Bad breath: How to get rid of the distress
Nov 01, 2005
Bad breath can be distressing and a social handicap; it’s been known to ruin many a love affair. Many people have occasional bad breath, often on first awakening, especially after a garlic- or onion-laden meal, or following an evening of alcoholic partying.
Bad breath can be distressing and a social handicap; it’s been known to ruin many a love affair. Many people have occasional bad breath, often on first awakening, especially after a garlic- or onion-laden meal, or following an evening of alcoholic partying. Since bad breath is mostly due to bacterial putrefaction in an unclean mouth, it can often be remedied by better mouth cleaning. But for some, bad breath is a tenacious problem that’s hard to control. It can arise from gum disease, lung infections and occasionally from systemic diseases such as diabetes, liver or kidney disorders. According to television commercials, the worst thing about bad breath is “not knowing you have itâ€. In many cases, people remain oblivious to their offensive breath through a phenomenon called “adaptation.†The cells in the nose responsible for smell become unresponsive to the continuous stream of bad odour. People may need to be tactfully told they have bad breath by a concerned friend or relative, or by their dentist. You can do a self-check by licking your wrist, letting it dry for a few seconds and smelling the area, or by cupping the hands over the mouth and sniffing your own breath.
Mouth problems
Over 90% of bad breath originates in the mouth, due to bacterial activity. Causes include poor tooth and tongue-cleaning, periodontal disease, mouth or throat infections, unclean dentures or poorly fitting dental restorations. The primary cause of bad breath is uncontrolled growth of bacteria on food remnants and waste matter stuck between the teeth or on the tongue. As the debris rots, it gives off foul-smelling gases. It is simple to check whether poor mouth care is to blame: don’t brush your teeth for a day or two and see what happens. But many people with very clean mouths still have bad breath, meaning that oral hygiene is not the only problem.
Saliva
Bad breath also varies according to the amount of saliva and its “pH†(acidity or alkalinity). Lack of saliva (which allows bacteria to colonise the teeth and tongue) and an alkaline environment increase the production of offensive gases in the mouth. Saliva irrigates the mouth, flushing out sulphur compounds, so anything that dries the mouth can create a bad odour. Talking also dries the mouth. Many teachers, for instance, have dry mouths because they talk all day — which can also happen to those who chat endlessly on phone. Other factors that contribute to mouth dryness are prolonged exercise, throat or sinus infections, mouth breathing (because of a cold or inflamed tonsils), stress and dehydrating medications. Anything that gets the saliva flowing and moistens the mouth can help rid bad breath.
Food choices and hunger
Certain foods (garlic, onions and some fish) and diets rich in fat and meat can cause bad breath. When these foods are digested, the smelly metabolites pass to the lungs where they are exhaled. In one study, even rubbing garlic on the feet led to bad breath! Missing meals, hunger fasting, starvation and low-calorie diets can also cause bad breath, as the breakdown products of body proteins used for energy are exhaled.
Psychiatric reasons Some people are convinced they have foul breath, although no one else, not even the examining physician notices it. Such people may have psychiatric problems, which lead to hallucinations that make them think they are “emitting bad smellsâ€. Such people may try to guard others from the smell by avoiding all social contact. They may forever apply deodorants, wash their clothes or compulsively use mints, mouthwashes and oral sprays.
Pinpointing causes Everyone has occasional bad breath, but for some it is a persistent and devastating problem. While it may be due to tooth, gum or other mouth problems — sometimes remedied by good oral care — tracing the causes can be baffling. A visit to the dentist is a first step in identifying the cause. Bad breath may be diagnosed in the old-fashioned way - the smelling or sniff test — describing a person’s breath, as sour, putrid, musty, garlicky, sweet or whatever. New devices that can analyse gases emanating from the mouth are now common in dental clinics, and may help trace the causes of bad breath. People breathe into a shoebox-sized device called a “halimeter,†and a read-out tells them the amount of sulphurous gases given off. But these devices have a narrow range and their use can be misleading. Diagnosis may require a thorough medical work-up to trace its origins.
