Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
Bad breath affects an estimated 25 percent of people. There are a number of possible causes of bad breath, but the vast majority comes down to oral hygiene. It is also known as halitosis, or fetor oris.
Halitosis can cause significant worry, embarrassment, and anxiety, but it is relatively easy to remedy.
* Bad breath is estimated to affect 1 in 4 people globally.
* The most common cause of bad breath is bad oral hygiene.
* If particles of food are left in the mouth, their breakdown by bacteria produces sulfur compounds.
* Keeping the mouth hydrated can reduce mouth odour.
* The best treatment for bad breath is regular brushing, flossing, and hydration.
Bad breath is a common problem that can cause significant psychological distress. There are a number of potential causes and treatments available.
Anyone can suffer from bad breath; it is the third most common reason why people seek dental care, after tooth decay and gum disease. Simple home remedies and lifestyle changes, such as improved dental hygiene and quitting smoking, can often remove the issue. If bad breath persists, however, it is advisable to visit a doctor to check for underlying causes.
CAUSES
Potential causes of bad breath include:
* Tobacco: Tobacco products cause their own types of mouth odour. Additionally, they increase the chances of gum disease, which can also cause bad breath.
* Food: The breakdown of food particles stuck in the teeth can cause odours. Some foods, such as onions and garlic, can also cause bad breath. After they are digested, their breakdown products are carried in the blood to the lungs, where they can affect the breath.
* Dry mouth: Saliva naturally cleans the mouth. If the mouth is naturally dry or dry due to a specific disease, such as xerostomia, odours can build up.
* Dental hygiene: Brushing and flossing ensure the removal of small particles of food that can build up and slowly break down, producing odour. A film of bacteria, called plaque, builds up if brushing is not regular. This plaque can irritate the gums and cause inflammation between the teeth and gums called periodontitis.
Dentures that are not cleaned regularly or properly can also harbour bacteria that cause halitosis.
* Crash diets: Fasting and low-carbohydrate eating programmes can produce halitosis. This is due to the breakdown of fats producing chemicals called ketones. These ketones have a strong aroma.
* Drugs: Certain medications can reduce saliva, and therefore increase odours. Other drugs can produce odours as they break down and release chemicals in the breath. Examples include nitrates used to treat angina, some chemotherapy chemicals, and some tranquilisers, such as phenothiazines. Individuals who take vitamin supplements in large doses can also be prone to bad breath.
* Mouth, nose, and throat conditions:
Sometimes small, bacteria-covered stones can form on the tonsils at the back of the throat, and produce odour. Also, infections or inflammation in the nose, throat or sinuses can cause halitosis.
* Foreign body: Bad breath can be caused if there is a foreign body lodged in the nasal cavity, especially in children.
* Diseases: Some cancers, liver failure, and other metabolic diseases can cause bad breath, due to the specific mixes of chemicals that they produce. Gastroesophageal reflux disease (GERD) can cause bad breath due to the regular reflux of stomach acids.
Rarer causes of bad breath
As mentioned earlier, the most common reason for bad breath is oral hygiene, but other situations can also be blamed.
*Ketoacidosis: When the insulin level of a person with diabetes is very low, the body can no longer use sugar, and so begins to use fat stores instead. When fat is broken down, ketones are produced and built up. Ketones can be poisonous when found in large numbers, and they produce a distinctive and unpleasant breath odour.
Ketoacidosis is a serious and potentially life-threatening condition.
*Bowel obstruction: Breath can smell like faeces if there has been a prolonged period of vomiting, especially if a bowel obstruction is present.
*Bronchiectasis: This is a long-term condition in which airways become wider than normal, allowing for a build-up of mucus that leads to bad breath.
<* Aspiration pneumonia:> A swelling or infection in the lungs or airways due to inhaling vomit, saliva, food, or liquids.
<<SYMPTOMS>>
The specific odour of breath can vary, depending on the cause of the problem. It is best to ask a close friend or relative to gauge your mouth odour, as it can be difficult to assess. If no one is available, one way of checking the odour is to lick the wrist, leave it to dry, and then smell it. A bad smell on this area of the wrist is likely to suggest bad breath.
Some individuals are concerned about their breath even though they may have little or no mouth odour. This condition is called <halitophobia> and can lead to obsessive mouth-cleansing behaviour.
<<TREATMENT>>
The best way to reduce bad breath is to practise good oral hygiene. This ensures that cavities are avoided, and reduces the likelihood of gum disease. It is recommended that individuals 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.
Alternatively, if gum disease is present, professional cleaning may be necessary to clear out the build-up of bacteria in pockets between the gums and teeth.
<<DIAGNOSIS>>
Often, a dentist would simply smell the breath of a person with suspected bad breath and rate the odour on a six-point intensity scale. The dentist may scrape the back of the tongue and smell the scrapings, as this area can often be a source of the aroma. There are a variety of sophisticated detectors that can rate odour more precisely.
<<HOME REMEDIES>>
Oral hygiene is the key to most bad breath issues. Other lifestyle changes and home remedies for bad breath include:
<1. Brush the teeth:> Be sure to brush at least twice a day, preferably after each meal.
<2. Floss:> Flossing reduces the build-up of food particles and plaque between the teeth. Brushing only cleans around 60 percent of the surface of the tooth.
<3. Clean dentures:> Anything that goes into the mouth, including dentures, a bridge, or a mouth guard, should be cleaned as recommended on a daily basis. Cleaning prevents the bacteria from building up and being transferred back into the mouth. Changing toothbrushes every 2 to 3 months is also important for similar reasons.
<4. Brush the tongue:> Bacteria, food, and dead cells commonly build up on the tongue, especially in smokers or those with a particularly dry mouth. A tongue scraper can sometimes be useful.
<5. Avoid dry mouth:> Drink plenty of water. Avoid alcohol and tobacco, both of which dehydrate the mouth. Chewing gum or sucking a sweet, preferably sugar-free, can help stimulate the production of saliva. If the mouth is chronically dry, a doctor may prescribe medication that stimulates the flow of saliva.
<6. Diet:> Avoid onions, garlic, and spicy food. Sugary foods are also linked to bad breath. Reduce coffee and alcohol consumption. Eating a breakfast that includes rough foods can help clean the back of the tongue.
If breath odour persists despite controlling these factors, it is recommended that an individual visits a doctor for further tests, to rule out other conditions.
