BAD BREATH
Bad breath, sometimes referred to as halitosis, can be highly embarrassing and in some cases may even cause anxiety. Little wonder therefore, that store shelves are overflowing with gum, mints, mouthwashes and other products designed to fight bad breath. Many of these products however, are only temporary measures because they do not address the root cause of the problem.
The causes of bad breath could be from certain foods, health conditions and habits, to name but a few. In many cases, bad breath can be improved with proper and consistent dental hygiene. To be sure a more serious condition is not causing the bad breath, one must see their dentist or physician especially if simple self-care techniques fail to solve the problem.
The definition of bad breath, or halitosis, is an unpleasant smell coming from the mouth. Halitosis can occur on occasion, or it can be a chronic condition.
CAUSES AND RISK FACTORS OF BAD BREATH
There are many risk factors and causes of halitosis, and occasionally, even healthy people have bad breath. Some common causes of halitosis include the following:
- Tobacco and tobacco products - Smoking and chewing tobacco can leave chemicals that remain in the mouth. Smoking can also promote other bad-breath causes such as gum disease or oral cancers.
- Food - A primary source of bad odors that come from the mouth is food. Some foods, (e.g. onions, garlic, spicy foods), and exotic spices (e.g. curry), some cheeses, fish, and beverages such as coffee can leave smell that linger. Other foods may get stuck in the teeth, thus will promote the growth of bacteria and dental plaque, which causes bad breath odor. Another food source is low carbohydrate diets, which may cause 'ketone breath'. Such diets cause the body to burn fat as its source of energy. The end-product of this is ketones, which causes a fruity acetone-like odor on the breath when exhaled. This same fruity odor in a diabetic patient might indicate uncontrolled blood sugars.
- Poor oral health - Food particles that remain in the mouth when a person does not brush or floss his/her teeth regularly, can rot and cause bad odor. Poor dental care can also lead to a buildup of plaque in the mouth and plaque causes odor of its own. Plaque buildup on the teeth can also lead to periodontal (gum) disease. When plaque hardens, it is referred to as tartar (calculus). The mild form of gum disease is called gingivitis, untreated gingivitis can advance to become periodontitis.
- Health problems - some health problems e.g. Pneumonia, Sinus infections, Sore Throat and other infections of the throat, the common cold, influenza (flu), tonsil stones, bronchitis, postnasal drip, diabetes, lactose intolerance, other stomach or digestion problems, and particular liver or kidney diseases may be associated with bad breath.
- Dry mouth - Xerostomia, (dry mouth) can also cause bad breath. Saliva helps moisten and actually cleanses the mouth, and when the body does not product enough saliva, bad breath may result. Dry mouth may be caused by problems with salivary gland, connective tissue disorders (Sjögren's syndrome) etc.
- Pregnancy - Nausea and morning sickness common during pregnancy may cause bad breath. In addition, hormonal changes, dehydration, and eating different foods due to cravings may also contribute to bad breath during pregnancy.
- Allergies - A lot of medications used to treat allergies can also cause dry mouth which is itself another cause of halitosis. Sinus congestion due to allergies can also cause people to breathe from their mouths, causing dry mouth.
- Medications - Many medications, including anti-histamines that are used to treat allergies and diuretics, can cause dry mouth, which in turn can cause bad breath.
- Mouth infections - Cavities, gum disease, or teeth which for some reason has been blocked from breaking through the gum (impacted teeth) may cause bad breath.
- Dentures and or braces - Food particles not properly cleaned from such appliances rot and cause bacteria and odor. Ill-fitting dentures may cause sores or infections in the mouth, which can cause bad breath.
- Morning breath – It is very common to have bad breath in the morning. The reason for this is because saliva production nearly stops during sleep. This allows bacteria that causes odor- to grow, causing bad breath.
- Other causes - Large doses of vitamin supplements, objects stuck in the nose (usually in children), and alcoholism may also cause bad breath.
SIGNS AND SYMPTOMS OF BAD BREATH
It is generally not difficult how to tell if one has bad breath. Others may notice someone has halitosis before the person does, so the other person may tell him or her about their bad breath or give them a larger than normal personal space. The most obvious sign or symptom of bad breath is noticing an unpleasant smell coming from the mouth.
Other signs and symptoms of bad breath include;
- Sour, unpleasant or changes in taste
- Dry mouth, and
- A coating on the tongue
SPECIALISTS THAT TREAT HALITOSIS
The first stop with halitosis is usually the dentist. If the dentist determines that the mouth is healthy, the patient is most likely to be referred to a physician to check for an underlying health problem.
- In the case of a periodontal disease, patient may be asked to see a periodontist, who is a dentist that specializes in gum disease and dental implants.
- If the patient has braces, it will be likely that the bad breath is caused by food getting stuck in the braces. Then the patient may be asked to see an orthodontist for adjustments.
