BAD BREATH (Halitosis)

©2003 Dr. Alva Irish

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Bad breath (halitosis) is a common problem which often comes from the activity of bacteria in the mouth. Although there is no way of knowing for sure, most adults probably suffer from bad breath occasionally, with perhaps a quarter suffering on a regular basis.

Bad breath can be acute or chronic depending on the underlying cause. It may indicate the need to clean the teeth and mouth more often, tooth or gum disease, or intestinal disorders.

Bacteria in mouth, diabetes, drugs, gum disease, heavy metal accumulation, infection, liver disease, not eating, poor diet, poor dental hygiene, smoking, sulfur, stress, parasite infestation and tooth decay can be some of the many causes of this very common problem.

Is bad breath treatable?

In the past, bad breath was often considered to be an incurable affliction. However, in recent years it has become increasingly evident that bad breath is usually treatable once a proper diagnosis is made.

The main problem is knowing whether we have it or not, because we are poor judges of our own breath odor. Some people suffer from bad breath without knowing it, while others build up exaggerated fears about breath odor even though they do not have it. The best way to find out whether we have bad breath is to ask for someone else's opinion. If we don't ask, other people are unlikely to tell us. And since bad breath can sometimes - fortunately rarely - be a sign of a significant general health problem, we should not be reluctant to tell people dear to us that they have a bad breath problem.

What should I do if I have bad breath?

If you have reason to believe that there is a problem, then see your dentist first, since bad breath often comes from the mouth itself.

When you see your dentist, it is a good idea to explain in advance that you will be asking for advice about bad breath. Also, try to go with someone who is familiar with the problem, to help give your dentist an objective picture of how bad the odor really is, how long it has been going on, and when it improves or gets worse. Since bad breath often varies, a family member or friend can also help determine whether the odor at the time of the appointment resembles, both in character and intensity, the odor that is generally troublesome.

If your dentist knows that the consultation is about bad breath, you may be asked not to eat, drink, smoke, chew gum, suck confectionery, use mouthwashes, breath fresheners etc., so that the odor will be more typical. You should also avoid using perfumed cosmetic products, such as perfume, aftershave and scented lipstick prior to the appointment, since it can interfere with the odor assessment. If your dentist is not told about the reason for the consultation beforehand, do these things anyway and tell the dentist that you have prepared for the appointment in this way.

In most cases (about 85-95%), the odor comes from the mouth rather than the nose. This is an indication that bacterial activity somewhere in the mouth is responsible. If the odor comes mostly from the nose, then the nasal passages may be involved.

Where does the odor come from?

Most cases of bad breath appear to be due to the breakdown of proteins by a variety of micro-organisms. Several of the breakdown products are foul smelling gases.

In people with healthy teeth and gums, the odor usually comes from the far back region of the tongue, and grows stronger when the patient starts talking. The dentist can sample this area using a plastic spoon. The odor coming from the spoon sample may then be compared to the overall odor. Although we do not know why, the very back of the tongue is an important source of bad breath, possibly as a result of postnasal drip, which can get stuck on the tongue and is then broken down by bacteria on the tongue surface.

If the back of the tongue is the problem, then the dentist can recommend a method of cleaning the area, either with a toothbrush, or a specially designed tongue scraper (in some countries, tongue cleaning is a common and ancient practice). It takes time and patience to overcome the gagging reflex. But, eventually, tongue cleaning becomes easy. Care should be taken to clean the back of the tongue thoroughly yet gently, without inflicting pain or sores.

Can gum disease cause bad breath?

In some people, bad breath is associated with gum disease, especially if rubbing the areas between the teeth and gums yields a foul odor. Your dentist can help prevent and treat gum diseases in various ways, depending on the type and extent of the problem, but your own daily home care makes all the difference in the world in maintaining gum health between appointments. Cleaning of the spaces between the teeth is of great importance. One home tip to healthy gums (and less bad breath) is to smell the odor coming from the dental floss, and to work to clean those areas more carefully.

People with gum disease often have higher levels of odor coming from their tongue, as well.

What can I do?

