Bad Breath - Halitosis

Reducing bad breath is an integral part of any dentist's job. Reports have shown that this is a major problem for a population of about 90 million people. It is known as Halitosis too and usually the foul smell comes from either the tongue or the gums. Bacteria, which grows in your mouth generates this smell, when they feed on food items left in your mouth. These decaying food particles release a chemical with sulfur in it and are the reason for the smell.

Anaerobic Bacteria

Roughly 85% of the people with Halitosis are diagnosed with some type of dental problems as the root cause of this problem. Of those without any teeth or gum problems, their tongue is the cause of the foul odor. The foul odor creating bacteria are known to accumulate on the tongue as well as the throat area, gum cavities and on teeth. They produce the sulfur compounds from these areas and cause the smell.

Bacteria Can Accumulate On Your Tongue Area Or Throat Area

The glands in your mouth are constantly producing saliva and this move to the back of the tongue. As the bottom of the tongue is uneven, the bacteria can easily hide there and work on the saliva. These bacteria, which do not need oxygen, create some sort of gases known as VLSCs. These gases are a major reason for the occurrence of halitosis. Anaerobic bacteria's presence can be noticed from the white build up on your tongue.

Medications

A lot of people are known to gain dry mouth (xerostomia) as a result of consuming medicines. And it is a really great environment for bacteria to grow.

Dry Mouth / Breathing Through Mouth

Breathing through your mouth while sleep causes your mouth to dry quickly and this is going to result in bad breath by morning. There are many other reasons like use of medications, dieting, exercising, consumption of alcohol or alcohol-based mouthwashes, smoking etc that can cause dry mouth. Infections in your mouth, diseases like oral cancer, oral candidiasis etc can also cause bad breath.

Physical Problems

Even if bad breath is known to originate for the most part from your mouth, there are some other causes of halitosis as well. Sinus problems and any nasal problems can be a reason for bad breath. Infections on your tonsil, oropharynx, lung infections like pneumonia or bronchitis, stomach and intestinal problems etc can cause bad breath in you. And some of these physical problems have their own associated odor as well. Examples are smell of rotten egg due to liver problems, sweet smell due to diabetes, sour breath due to intestinal problems, musty smell due to either typhoid fever or scarlet fever.

Diet

Milk products are known to increase halitosis causing bacterial activity and the associated creation of VLSCs. Smell of spicy food items like coffee, onions, garlic etc are usually found in people's breath even 3 days after their consumption. The stomach is known to absorb onions and let the smell go out later through the lungs. There have been scientifically proven cases of onion smell coming through breath when the onion was actually applied only on the sole of the person's feet. Coffee and similar acidic food items make life easier for the odor causing bacteria, as they love acidic environment.

Detection

Most people are known to have mild halitosis. But severe halitosis is comparatively rare. Whatever be the nature of bad breath, a thorough check up is necessary to get to the cause of the problem. As it is not very easy to measure a person for the level of his halitosis or its cause, its diagnosing is not an easy task. There are some in-office tests that can be done at a dentist's office and then there are some self-monitoring tests that can be done by the patient himself. Both of these are a bit embarrassing to the patient and the methods are not perfected yet.

Some one from your family (preferably husband or wife) or a friend has to be involved in order to conduct self-monitoring tests. As the patient's brain is known to suppress odors coming out his own body, testing for these odors himself won't provide accurate results. As such, the only way you can do these tests at home is by hiring some one else for doing the odor testing. And this won't be an exciting job for any one! In case the chosen odor judge is not sporting enough to smell your breath directly, you can collect some of your saliva in a spoon or lick on your hand and let him smell the spoon of your hand. As the spoon is known to pass the smell better than your hand, it is the better tool to obtain accurate results. Another available method involves a home microbial test where cotton tipped applicators are used to get saliva from tongue and then it is placed in a test tube with a chemical medium. If you have severe halitosis, the medium will change its color in a short time.

There can be multiple tests involved in in-office testing like odor judge testing, microbial and fungal testing, the salivary incubation test, volatile sulfur detection testing and possibly artificial noses in the near future.

None of the existing testing procedures are very accurate. Making sure that the patient has halitosis or finding the reasons for halitosis is not possible in these methods. There are supporters and critics available for even the latest gadget, a sulfide monitor designed to test halitosis. This testing gadget is supposed to measure the amount of sulfur in the person's breath. But the results are not very reliable. As such, this portable sulfide monitor won't be an appropriate tool to do initial testing. But this can be used to keep track of the patient's improvement during the treatment period. These tests are not commonly done at the regular dental offices.

