Healthy people with healthy mouths who clean their teeth daily are expected to have a fresh non-odorous breath.
Fresh breath gives you the confidence to be close to others and enjoy life without worrying about looking for upsetting "body language" from those near you to indicate you have a problem.
Unfortunately many things can produce an abnormal balance that affects our breath and can result in bad breath, otherwise known as halitosis.
Things that can cause bad breath
- unclean teeth, by lack of toothbrushing and flossing
- Dental plaque (now known as biofilm) is a sticky whitish film that starts to build up on teeth within 24 hours of eating or drinking. It contains bacteria which can release toxins that cause gum disease, tooth discolouration and also acid in the presence of sugar that leads to tooth decay.
- the food and drink we ingest e.g. garlic, alcohol
- cigarette/cigar smoking - Tooth decay and gum disease can also lead to bad breath.
- Certain types of oral bacteria can build up in sufficient numbers in secluded areas of the mouth, particularly in crevices, cavities and as a coating over the back of the tongue. The bacteria are known as anaerobic because they thrive in the absence of oxygen. Because the bacterial colony can grow without oxygen it can become quite a thick discoloured layer on the surface of the back of the tongue. The growth of this type of bacteria is retarded or slowed by the presence of high levels of oxygen, and it is this weakness that gives us a simple treatment for bad breath.
It is easy to check for the presence of bacterial plaque on the back of the tongue by standing in front of a mirror, poking the tongue out of the mouth and closely inspecting the surface of the tongue.
The reason this colony of anaerobic bacteria on the tongue is so significant is because of the metabolic by-products that it produces, called volatile sulphur compounds (VSC). These compounds have the same bad smell as the gas produced by a rotting egg (hydrogen sulphide). So the bad breath is caused by the bacteria creating the gaseous VSC.
University studies suggest that people who do not have bad breath invariably do not have these anaerobic bacteria in large quantities in their mouths. Instead they have a better balanced "good" collection of bacteria. Another method of managing bad breath then is to try and replace the bad anaerobic bacteria with the good oxygen-loving (or aerobic) bacteria. This is known as the probiotic approach.
- Finally some medical conditions result in a release of gases from the lungs, such as the ketone gases of diabetes etc
- Other conditions or medications can affect the normal flow of saliva through the salivary glands and into the mouth.
The flow rate and chemical composition of saliva serves to neutralise and flush the mouth of the effect of the plaque bacteria. Anything that reduces this function of saliva (like salivary gland disease, reduction in physiologic functioning of the salivary glands that occurs naturally in old age and during sleep or certain prescribed medications) can also result in bad breath.
Hence the phenomenon well known as "morning breath" also noticed during stress or excercise, which is related to a reduction of salivary flow (drying of the mouth) acting together with the bad breath causing oral bacteria.
Treatment of Bad Breath
The way to deal with bad breath depends on the degree of the problem. The management can range from simple natural methods to more complex clinical ones. Simple natural methods
Being healthy, drinking lots of water, eating healthy food and drink, reduction in coffee and alcohol intake, not smoking all helps to provide a normal oral environment less prone to halitosis (bad breath). Proper technique, and daily tooth brushing and an interdental cleaning routine (by flossing and/or using inderdental products to clean in between the teeth) is required to remove the dental plaque from the teeth and gums. this is always the first place to start in managing any bad breath problem. Our favourite interdental cleaners are the Australian made Piksters interdental brushes and the easy to use floss-picks by the Piksters people. Others prefer good old fashioned dental floss. Of course, by visiting your dentist regularly you can ensure that tooth decay and gum disease is prevented and/or properly treated if present. In addition to this, the removal of the anaerobic bacterial coating on the back of the tongue is needed to eradicate the major cause of VSC production in the mouth. While this can be done with a toothbrush, most people find it more comfortable to use a special tongue cleaning device.
Medical methods
The Volatile Sulphur Compounds (VSC) produced in the mouth by the anaerobic bacteria can be neutralised, and the bacteria themselves destroyed, by using specially designed chemical toothpastes and mouthwashes.
One of the most effective chemicals in this regard is called Cloralstan™ ( Chlorine Dioxide ), which produces oxygen that creates an unfavourable environment for the anaerobic bacteria as well as binds with the SVC to neutralise the sulphide smell.
Over a short period of time of using these methods the production of the VSC reduces and the bad breath goes away.
Unfortunately some toothpastes and mouthwashes, as well as so-called fresh breath mints, claim to remove bad breath. But all they do is mask the VSC smell with a pleasant fragrance which very soon dissipates leaving the user no better off at all. In addition to this, mouthwashes which contain alcohol can actually lead to bad breath by causing the mouth to dry out. The use of Alcohol-Free mouth rinses, particularly the world-famous CloSYS products, for treating and preventing bad breath are highly recommended.
Probiotic methods
As described, a more complex method of managing a more severe variety of bad breath is to try and produce a bacterial environment in the mouth which is composed mainly of the good bacteria and not the bad bacteria. This method of changing the type of population of bacteria by substituting the harmful type with one that does not produce harm (or VSC) is known as the probiotic approach.
Once again the easiest way of implementing this change in the bacterial flora or makeup of the mouth is through the use of specially designed toothpastes, mouthwashes and lozenges.
IMPORTANT NOTE:
Persistent bad breath needs to be investigated by your dental and/or medical professional.
Bad Breath CausesDr John A Grapsas Dental Surgeon BDSc(WA) Australia
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