• Visit your dentist regularly.
• Have your teeth cleaned periodically by a dental professional.
• Floss or otherwise clean between your teeth, as recommended by your dentist. Choose unscented floss so that you can detect those areas between your teeth that give off odors, and clean them more carefully.
• Brush your teeth and gums properly.
• Ask your dentist to recommend a toothbrush or scraper for your tongue. Clean your tongue all the way back gently, but thoroughly.
• Drink plenty of liquids.
• Chew sugar-free gum for a minute or two at a time, especially if your mouth feels dry. chewing parsley, mint, cloves or fennel seeds may also help.
• Clean your mouth after eating or drinking milk products, fish and meat.
• Unless your dentist advises otherwise, soak dentures overnight in antiseptic solution.
• Get control over the problem. Ask a family member to tell you whenever you have bad breath.
• If someone in your family or a close friend has bad breath, find a kind way to let them know. If you can't tell them directly, leave this fact file lying around. They may get the message.
• Ask your dentist to recommend a mouthwash which has been shown to be clinically effective in fighting bad breath.
• Use it most effectively right before sleeping.
• Eat fresh, fibrous vegetables such as carrots.

The most effective natural treatments of choice for the various causes of bad breath are:

• Acidophilus maintains healthy intestinal flora
• Bee propolis Rinse your mouth with it, or use the lozenges for its anti-bacterial, wound healing effect.
• Chlorophyll cleanses blood, natural mouthwash, rich in nutrients
• Vitamin C wound healing of mouth
• Zinc breaks down sulfur
• Alfalfa rich in chlorophyll, Alfalfa is a source of minerals, enzymes and vitamins. Chlorophyll has been used as a blood detoxifier and nutrient.
• Cardamom aromatic, Aids the digestive system: anorexia, colic, cramps, dyspepsia, flatulence, heartburn, indigestion and vomiting.
• Chamomile anti-bacterial
• Echinacea anti-bacterial
• Garlic (odorless) antibiotic
• Myrrh anti-bacterial, antiseptic, astringent, is good for gum disorder-and mouth ulcers and for treating chest infections, sore throats and chronic bronchitis.
• Peppermint aromatic
• Rosemary aromatic
• Sage aromatic
• Licorice Gl a special formula that combines standardized extracts of Glycyrrhiza glabra, the typical European licorice, and Zingibar officinale, commonly known as ginger. Licorice has been shown in studies to support a healthy stomach and intestinal tract by increasing mucus secretion by the stomach lining cells, improving mucus quality, and repairing intestinal cells.
• Detoxinal Modern living takes its toll on our bodies and puts added pressure on our liver and kidneys – the body's detoxifying organs. Diets high in fats and food additives, combined with increased levels of air and water pollution, make it more important than ever to support the body's efforts to detoxify itself. Detoxinal combines a variety of beneficial herbs and nutrients to optimize the body's detoxifying process
• Candistatin was specifically developed to help the body maintain healthy yeast levels in the gastrointestinal tract. Maintaining the proper balance of intestinal flora is important for optimum health and absorption of nutrients.
• Paraclear Paraclear's unique combination of nutrients work together to detoxify the body and cleanse the intestinal tract, without disturbing the normal balance of intestinal flora that inhabit the gastrointestinal system. The herb, Sweet Annie, is an extract from the leaves of the Artemisia plant cultivated in Europe and Asia. Used for over 2,000 years in China, sweet Annie contains essential oils that help detoxify the intestinal tract.
• Zygest Enzymes are essential for proper digestive health. They convert the food we eat into chemical structures that can pass through the cell walls.
• Bioflora The digestive tract is home for millions of different beneficial microorganisms that help maintain a healthy gastrointestinal environment. Bioflora returns the flora to its proper balance.

References:

Burps, Boogers, and Bad Breath (Spyglass Books) by David Conrad
Curing Common Complaints: From Bad Breath to Fatigue, Heartburn and Tooth Stains: The Best Doctor-Tested Tips to Relieve Everyday Health Concerns (The Family Home Remedies Collection)
Our Hero Has Bad Breath by Peter Robins
Dog Breath! : The Horrible Trouble With Hally Tosis Dav Pilkey
Bad Breath: A Multidisciplinary Approach Daniel van Steenberghe ed., Mel Rosenberg
Beating Bad Breath: Your Complete Guide to Eliminating and Preventing Halitosis by Richard A. Miller
The Bad Breath Book by Fred Siemon