Treatment

Make It A Habit To Frequently Brush And Floss Your Teeth

Any food items left on your teeth would be a feast for bacteria and they create halitosis causing Volatile Sulfur Compounds (VLSCs) out of them. You should spend at least two minutes of time to brush your teeth. And a third of the teeth surface is hidden from the toothbrush and can't be cleaned with brushing. Flossing is necessary to clean these locations.

Using Products Designed To Do So Can Minimize Halitosis's Effects

Some examples of such products are halitosis toothpaste, non-alcoholic sulfur decreasing mouthwashes, sugar free chewing gum and breath mints.

Clean Your Tongue

The uneven surface of the tongue and the mucous layer are hiding places for anaerobic bacteria and they can cause the formation of whitish surface. They love to stay under the mucous layer and remains of food we consume without Oxygen contact. Most of these bacteria can be removed by regularly using tongue cleaners. Mechanical debridement is one of the best remedies for bad breath. This procedure simply involves a detailed brushing and flossing of your teeth as well as cleaning of your tongue. A tongue scraper can provide some halitosis relief as well. Always use a tongue scraper all the way back of your tongue first and then work towards the front and this has to be repeated many times.

Drink Lots Of Water

If you drink enough water, this would remove excess saliva and bacteria from your mouth.

Use Mouthwashes

A good mouthwash should remove all the harmful bacteria while leaving normal bacteria in your mouth. There are a variety of mouthwashes available with ingredients like quaternary ammonium, zinc, chlorhexidine, chlorine dioxide, triclosan etc. The most popular ones among these are chlorhexidine and chlorine dioxide. As chlorhexidine is a really strong mouthwash, it needs to be used only for short durations. Chlorine dioxide is safe to be used for a longer term. There are some question marks on this mouthwash also. Scientific studies on animals have shown that chlorine dioxide can destroy sulfur compounds that are a reason for halitosis. But this is not proven in humans yet. As most mouthwashes contain alcohol, this may cause the drying out of your mouth and that can eventually lead to worsening of your halitosis condition.

Chew Sugarless Gum

As more saliva is produced while chewing gum, this will help in washing harmful bacteria away.

Watch For Signs Of Gingivitis Or Dental Problems

Periodontal disease is an infection associated with gums and is caused by bacteria. As a result gaps may be formed between your teeth and gum and this area can't be cleaned easily. As large number of bacteria can stay in these gaps, sever halitosis is possible and can only be treated by undergoing treatment methods involving very thorough teeth cleaning. Warning signs for this damaging condition can be swollen gums, loose teeth, bleeding gums, pain while chewing, pus etc.

Systemic Disease Management

Use of antibiotics, controlling mucous levels in your nose, stopping the usage of halitosis causing medicines or food items, salivary substitutes, controlling systemic diseases etc can help you to rein on your condition.

Get Regular Dental Check-Ups

Every adult should get his dental check up done at least once in every six months. Otherwise, they may not be aware of dental problems until it is too late. A qualified dentist will notice problems like abscesses, cavities, periodontal disease, impacted teeth etc early.

Halitosis After Brushing

An important section of cosmetic dentistry is exclusively dealing with the causes and remedies for halitosis. There have been some studies and more needs to be done on treatment in particular.

Halitosis can be arising due to problems in various areas of the patient's body like mouth, tongue, nose, sinus, lungs, stomach etc. Problems in these areas, indigestion of certain food items, use of certain medicines etc can be the reason behind this. The hardest part is to figure out if severe halitosis is present or not. If this is established, then can try to figure out the root of the problem. A dentist and physician have to work in tandem to see if the problem is arising from the mouth or some other region of his body.

If the doctors figure out your mouth as the source of halitosis, then you have to figure out what is the exact oral problem. This can be tooth decay, periodontal disease, xerostomia or dry mouth, oral candiasis or fungal infection, oral cancer, VSCs emitting bacteria that usually reside on your tongue etc.

Proper brushing of your teeth, palate and tongue is the initial step to be taken so as to avoid halitosis. Tongue cleaners or tongue scrapers are also known to help reduce bad breath. If the problem is persisting even after adhering to a strict cleaning regimen of brushing, flossing and scraping, then you may need to try some other treatments. If dry mouth is the cause of your problem, salivary stimulants can be helpful. Mouthwashes containing zinc or chlorine dioxide are available in market and are thought to be of help.

The very first thing you should do is to get thoroughly examined by your dentist by taking radiographs and cancer testing. If the dentist clears you, then make an appointment with your physician and see if there is another cause for the problem. At the same time you have to stick to known practices of oral hygiene like proper brushing, flossing, tongue cleaning etc.