am of the opinion that the bad breath in your case may be because of the caries tooth of the left last lower molar and the inflamed tonsils.
The reason behind the foul smell of the qtip when used over the left tonsil is because, your left tonsil is bigger compared to that of the right with more number of crypts. Hence the accumulation of the food material will be more on the left rather than the right. The accumulated food material with bacteria acting on it gives a foul smell.
2. Secondly, the tonsils and the posterior pharyngeal wall still looks red and inflamed indicating the residual infection. This could also contribute to the foul smell.
3. The caries tooth on the left lower molar can also cause bad breath.
4. Do not worry! Neither your history suggests of any indications towards cancer nor the photograph and the blood reports. Let me make it very clear to you that cancer of the tonsils are not seen in your age.
My honest suggestions to you are:
1. Drink plenty of warm water
2. Use povidone iodine throat spray or gargles for a week or ten days, to reduce the inflammation and bad breath.
3. If you have any problems related to the acid reflux, it has to be treated with proton pump inhibitors.
4. Consult your dentist for a complete evaluation.
5. Avoid chilled food and beverages/smoking/coffee/alcohol if any.
Hope I have answered your query; I will be available for the follow up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Oh, That Makes sense, Thank you sir.
Quick question, That tooth had a cavity filling about 5 years ago and cracked last year. Can it get infected if it has been filled because of the new crack?
Do you think the swelling will go down on it's own or is a dental intervention needed?
Thanks again sir.
Quick question, That tooth had a cavity filling about 5 years ago and cracked last year. Can it get infected if it has been filled because of the new crack?
Do you think the swelling will go down on it's own or is a dental intervention needed?
Thanks again sir.
Brief Answer:
The tonsillar swelling may or may not recede...
Detailed Answer:
Hi
Thanks for writing back. My sincere apologies for the delay in answering the query.
1. Yes, the cavity can get infected even in the presence of the filling.
2. The tonsillar swelling may or may not reduce in the size. If it has swollen because of the infection, then the size may reduce. But, there is no relation between the tonsil and the infected molar tooth.
3. I would suggest you to consult your dentist for a complete evaluation.
4. Please follow the preventive measures as discussed in my previous response, you will definitely notice the difference.
I wish you good health and good luck.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
The tonsillar swelling may or may not recede...
Detailed Answer:
Hi
Thanks for writing back. My sincere apologies for the delay in answering the query.
1. Yes, the cavity can get infected even in the presence of the filling.
2. The tonsillar swelling may or may not reduce in the size. If it has swollen because of the infection, then the size may reduce. But, there is no relation between the tonsil and the infected molar tooth.
3. I would suggest you to consult your dentist for a complete evaluation.
4. Please follow the preventive measures as discussed in my previous response, you will definitely notice the difference.
I wish you good health and good luck.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2540 Questions
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