Tips for Preventing Bad Breath

April is National Halitosis Month

You: Hey, Bob, have a mint!
Bob: No, thank you.
You: No, REALLY BOB, I INSIST YOU TAKE A MINT!

Do people seem to always be in a hurry when you want to chat? Have you noticed acquaintances moving away as you attempt to move closer to talk to them? Fifty percent of Americans have a problem with bad breath.

Halitosis is a subject everyone has trouble mentioning to the offender. Mothers, best friends, spouses, and paramours are collectively guilty when it comes to discussing bad breath with their intimates. Why should this be such a social taboo, when you would be doing the person with halitosis a favor? Generally speaking, most people with bad breath are unaware their breath stinks. This is due to their olfactory receptors being supersaturated with their mouth odor, causing them not to appreciate any difference between what is a pleasant versus an unpleasant odor.

To see if you have halitosis, go outside and breathe fresh air for a few minutes. This will allow your olfactory receptors to be cleared. Now lick the back of your hand and smell it after the saliva dries. If you find the odor unpleasant, continue reading. The most common cause of bad breath is poor oral hygiene. This leads to an overgrowth of gram negative anaerobic bacteria (Fusobacterium polymorphum and nucleatum, Veillonellaalcalescens, Bacteroides funiliformis, Bacteroides melanogenicus, and Klebsiella pneumoniae) in the mouth which produce volatile sulfur containing fetid products such as hydrogen sulfide, methyl mercaptan, dimethyl sulfide, and dimethyl disulfide. Cadaverine, putrescine, indole and skatole are also produced and contribute to breath smelling bad (these compounds are also present in flatus).

The most effective way to treat bad breath is to thoroughly cleanse the back one-third of the tongue; this is where the majority of bacteria reside that produce the foul smelling fermentation compounds. The front part of the tongue is constantly being cleansed when it is moved against the hard palate. The back of the tongue only contacts the soft palate, and this is not an effective cleansing action. Use an alcohol or chlorhexidine containing mouthwash and say "AHHHHHH" while gargling so the mouthwash will reach the back of your tongue.

Mouthwashes that can help reduce odor causing oral bacteria:

  • BreathRx - contains chlorhexidine
  • Crest Pro-Health - contains cetylpyridunuim
  • Smart Mouth - contains zinc

Using a tongue scraper can also help. This can be purchased over the counter at a drug store. Use toothpaste containing hydrogen peroxide. The oxygen released will make the environment less hospitable for the anaerobic bacteria. Brush the back of your tongue with your toothbrush. Wash your toothbrush in the dishwasher on a regular basis. Alternatively, mix a little hydrogen peroxide with your mouthwash and gargle with it. You may need to have your teeth cleaned every 3-4 months instead of the traditional 2 times a year. A plaque layer as thin as 0.1- 0.2mm becomes depleted of oxygen creating the ideal environment for gram negative bacterial overgrowth. If you are unable to brush and floss after eating, rinse and gargle with water and chew sugarless gum. If you have bad breath accompanied by sinus pain, facial pain or discolored mucous when you blow your nose, you should see your doctor to be evaluated for a sinus infection. If none of the above measures are effective, see your dentist and internist for a more in depth evaluation. By the way, it is now known that having periodontal disease increases your risk for coronary artery disease. So theoretically, you could die from having bad breath.

Causes of Halitosis

  • Poor dental hygiene- cavities, gingivitis, excessive plaque accumulation
  • Sinusitis
  • Tonsillitis
  • Rhinitis
  • Nasal infections
  • Mouth sores
  • Medications
  • Alcohol
  • Cigarettes, tobacco
  • Coffee, onions, garlic, pastrami, diets high in fat and protein
  • Bronchitis
  • Pneumonia
  • Diabetes not well-controlled
  • Dehydration
  • Gastro esophageal reflux
  • Oral cancer
  • Salivary gland abnormalities
  • Oral appliances - dentures, braces, retainers
  • Oral Candidiasis
  • Dry mouth