- In babies or young children, bad breath may be a sign of infection or an undiagnosed medical problem. Consult a pediatrician or dentist if an infant or young child has bad breath.
When to see a doctor
- It may be necessary to review oral hygiene habits if one experiences bad breath. Try to make lifestyle changes like brushing the teeth and tongue after eating, using dental floss, and drinking plenty of water.
- If the bad breath persists after making such changes, see the dentist. If the dentist suspects a more serious condition is causing the bad breath, he or she may refer you to a physician to find the cause of the odor.
Patients must see a dentist or doctor for diagnosis if bad breath is accompanied by;
- Fever or fatigue,
- Sores in the mouth,
- Persistent dry mouth,
- White spots on the tonsils,
- Pain or difficulty with chewing or swallowing,
- Broken teeth or dental pain,
- Also see a doctor or dentist if bad breath develops after taking a new medication, after recent dental surgery, or any other symptoms develop that are of concern.
DIAGNOSIS
Often, a dentist will simply smell the breath of a person with suspected halitosis and rate the odor on a six-point intensity scale. The dentist may also scrape the back of the tongue and smell the scrapings as this area can often be a source of the aroma. Doctors may recommend an appointment for the morning, before brushing the teeth. You can expect to answer questions regarding how often you brush and floss, the kinds of food you eat, and any allergies or diseases you may have. However, there are a variety of sophisticated detectors that are used to rate odor more precisely.
They include the following:
- Hali meter - This detects low levels of sulfur.
- Gas chromatography - This test measures three volatile sulfur compounds: Hydrogen sulfide, methyl mercaptan and dimethyl sulfide.
- BANA test - This measures levels of a specific enzyme produced by halitosis-causing bacteria.
- Beta-galactosidase test - Levels of the enzyme beta-galactosidase have been found to correlate with mouth odor.
TREATMENT OPTIONS FOR BREATH ODOR?
- If breath odor is due to a plaque buildup, a simple dental cleaning may solve the problem. It may be necessary to have a deep dental cleaning if it is periodontal disease.
- Treating underlying medical problems, such as a sinus infection or kidney disease, can also help improve breath odor.
- The dentist may recommend that you use an artificial saliva product and drink plenty of water if dry mouth causes your odor problem.
- The best method to reduce halitosis is to practice good oral hygiene. This way, cavities and the likelihood of gum disease are reduced or avoided.
- Individuals are advised to visit the dentist for a check-up and cleaning twice a year.
- The dentist may recommend a toothpaste that includes an antibacterial agent or an antibacterial mouthwash.
- In the event of a gum disease, professional cleaning may be necessary to clear out the build-up of bacteria in pockets between the gums and teeth.
LIFESTYLE AND HOME REMEDIES
To reduce or prevent bad breath one must:
- Brush their teeth after eating. Try to keep a toothbrush at work to use after eating. Brush with a fluoride-containing toothpaste at least twice a day, importantly after meals. Toothpastes that has antibacterial properties has been revealed to reduce bad breath.
- Floss at least once a day. This removes food particles and plaque from between the teeth, which helps to control bad breath.
- The tongue harbors bacteria, so brushing it a bit more carefully may reduce odors. People who have a coated tongue from a significant overgrowth of may benefit from using a tongue scraper, or perhaps use a toothbrush that has a built-in tongue cleaner.
- Use over-the-counter mouthwash can help kills breath-causing bacteria and may temporarily mask bad breath odors, but may not treat the underlying cause.
- If one wears a bridge or a denture, clean it thoroughly at least once a day or as directed by the dentist. Dental retainers or mouth guards must be cleaned each time before use.
- To maintain a moist mouth, avoid tobacco and drink plenty of water (not coffee, soft drinks or alcohol) all of which can lead to a drier mouth. Chew gum or suck on sugarless candy to stimulate saliva. For chronic dry mouth, the dentist or physician may prescribe an artificial saliva preparation or an oral medication that stimulates the flow of saliva.
- Adjust your diet. Avoid foods such as onions, garlic and the eating of sugary foods that can cause bad breath.
- Toothbrushes should be changed regularly (about every three to four months) especially when it becomes frayed and choose a soft-bristled toothbrush.
- Regular visits to the dentist, (generally twice in a year) to have the teeth or dentures examined and cleaned
HOW TO PREVENT BREATH ODOR?
Teeth must be brushed two or more times each day,
Daily floss, while making sure to get in between the teeth,
Use antimicrobial mouthwash daily to kill bacteria,
Brushing the tongue with a toothbrush or tongue scraper can also help remove bacteria,
Staying hydrated to help eliminate or prevent breath odor,
Drink water to wash away food particles and keep the mouth moist,
Quitting smoking can also help keep the mouth moist and free of odor,
Clean dentures, mouth guards, and retainers daily,
Replace old toothbrushes every three months,
Schedule a dental cleaning and examination every six months.