The Smile Studios’ Shirley Jones looks at the causes and cures for bad breath
Halitosis is a common problem. Halitosis, or chronic bad breath, affects approximately 1 in 4 people. Unlike other mouth odours that may linger after meals or occur during the morning, halitosis cannot be cured with breath mints or mouthwash alone.
Halitosis is a condition that can cause some embarrassment and social anxiety, but more importantly, it can be an indication of a more serious underlying problem like gum disease or tooth decay.
Bad Breath Facts
• Bad breath affects approximately 25% of people worldwide.
• Food particles break down in the mouth, releasing sulphur, which causes bad breath.
• Poor oral health habits are the leading cause of bad breath.
• The best way to treat bad breath is with regular brushing and flossing and scheduled visits to your dentist.
What causes bad breath?
There are several causes for bad breath that you should be aware of and include:
• Poor Dental Hygiene
The primary cause of bad breath is usually poor dental hygiene. Without regular brushing and flossing bacteria build-up on your teeth and produce a film of plaque which can cause acid build-up and tooth decay? Not regularly brushing and flossing also leaves food particles stuck to your teeth which break down and produce a bad smell.
• Poor Hydration
Poor hydration can cause dry mouth and restrict saliva production. Water can also help to wash away food particles and bacteria that cause bad mouth odour.
Some foods contain high levels of sulphur that when broken down by the digestive system produce malodorous molecules that are carried by the bloodstream to the lungs and are breathed out. These foods include members of the allium family such as onions and garlic. Other foods that can cause bad breath include fish, dairy products, and cruciferous vegetables.
Crash dieting has also been linked with bad breath. Especially, diets those are high in protein and low in carbohydrates as they cause the body to produce ketones which smell unpleasant.
Smoking and chewing tobacco can contribute to bad breath as the nicotine and chemicals contained in tobacco can dry out the mouth. When your mouth does not produce enough saliva, it cannot wash away food particles and bacteria that build-up in your mouth. A lack of saliva can also change the pH level in your mouth, allowing bacterial colonies to multiply more easily.
Smoking has also been linked with gum disease  as it can cause the gums to recede exposing the root of the tooth to bacteria increasing the risk of infection.
Some medications have been known to cause bad breath due to the breakdown of the compounds in the medications, or due to a reduction in saliva production. Medications associated with bad breath include some chemotherapy drugs, medications for treating angina, and some types of tranquilisers.
• Health Conditions
Liver disease, some cancers, and metabolic diseases have all been linked with bad breath as they produce certain malodorous compounds. Infections of the mouth, nose, and throat can also create small stones that can become covered in bacteria that emit bad odours.
How to identify bad breath?
It can be challenging to know whether you have bad breath. One method is to lick the inside of your wrist and let it dry. If you have halitosis, you should be able to smell a distinctive odour on your wrist.
If you suspect that you may have halitosis, make an appointment with your dentist to perform some diagnostic tests to help determine the cause. Some tests they may administer include:
• Halimeter which measures low levels of volatile sulphur compounds present in your breath and at particular places around your mouth.
• Portable gas chromatograph to detect the levels of different sulphur compounds including Hydrogen sulfide, methyl mercaptan, and dimethyl sulfide.
• BANA test measures the level of an enzyme produced by bacteria in the mouth which produce odorous waste products.
• Beta-galactosidase test to determine the presence of this enzyme which has been linked with bad breath.
How to Cure Bad Breath
There are several different cures suited to various causes of bad breath. Some cures include:
• Good Oral Hygiene
The most effective way to cure bad breath is with a good oral hygiene routine. Brushing and flossing twice daily, including once before bed, can help to eliminate most of the bacteria responsible for bad breath and remove food particles from between teeth. You can also use mouthwash once per day as an added precaution against bacteria and to freshen your breath.
• Quit Smoking
There are numerous reasons to quit smoking, but bad breath can also be cured by quitting. Quitting smoking isn’t easy, but there are many resources available to help you, including your local doctor and the national quit helpline.
• Drink Water
Keeping yourself hydrated throughout the day can help to boost saliva production and rinse away bacteria and food particles. It is recommended that you drink approximately 2L of water per day. Carry a water bottle with and take sips between and after meals.
• Clean Mouthpieces
Make sure to clean anything that regularly comes into contact with your mouth. This includes dentures, mouth guards, retainers, and toothbrushes. A good brush with your toothbrush and rinse under warm water should remove any harmful build-up. You should also change your toothbrush every 2 - 3 months to avoid reintroducing bacteria back into your mouth.
• Change Your Diet or Medication
Avoiding foods like garlic and onions can help to eliminate breath odours. If you can’t avoid these foods, try to brush or chew sugar-free gum after meals to freshen your breath.
If the problem is your medication talk with your doctor about the effect they are having on your breath, and discuss the possibility of changing your medications or the dosage.
In conclusion, fresh breath is like a brighter smile. It improves confidence and indicates better overall oral health.
Shirley Jones works for The Smile Studios Dental Group. For more information, visit https://www.thesmilestudios.co.uk/
1] Journal of the Indian Society of Periodontology. 2011 Oct-Dec; 15(4): 383–387 Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283937/