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Bad Breath: Halitosis

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Bad breath, also known as Halitosis, is an unpleasant and embarrassing condition. Unfortunately, a lot of individuals with this condition don’t even know they have it. Halitosis is caused by health conditions, certain foods and lifestyle habits. There are several products for bad breath including mouthwashes, mints, sprays and parsley oil capsules but these products offer temporary control. If improved oral hygiene does not improve the condition, a dentist should be consulted to check for mouth problems and a doctor may be needed to detect systemic ailments.

Certain foods such as Garlic and Onions cause bad breath. When the food in absorbed into the bloodstream it is transferred to the lungs and exhaled. These odours remain until the body has eliminated the offending food.

When teeth are not brushed and flossed daily, food particles in the mouth rot and encourage growth of bacteria which leads to bad breath. Saliva plays an important role in the mouth to cleanse, moisten and remove particles that may cause bad breath. A dry mouth, known as Xerostomia, usually leads to bad breath because the flow of saliva is reduced. When the mouth is dry, dead cells build up on the tongue, cheeks, gums and palate which decompose and lead to odour. The mouth is usually dry during sleep and this is worsened if you sleep with your mouth open. On waking, individuals have bad breath. Xerostomia may be caused by salivary gland problems, certain medications or by breathing through the mouth constantly. Artificial saliva, increased water intake and avoiding sugar may be prescribed to treat this condition.

Smoking tobacco causes bad breath, stains the teeth, affects taste buds blunting the sensation of taste and irritates the gums. This habit should be discouraged. Medical disorders that may cause bad breath include Infections along the respiratory tract, Chronic sinusitis, Postnasal drip, Tonsillitis and Strep Throat, Lung abscess, Chronic Bronchitis, Diabetes and Gastrointestinal, Liver and Kidney problems. Lung abscesses and chronic chest infections cause extremely foul breath. Patients with Liver failure often have “fishy” breath while those with Kidney failure have “urine-like” breath. Uncontrolled diabetes leads to ketoacidosis and patients have a distinct “fruity” or “acetone-like” breath. Gastrointestinal diseases like hiatal hernia and gastroesophageal reflux disease (GERD) lead to bad breath. Individuals on low carbohydrate diets have what is popularly referred to as “Atkin’s Breath” (named after the developer of the Atkin’s diet).

Periodontal (Gum) Disease presents with persistent bad breath and/or an unpleasant taste in the mouth. Gum disease is caused by plaque which is the colourless sticky film of bacteria that constantly forms on the teeth. Toxins created by the bacteria irritate the gums, cause tooth decay and in advanced cases, gums, jaw bones and other structures that support the teeth may become damaged. Pockets of plaque develop between the teeth and gums that give rise to offensive breath. Denture wearers may develop bad breath if the dentures are not cleaned regularly or if they don’t fit well. Regular dental check ups help detect the disease early so adequate treatment may be given to prevent complications.

In several cases, proper oral hygiene and avoiding foods that cause bad breath are treatment enough. If bad breath persists after adequate oral hygiene has been practiced, a dentist should be consulted and if the cause of bad breath is not oral, a doctor should be consulted.

If you have constant bad breath, it is a good idea to keep a log of food consumed and medication taken to identify odour causing foods and drugs. Teeth should be brushed twice a day with a fluoride containing toothpaste to combat plaque and remove food particles. Floss or an interdental should be used to clean in between teeth. Patients who use removable dentures should take them out at night and clean them properly before reapplying them. Mouthwashes are cosmetic and only have a temporary effect on bad breath.

Tips to help improve bad breath include brushing teeth regularly and if possible after each meal, flossing or using an interdental at least once a day, paying attention to tongue hygiene by brushing or using a tongue scraper. Denture wearers should pay attention to cleaning them properly and toothbrushes should be changed regularly. Drinking plenty of water helps keep the mouth moist and chewing gum and sucking sweets (preferably sugar-free) help stimulate saliva production. Chewing parsley after eating garlic helps neutralise the odour or you may want to avoid eating foods that lead to bad breath.

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