Dear Roopashree,
Please keep my question anonymous.
I am a woman and, once a year, in summer (mostly May), I get a bad boil inside my private parts.
It is very painful until it bursts which takes about a week. It is difficult to walk, sit or sleep.
What can I do to prevent this from happening?
Thank you.

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Ans: Hello
I'm happy to know you brush and floss regularly. Please continue to do so.
While poor oral hygiene is the leading cause of bad breath, it is definitely not the only cause. Please be informed that it can be caused by various other factors, too.

Here are some of the most common causes of bad breath, also known as HALITOSIS.

Oral Health Issues
1. _Poor oral hygiene_: Infrequent brushing and flossing can lead to the buildup of bacteria, plaque, and tartar, causing bad breath.
2. _Gingivitis and gum disease_: Inflammation and infection of the gums can cause bad breath.
3. _Tooth decay and cavities_: Bacteria in the mouth can break down food particles, especially sugars, and release volatile sulfur compounds (VSCs) that cause bad breath.

Food and Drinks
1. _Onions and garlic_: These foods contain sulfur compounds that can be released in the mouth and cause bad breath.
2. _Coffee and tobacco_: These substances can dry out the mouth, leading to an increase in bacteria and VSCs.
3. _Spicy or acidic foods_: Foods like citrus fruits, tomatoes, and spicy dishes can irritate the mouth and cause bad breath.

Medical Conditions
1. _Diabetes_: Uncontrolled diabetes can lead to dry mouth, which can contribute to bad breath.
2. _Gastroesophageal reflux disease (GERD)_: Stomach acid can flow up into the mouth, causing bad breath.
3. _Sinus infections and respiratory issues_: Postnasal drip and respiratory infections can cause bad breath.
4. _Kidney disease and liver disease_: These conditions can cause a buildup of toxins in the body, leading to bad breath.

Lifestyle Factors
1. _Smoking and tobacco use_: Tobacco products can dry out the mouth and cause bad breath.
2. _Alcohol consumption_: Excessive alcohol consumption can lead to dry mouth and bad breath.
3. _Medications_: Certain medications, such as antidepressants, antihistamines, and decongestants, can cause dry mouth and bad breath.
4. _Hormonal changes_: Hormonal fluctuations during menstruation, pregnancy, or menopause can lead to bad breath.

Other Factors
1. _Dry mouth_: A lack of saliva can contribute to bad breath.
2. _Mouth breathing_: Breathing through the mouth instead of the nose can dry out the mouth and cause bad breath.
3. _Poor digestion_: Undigested food particles in the stomach can be released into the mouth, causing bad breath.


If you're concerned about bad breath, it's essential to consult your dentist so that he can examine your teeth and gums thoroughly to rule out local factors and address any underlying medical conditions.

Mouthwashes definitely help by keeping the oral bacteria under control. At least temporarily. They mask mouth odours and give you a feeling of freshness.
But the root cause of the problem still needs to be identified and suitably treated. Also, please note that mouthwashes are not a substitute for regular brushing and flossing.
Your dentist will guide you on what mouthwash suits you best depending on your lifestyle, oral hygiene and medical history.
Meanwhile, here are some good attributes to look for in a mouthwash:

Active Ingredients
1. _Antibacterial agents_: Chlorhexidine, triclosan, or essential oils (e.g., tea tree oil) to combat bacteria and plaque.
2. _Anti-inflammatory agents_: Ingredients like aloe vera or chamomile to reduce gum inflammation.
3. _Antifungal agents_: Ingredients like domiphen bromide to combat fungal infections.
4. _Fluoride_: To strengthen tooth enamel and prevent decay.

Additional Benefits
1. _Anti-plaque and anti-gingivitis properties_: To help prevent the buildup of plaque and reduce the risk of gingivitis.
2. _Bad breath prevention_: Ingredients like chlorine dioxide or zinc to help eliminate volatile sulfur compounds (VSCs) that cause bad breath.
3. _Sensitivity relief_: Ingredients like potassium nitrate or strontium chloride to help desensitize nerves and provide relief from tooth sensitivity.
4. _Whitening agents_: Mild abrasives or hydrogen peroxide to help remove surface stains and whiten teeth.

Safety and Comfort
1. _Alcohol-free_: To avoid drying out the mouth and reducing saliva production.
2. _Sugar-free and artificial sweetener-free_: To make the mouthwash suitable for people with dietary restrictions or preferences.
3. _pH balanced_: To ensure the mouthwash doesn't disrupt the natural pH balance of the mouth.
4. _Gentle and non-irritating_: To minimize the risk of mouth irritation, especially for people with sensitive teeth or gums.

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Ans: Mild gingivitis can be treated and managed at home with good oral hygiene practices and some natural remedies. However, if the condition persists or worsens, it's essential to consult a dentist for professional treatment.

Home Treatment and Prevention:

1. *Brushing and Flossing*: Brush your teeth at least twice a day and floss once a day to remove plaque and food particles.
2. *Saltwater Rinse*: Rinse your mouth with warm saltwater several times a day to reduce inflammation and kill bacteria.
3. *Antibacterial Mouthwash*: Use a commercial hydrogen peroxide/chlorhexidine gluconate mouthwash to kill bacteria and reduce inflammation.
4. *Dietary Changes*: Eat a balanced diet rich in fruits, vegetables, and whole grains, and avoid sugary and processed foods.
5. *Vitamin C* plays a significant role in gingival health. So make sure you have fresh citrus fruits (preferably unrefrigerated) on a regular basis. The other option is to take Vitamin C supplements.

When to Consult a Dentist:

1. *Persistent Gingivitis*: If your gingivitis persists despite good oral hygiene practices and home remedies.
2. *Severe Symptoms*: If you experience severe symptoms like bleeding gums, pain, or swelling.
3. *Gum Recession*: If you notice gum recession or exposed roots.
4. *Loose Teeth*: If your teeth become loose or mobile.


Remember, while home treatment and natural remedies can help manage mild gingivitis, regular dental check-ups and professional cleanings are essential to prevent and treat gum disease.

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