Brief Answer:
bad breath evaluation..

Detailed Answer:
Hello XXXX, Welcome to HCM,
I've gone through your query and understand your concern,

Bad breath can be there due to several reasons..

It's good that you brush twice daily and scrape the tongue, I'd suggest you to use rinsing as well as flossing to combat with any hidden, small food particles which may attract bacterial colony formation, thus can result in this..

Use Chlorhexidine mouthwash twice daily as well as flossing for next 7 days and observe if it progresses..remember, good brushing, with round the clock rinsing and flossing offers maximum protection as well as as cleansing off the potential bad-breath causing bacteria..

Staying well hydrated is extremely important as dry mouth is another culprit for causing bad breath..drink plenty of water through out the day (~ 2.5-3 ltr per day)..

Please avoid smoking / chewing any nicotine products (if you do), as they're quite prone for causing this too..

Now when you said you've saliva in your mouth after waking up, do you mean sour taste/acidic feeling ? If yes, then you should start on PPI/antacid like Cap PANTOPRAZOLE 40 mg Once daily in empty stomach, 15-20 min before breakfast for next 15 days as it signifies the acid reflux which is another cause for the bad breath..

Also start chewing cloves, green cardamom every once in a while, it'll help..

With all these, it should improve within a matter of few days, but if despite following these, there's any recurrence of bad breath then I'd suggest you to schedule an appointment with a Dentist for a detailed oral cavity examination to rule out any underlying cavity/plaques and/ any fungal infection of the tongue and a few relevant investigations as per the findings ..


Take Care
Kind Regards

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Brief Answer:
follow-up consultation..

Detailed Answer:
Hello XXXX, Welcome back,
Thanks for following up,

Yes, then there's no acid reflux, so antacids are not needed..

Yes you can avoid foods with strong pungent odor (i.e. onion (raw), garlic, excessive coffee, alcoholic beverages, broccoli, radish etc.), try to have more of yogurt, curds, apple, citrus fruits, some minty sugarless gums every once in a while, it'll help..

Yes, constipation can certainly add on to it..just start implementing the following advises first and observe how you stay in the due course..

Start the day with a full glass of water(preferably XXXXXXX warm with a squeeze of lime/lemon and a tsf of honey) and some physical exercises (not necessarily gym, but simple stretching and free hand exercises, jogging will do too), followed by a visit to the wash-room..try to make it a routine..initially it'll be difficult, but, if practiced daily, soon the body will adapt and bowel habits will be regularized too..

Do not strain during defecation..

Avoid junk/processed/deep fried foods.. start having organic foods, replace the daily grains (wheat, flour etc.) to whole grain foods..

Have plenty of fresh seasonal fruits, include green leafy veggies in your daily diet (even salads will do)..

Although you've mentioned drinking plenty of fluids, I'd still suggest to drink plenty of water only and not too much of other fluids, stay well hydrated (at least 3 ltr per day), it's extremely important..

Try to have a proper sleep routine of 6-8 hrs per day..try to avoid stress..

You can also take a daily dose of Probiotics (twice daily with/after food for next 15 days)..and observe how you stay..

With all these measures followed strictly, it should regularize in a matter of time, do observe how you stay in the due course.. if despite following these there's no significant improvement within a week or so, then the Gastroenterologist check-up can be planned..


Take Care
Kind Regards

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