Bad Breath Needs Dental Aid

Dr Neeraj Verma

Bad breath coming from the mouth is known as halitosis. Bad odor is estimated to be the third most frequent reason for seeking dental aid, following tooth decay and periodontal disease. Whether the smell is from an oral source or not, halitosis has significant impact, personally and socially.
How does bad breath occur?
After eating any food item, it sticks in between the teeth and on the tongue. If allowed to remain there, it is acted upon by bacteria and other micro organisms present in the mouth. This causes food rot, leading to bad smell.
Some food items themselves cause bad breath because of their inherent odor. Common examples of such food and beverages include onion, garlic, cheese, certain spices, orange juice and soda. Once these are digested and the volatile oils are absorbed into the blood stream, they are carried into the lungs and given off as bad breath.

Bad breath may also be a sign of a health problem. Chronic lung infections, liver or kidney diseases and diabetes are some conditions that may result in bad breath in these chronically ill patients. The other sources of bad breath could be nose, tonsils and stomach.

In most cases (85-90 percent) bad breath originates in the mouth itself. The intensity of bad breath differs during the day due to eating certain foods as mentioned above, or obesity, smoking and alcohol consumption. Because the mouth is exposed to less oxygen and is inactive during the night, the odor is usually worse upon awakening (morning breath).

The most common location for mouth related halitosis is the tongue. Large quantities of naturally occurring bacteria are often found in the posterior dorsum or the back portion of the tongue, where they are relatively undisturbed by normal activity. This part of the tongue is relatively dry and poorly cleansed. The odors are produced mainly due to anaerobic breakdown of proteins into individual amino acids, which further breakdown to produce foul gases.

Gum disease occurring as chronic periodontitis, sublingual bacterial plaque, or pus pockets in the gums are some of the other local causes of bad breath.

Bad Breath Needs Dental Aid

Dr Neeraj Verma

Diagnosing causes of bad breath
Before diagnosing the causes of bad breath, occurrence of halitosis should be confirmed as below:

Self diagnosis
Smelling one’s own breath odour is often difficult. However, many people with bad breath are able to detect it in others.
Simplest and most effective way to know whether one has bad breath is to ask a trusted adult family member or very close friend (confidante).

Professional diagnosis
If bad breath is persistent and all other medical and dental factors have been ruled out, specialized testing and treatment is required. Some of several methods for diagnosis are:
1) Halimeter: A portable sulphide monitor used to test for level of sulphur emissions in the breath.
2) Gas chromatography: Portable machine specifically designed to digitally measure the molecular levels of three major sources in sample of mouth air (hydrogen sulphide, methyl mercaptan, dimethyl sulphide).
3) Bana test: This test is directed to find the salivary levels of an enzyme indicating the presence of certain halitosis selated bacteria.

Home care and treatment for bad breath

  1. Tongue cleaning: Gently cleaning the tongue surface twice daily is the most effective way to keep bad breath in control that can be achieved using a tongue cleaner or tongue brush to wipe off the bacterial biofilm, debris and mucus.
  2. Eating healthy breakfast with rough food helps clean the very back of tongue.
  3. Chewing gum: Since dry mouth can increase bacterial build up and cause or worsen bad breath, chewing sugarless gum can help with production of saliva and thereby help to reduce bad breath. Some chewing gums contain special anti-odor ingredients.
  4. Gargling: Right before bedtime, with an effective mouth wash such as chlorhexidine, zinc gluconate chlorine dioxide, is a common method to reduce bad odor. However, one should consult a dentist and use these gargles and mouth washers under the guidance of a qualified dentist.
  5. Maintaining proper oral hygiene: Teeth brushing, flossing, periodic visit to dentist and hygienist. Flossing is important in removing rotting food debris and bacterial plaque from between the teeth. Dentures should be properly cleaned and soaked overnight in antibacterial solution.
  6. Maintain water levels in the body by drinking several glasses of water a day.
Dr Neeraj Verma is Senior Consultant – Dental, Indraprastha Apollo Hospitals, New Delhi.