Treatment
Since the most common cause of bad breath in otherwise healthy people is overgrowth of bacteria and mouth neglect, the first step in remedying it is to locate its origins and improve mouth care. Dentists can advise on oral hygiene (how to brush and floss the teeth), can detect and treat mouth disorders, refit poorly fitting dentures and crowns, and refer people to other specialists. Management of bad breath includes attention to diet, and avoiding anything known to cause it. Anything that promotes saliva flow, chewing and tongue action can reduce mouth malodour. Strategies may include eating oranges or other citrus (acidic) fruits, chewing fibrous vegetables (such as celery), sucking lemon drops or chewing sugarless gum. One dentists notes that ‘rinsing with lots of tap water may not be helpful as it washes away the protective saliva and may worsen rather than diminish the odour.†Medications that are mouth-drying (such as antihistamines, antidepressants, anticoagulants) might be replaced with other, less drying forms. Persistent bad breath may require the attention of a specialist. Agencies
Ends
Mouth problems
Over 90% of bad breath originates in the mouth, due to bacterial activity. Causes include poor tooth and tongue-cleaning, periodontal disease, mouth or throat infections, unclean dentures or poorly fitting dental restorations. The primary cause of bad breath is uncontrolled growth of bacteria on food remnants and waste matter stuck between the teeth or on the tongue. As the debris rots, it gives off foul-smelling gases. It is simple to check whether poor mouth care is to blame: don’t brush your teeth for a day or two and see what happens. But many people with very clean mouths still have bad breath, meaning that oral hygiene is not the only problem.
Saliva
Bad breath also varies according to the amount of saliva and its “pH†(acidity or alkalinity). Lack of saliva (which allows bacteria to colonise the teeth and tongue) and an alkaline environment increase the production of offensive gases in the mouth. Saliva irrigates the mouth, flushing out sulphur compounds, so anything that dries the mouth can create a bad odour. Talking also dries the mouth. Many teachers, for instance, have dry mouths because they talk all day — which can also happen to those who chat endlessly on phone. Other factors that contribute to mouth dryness are prolonged exercise, throat or sinus infections, mouth breathing (because of a cold or inflamed tonsils), stress and dehydrating medications. Anything that gets the saliva flowing and moistens the mouth can help rid bad breath.
Food choices and hunger
Certain foods (garlic, onions and some fish) and diets rich in fat and meat can cause bad breath. When these foods are digested, the smelly metabolites pass to the lungs where they are exhaled. In one study, even rubbing garlic on the feet led to bad breath! Missing meals, hunger fasting, starvation and low-calorie diets can also cause bad breath, as the breakdown products of body proteins used for energy are exhaled.
Psychiatric reasons Some people are convinced they have foul breath, although no one else, not even the examining physician notices it. Such people may have psychiatric problems, which lead to hallucinations that make them think they are “emitting bad smellsâ€. Such people may try to guard others from the smell by avoiding all social contact. They may forever apply deodorants, wash their clothes or compulsively use mints, mouthwashes and oral sprays.
Pinpointing causes Everyone has occasional bad breath, but for some it is a persistent and devastating problem. While it may be due to tooth, gum or other mouth problems — sometimes remedied by good oral care — tracing the causes can be baffling. A visit to the dentist is a first step in identifying the cause. Bad breath may be diagnosed in the old-fashioned way - the smelling or sniff test — describing a person’s breath, as sour, putrid, musty, garlicky, sweet or whatever. New devices that can analyse gases emanating from the mouth are now common in dental clinics, and may help trace the causes of bad breath. People breathe into a shoebox-sized device called a “halimeter,†and a read-out tells them the amount of sulphurous gases given off. But these devices have a narrow range and their use can be misleading. Diagnosis may require a thorough medical work-up to trace its origins.
Treatment
Since the most common cause of bad breath in otherwise healthy people is overgrowth of bacteria and mouth neglect, the first step in remedying it is to locate its origins and improve mouth care. Dentists can advise on oral hygiene (how to brush and floss the teeth), can detect and treat mouth disorders, refit poorly fitting dentures and crowns, and refer people to other specialists. Management of bad breath includes attention to diet, and avoiding anything known to cause it. Anything that promotes saliva flow, chewing and tongue action can reduce mouth malodour. Strategies may include eating oranges or other citrus (acidic) fruits, chewing fibrous vegetables (such as celery), sucking lemon drops or chewing sugarless gum. One dentists notes that ‘rinsing with lots of tap water may not be helpful as it washes away the protective saliva and may worsen rather than diminish the odour.†Medications that are mouth-drying (such as antihistamines, antidepressants, anticoagulants) might be replaced with other, less drying forms. Persistent bad breath may require the attention of a specialist. Agencies
Ends