Bad Breath (Halitosis) – Getting Rid of the Stench
Would you sit in a lesson given by a lecturer whose breath smells terrible?
There’s no doubt that the answer is definitely no.
Bad breath is a common problem experienced by one out of every four people at different degrees of severity. Bad breath, or by its official name – halitosis (from the Greek halitos - breath, osis - abnormal), is a problem that has social, occupational and psychological implications.
There are two types of bad breath;
one type is bad breath that passes, while the other type is a chronic odor from the mouth.
The passing type is influenced by several factors, such as food (for example, garlic and onion), dryness of the mouth and medications. The chronic type is more difficult to treat and requires constant attention.
What are the causes of bad breath?
In approximately 85-90% of the cases, the source of the odor is inside the mouth, and the primary cause is bacteria located in the mouth. It is possible to find hundreds of strains of bacteria inside the mouth. Several dozens of them break down proteins which are present due to food residue, dead epithelial cells which have shed and even mucus which has descended from the nose. The results of this breakdown are odorous compounds. In bad breath, it is possible to find sulfurous compounds similar to the smell of rotten eggs, odors of rotten meat, dead bodies and sweaty feet - smells which are not very pleasant, to say the least.
The primary place where these bacteria are located is at the base of the tongue. The tongue is rough, so leftover food can get stuck on it. In addition, at the bottom side of the tongue, residual food is less likely to be washed away by the saliva, so this is an ideal location for the odor-emitting bacteria. Additional locations in the mouth which contribute to the bad breath are between the teeth where leftover food accumulates, faulty restorations such as crowns, dirty and untreated dentures, areas with periodontitis and abscesses.
Saliva plays an important role. The saliva washes away the residual food and the by-products of the bacteria’s breakdown activity. This is the reason why breath smells worse in the morning. Overnight, less saliva is excreted and especially in those who sleep with an open mouth, dryness in the mouth is increased, allowing the bacteria to break down the proteins from residual food and create odorous compounds. The phenomenon is also prominent when the mouth is dry, after prolonged speaking, fasting, using medications which cause dryness of the mouth and in situations of anxiety.
The other 10% of cases are caused by areas external to the mouth, primarily the nose (for example, chronic sinusitis), the tonsils and finally, there are a few cases which are caused by the digestive system. In rare cases, systemic diseases can cause bad breath, such as diabetes, liver diseases and kidney diseases.
How is bad breath diagnosed?
People who suffer from bad breath are not always aware of their condition and there are scholars who believe that this is due to the fact that they have become accustomed to the smell. One of the suggestions for self-diagnosis is to lick the back of the hand, wait for the saliva to dry and then smell it. This method may be problematic because a person may exaggerate or ignore the problem. The best way to diagnose is simply to ask someone close to you to smell your breath and tell you if it is unpleasant – this is the most correct method. There are technological means of checking but in fact, the most effective method is to ask someone close to you to smell your breath.
Take into account that our breath changes during the course of the day and is influenced by your diet and the amount of saliva in the mouth; therefore, your breath should be checked a few times in order to decide.
There is a group within those who complain that they suffer from bad breath yet don’t objectively have bad breath; rather, they are worried that their breath smells bad. They usually clean their mouths obsessively, and this sometimes has a negative social impact on them. They interpret people’s behavior toward them incorrectly and thus fuel this notion. This state is called halitophobia and requires behavioral psychological treatment. Some individuals who suffer from halitophobia will not even acknowledge the problem and will not seek help.
How to treat Bad Breath? Tips for a fresh breath:
- Maintaining oral hygiene - It is important to brush and clean between the teeth using aids such as dental floss, in order to remove food residue. It is very important to come to the dental clinic for routine examinations, for teeth cleaning and guidance by the dental hygienist. All points affected by caries should be treated and any faulty restoration should be replaced. If you use dentures, you must make sure to clean them immediately following every meal, washing them with water and dish soap and using the designated cleaning tablets.
- Tongue - As mentioned, the tongue is the primary location of bacteria that causes bad breath. Use special tongue brushes to scrape all of the residual food, especially at the back part of the tongue. There are those who suffer from a sensitive gag reflex and in cases like these, it is indeed difficult, but usually over time, they will become accustomed to this type of cleaning.
- Diet - It is preferable to avoid foods which themselves cause bad breath, such as garlic and onions. Eat foods such as firm fruits and vegetables and whole grain bread. Eating these types of foods will yield two desirable results: the increased chewing will stimulate saliva excretion, and the “rough” foods will help scrape the odorous bacteria off of the tongue. This is very important at breakfast, to clean the tongue following the night.
- Sugar-free chewing gum and candies – Using these will increase saliva excretion, to assist in washing away the bacteria and residual food.
- Drink water - Water will assist in washing away residual food and will prevent dryness in the mouth.
- Avoid drinking alcohol - Alcohol causes dryness of the mouth. Notice that some of the mouthwashes sold contain alcohol.
- Avoid smoking - Aside from the smell of the cigarettes which is odorous itself, smoking dries out the mouth, harms the gums and worsens periodontal diseases. It also creates phlegm and residue on the tongue and the odor mixes with the smells in the mouth.
- Use mouthwash - The washing process itself assists in removing residual food. There are products especially made to treat bad breath. Some include antibacterial substances, oil phases to remove residual food and other substances which neutralize odor. Stay away from mouthwashes that contain alcohol. It is important to emphasize that not all of the bacteria can be removed from the mouth. In addition to the “bad” bacteria, there are quite a few “good” types of bacteria, and antibacterial products do not differentiate between the bad and the good types. Using mouthwash is a good addition to the routine but is not a replacement for mechanically cleaning residual food and bacteria. Those who suffer from bad breath especially in the morning should use mouthwash before going to sleep.
- Avoid dryness of the mouth – You can drink water and use sugar-free gum and candies. If the dryness is caused by medications (for example, antidepressants and anti-anxiety medications), consult with your doctor to see if you can use an alternative medication. A person who suffers from dryness in the mouth can use products which are like “artificial saliva.”
- Home remedies - Since this problem has existed from time immemorial, various cultures developed solutions using herbs to treat the problem. Some treatments use: parsley, cinnamon, fennel seeds, guava peels and gum tree sap.