My problem is bad breath, also called halitosis

I have been having bad breath for a while now. Kindly explain the problem and potential remedies for it. Wishing you all the best in your commitment in serving us.

Worried Man.

Thanks for your question. Bad breath, also known as halitosis, is a common problem that can cause significant psychological distress. Anyone can suffer from bad breath. It is estimated that 1 in 4 people have bad breath on a regular basis.

Common Causes

• Tobacco products cause their own types of mouth odour. Additionally, they increase the chances of gum disease which can also cause bad breath.

• The breakdown of food particles stuck in the teeth can cause odours. Some foods such as onions and garlic can also cause bad breath. 

• Dry mouth: Saliva naturally cleans the mouth. If the mouth is naturally dry or dry due to a specific disease, such as xerostomina, odours can build up.

• Crash diets: Fasting and low-carbohydrate eating programmes can produce halitosis. This is due to the breakdown of fats producing chemicals called ketones. 

• Drugs: Certain medications can reduce saliva and, therefore, increase odours. Other drugs can produce odours as they breakdown and release chemicals in the breath. 

• Mouth, nose, and throat conditions.

• Foreign body: Bad breath can be caused if they have a foreign body lodged in their nasal cavity, especially in children.

• Diseases: Some cancers, liver failure, and other metabolic diseases can cause halitosis, due to the specific mixes of chemicals that they produce. 

• Bowel obstruction: Breath can smell like feces 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 it yourself.

• If no one is available, one way of checking the odour is to lick your wrist, leave it to dry, and then smell it. A bad smell on this area of the wrist is likely to suggest that you have halitosis.

• 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 behavior.

Home Remedies

Other lifestyle changes and home remedies for bad breath include:

• Brush the teeth: Be sure to brush at least twice a day, preferably after each meal.

• Floss: Flossing reduces the build-up of food particles and plaque from between the teeth. Brushing only cleans around 60% of the surface of the tooth.

• Clean dentures: Anything that goes into your mouth, including dentures, a bridge, or a mouth guard, should be cleaned as recommended on a daily basis. 

• Changing toothbrush every 2 to 3 months is also important for similar reasons.

• 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. 

• Diet: Avoid onions, garlic, and spicy food. Sugary foods are also linked to bad breath. Reduce coffee and alcohol consumption. 

• If breath odour persists despite controlling these factors, it is recommended that an individual visits a doctor.

Diagnosis

Often, a dentist will simply smell the breath of a person with suspected halitosis 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, they include for example Halimeter that detects low levels of sulfur.

Treatment

• The best method to reduce halitosis is 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.