Dealing with bad breath

PHOTO: Dealing with bad breath

ONCE in a while, someone walks into a room and chokes every living thing in it with the overwhelming scent of perfume.

The wearer is oblivious to the reaction of others as the sense of smell has become acclimatised to the constant stimulus.

In a similar fashion, those with bad breath have no inkling how the foul odour affects those within the "smell radius".

Foetor oris is Latin for "stinky mouth". In scientific nomenclature, malodorous breath is termed as halitosis.

Who has it? Unfortunately, everyone, at some time of the day, but for some poor souls, it's all day long.

A simple test would be to lick the inside of the wrist, let the saliva dry a bit, and take a sniff. Try doing this first thing in the morning for full impact!

Bad breath certainly has unavoidable social connotations.

One can accept a less than perfect visual image, but when subjected to the smell of rotten eggs at close proximity, it's a tough call indeed.

The eye can behold, the nose cannot endure!

Impolite as it may sound, foul odour that encroaches the breathing space of others provokes emotional, physiological and psychological reactions of friends, acquaintances and work colleagues.

It is estimated to be the third most common complaint presented at the dental clinic in the US.

Mouth odour

The mouth is like a swamp, harbouring 600 different types of bacteria, some of which makes the oral orifice smell bad.

These little bugs contribute to the stench by their decomposition of food particles, cellular debris and mucous trapped in between teeth, gums, the back of the tongue and throat, releasing offensive sulphurous gases.

Unhealthy, inflamed gums and plaques are the chief causes of halitosis as there are high concentrations of bacteria here. The back of the tongue is a notorious hideout for rogue bugs.

Ill-fitting dentures, bridges, crowns and poor dental hygiene promotes bad breath.

A persistent sneezer with clogged sinuses, throat or respiratory tract infection are the common non-dental sources of foul breath.

The tonsil are two marble-like lymph tissues at the throat, with little crevices on its surface.

Food particles and cellular debris can collect in these nooks and crannies, inviting bacteria to work on it.

Mouth ulcers and more sinister lesions like oral and nasopharyngeal cancer can present with halitosis.

The morning after

The morning after

The self-cleaning mechanism in the mouth is a technology patented by nature.

The swirling movement of the tongue and the drooling of saliva helps to sweep food, bacteria and what nots, flushing them down into the gullet en route to the stomach.

This explains the "morning after" breath, because during sleep, there is stagnation and reduced saliva flow, a situation particularly aggravated in the mouth breather and sonorous sleeper.

The auto cleanser enters into the sleep mode.

Dry mouth (xerostomia), fasting, the side effects of taking certain medications (eg antihistamine, antispasmodic etc), consuming beverages like coffee and alcohol, and reduced saliva production (Sjogren's syndrome) contributes to unpleasant mouth odour.

More than a mouthful

An unhealthy gut leaves tell-tale smells, from both ends! 

Acid reflux, indigestion, poor bowel habits, and a preponderance of "bad gut bacteria", allow the back-flow of noxious gases that spews from the mouth, although the origins lie deep down, ten meters from the oral orifice. 

Halitosis is a challenging issue for poorly controlled diabetics. 

In an environment of high blood sugar, of which little gets into the cells for utilisation, the body trims the fat and breaks down proteins for a secondary source of energy, thereby creating an acidic state known as ketoacidosis. 

Sweet, sickly ketones exude from the breath, which is aggravated by dehydration and a dry mouth.

Together with gum infections, which occur more readily, these factors pave the way for a uniquely unpleasant breath. 

Dentist says


The dentist says

Since the bulk of the causes of halitosis originate from the oral cavity, let's hear it from the horse's mouth.

Sitting in the dentist's chair was never one of my favourite pastimes, but Dr Catherine Chong has turned my visits to her office into "dental spa" sessions.

With due respect, the following is an extract from a casual interview.

CS: Dr Chong, why do dentists wear masks?

Dr Chong: To prevent droplet infection lor ... ahh, also to reduce contaminated spray on the face.

CS: What about to mask out bad breath?

Dr Chong: Yeah, and that too (chuckles).

CS: What is the number one reason patients come to see you for?

Dr Chong: Pain is usually their motivating factor.

CS: What about halitosis, do patients present that as their chief complaint?

Dr Chong: Hardly, either they are not aware or they live with it. They usually do not bring up the smelly issue.

CS: Is the cause of bad breath usually obvious?

Dr Chong: Yes, in the majority of cases, there is a dental cause, like unhealthy gums, plaques, caries, problems with dentures and general oral neglect.

However, among those who complain of having bad breath, it is often due to a non-dental cause like sinusitis or poor digestive health.

CS: Since all of us do have, on occasions, breath that is a tad bad, especially in the mornings and after certain foods, is that normal?

Dr Chong: Call that physiological halitosis if you like. It usually becomes less noticeable after brushing, flossing or eating a meal.

However, some individuals have a highly disproportionate perception of their intensity of bad breath (even though unnoticed by others).

And we went on and on exploring the stinky problem. This is what she recommends:

  • Regular dental check-ups, treating obvious causes.
  • Brush teeth after every meal.
  • Floss the spaces in between.
  • Clean and brush the tongue.
  • Rinse with mouthwashes.
  • Chew on sugarless gum.
  • Remove and clean dentures, nightly.

Might I also add that practising a healthy lifestyle, such as adopting regular exercises, ensuring adequate hydration, healthy diet (balanced with five to six serving s of fruits and vegetables daily), supplements for optimal health (multivitamins, antioxidants, fish oil, etc) and looking after gut well being (probiotics, fibre and digestive enzymes) helps.

Dental hygiene is an integral component of general health. In the absence of dental causes, other more pressing undercurrents need to be unmasked and tamed.

Halitosis is more than just a social handicap; something is rotting, and it better not be your health!