Halitosis, or bad breath, is a combination of the Latin word halitus meaning “breath” and the Greek suffix “osis” which means “afflicted with” or “condition.” The word itself was actually coined by Listerine in 1921 as part of an advertising campaign. It is not a modern affliction but one that can actually be traced back as early as 1550 BC. Early Roman records speak of a man who made his goat gargle with rosewater because of its fetid breath.
Halitosis describes any breath odor that is disagreeable, offensive or unpleasant. The term halitosis in used to describe a foul odor that may be noticeably present as an afflicted individual exhales. The smell may be from the mouth cavity or some underlying condition. In the case of 90% of the people, the odor is caused in the mouth.
Probably the worst effect of having halitosis, or bad breath, is the social and personal ramifications that may leave an individual feeling embarrassed or socially inept. A small percentage of people can have a chronic case of bad breath, which is more serious, and resulting symptoms of stress and depression may occur. Therefore, there are two types of halitosis, transient and chronic.
Halitosis is caused by what is referred to as volatile compounds (VCS) which are caused by anaerobic bacteria that are accumulating in moist areas of the mouth, the surface of the tongue, between the teeth, the back of the molars and below the surface of the gum line.
The tongue is considered a breeding ground for anaerobic bacteria because of the uneven surface. The results of this bacterial growth is a fetid smell caused by smelly compounds and fatty acids. The area of the tongue most likely to be the culprit is on the posterior dorsum of the tongue. This area of the tongue, towards the back of the mouth, is generally poorly cleaned in daily hygiene and bacterial populations can thrive there.
Some conditions or artificial situations such as medication can lead to the propagation of VCS in the mouth.
Halitosis as a Symptom of Causal Conditions
- Gall Bladder Disease
- Liver Failure or Cirrhosis
- Viral Infections
Halitosis as a Result of Medication
- Choral Hydrate
Symptoms of Halitosis
For the majority of people, halitosis is caused by poor oral hygiene, periodontal disease, gingivitis, gum disease, accumulation of food between the teeth or the eating of certain foods and drinks, such as cheese, garlic, onion and orange juice. Tobacco products can also cause bad breath. These types of transitory halitosis last between 48 to 72 hours. Other causes may be dentures, heavy metal accumulations, alcohol-based mouthwashes or a lack of Vitamin B or zinc.
Morning breath is another form of transitory halitosis and is caused by an accumulation of a thin coating on the tongue, teeth, gums and throat that has not been properly cleaned away. The sleep cycle actually mimics an anaerobic situation because saliva production is reduced and the surfaces of the mouth are susceptible to the formation of bacteria and VCS. Individuals who suffer either chronic or transitory halitosis may experience dry mouth, a sour or metallic taste, postnasal drip, or a white or yellow film on the tongue.
Some individuals who think they are dealing with halitosis may be presenting with a symptom of a condition or disease. These types of malodorous smells should be brought to the attention of a health professional.
- Fecal breath odor typically accompanies an intestinal or gastrointestinal obstruction.
- Fruity breath odor is a side product of respiratory elimination of excess acetone.
- Ammonia breath odor or “fishy” breath is common in end-stage renal failure.
- Musty, sweet breath odor occurs with severe liver disease such as hepatic encephalopathy.
The diagnosis of halitosis can be made by either a physician or a dentist. These healthcare professional will take a patient’s history and perform a physical or oral examination. Special consideration may be given to geriatric, pediatric or conditional pointers in the examination and diagnosis.
While some healthcare professionals may recommend additional teeth brushing as a way to combat halitosis, others will contraindicate that process and state that brushing the teeth too often creates dry mouth, which in turn make the halitosis worse. Their recommendation is that brushing the teeth is limited to twice daily and saliva stimulation be increased to combat the condition.
Preventative oral care can decrease the incidence of halitosis. Cavities should be filled and periodontal procedures, such as scaling and planing, should be performed to reduce bacteria on the surfaces of the teeth and gingival cavities of the mouth. Additionally attention must be paid to the tongue. Many professionals recommend tongue scraping as a way of decreasing the odor of halitosis.
There are special techniques and equipment employed to help forestall the progression of halitosis or possibly halt it all togethe. A halimeter is a portable monitor that test for VCS or sulfur emission that may be used to determine causal effect. However, this monitor is not sufficient to test for all types of VCS. Gas chromatography is a more effective measure by a method of digitally measuring molecular levels of VCS. The BANA test is a directed means of measuring an enzyme present in bacteria populations, which results in halitosis.
Although these technologies have proven helpful, the best diagnostic test is the sniffing and scoring of the type and level of the odor. This is done by trained individuals and is assessed on a six-point intensity scale.
The majority of healthcare professionals recommend the following methods for combating halitosis.
- Gently clean the surface of the tongue twice daily using either a tongue cleaner or tongue brush/scraper. Brushing a small amount of antibacterial tongue gel onto the surface of the tongue may help inhibit the growth of odor-causing bacteria.
- Chewing sugarless gum aids in the production of saliva and the saliva in turn helps cut down halitosis. Chewing gum is an excellent means of combating halitosis, especially when the mouth is dry or normal oral hygiene is not possible.
- Gargle before bedtime with the appropriate mouthwash. Mouthwashes and toothpastes can sometime counteract the efficacy of each other so it is advisable not to use mouthwash directly after brushing the teeth.
- Maintain regular dental visits. Teeth-cleaning, regular prevention and treatment of cavities is essential in eliminating the cause of bad breath.
- Floss regularly. Flossing eliminates bacterial growth and plaque that can accumulate in the interspaces of teeth.
- Dentures wearers should properly clean and store their dentures when not in use.
Methods of self-diagnosis are to lick the back of the wrist, let it dry for a period of two to five minutes and then smell the wrist. If a malodorous smell is still detected, the person is at risk for bad breath. Another method is to scrape the back of the tongue with an inverted teaspoon and smell the resulting residue on the spoon. Most halitosis sufferers cannot detect their own breath smells and women have a more keen sense of smell than men do. If no odor is detected, a family member or friend may be pressed into service to help ascertain the existence of odor.
The elimination of certain foods may be beneficial in reducing bad breath. Foods high in sugar create a breeding ground for bacteria in the back of the throat. Acidic foods create the same type of environment for bacteria on the tongue. A reduction of high-fat foods, excessive amounts of meat. exotic spices and dairy products may be all that is needed to eliminate the bad breath.
A high number of transitory halitosis may occur when a person eats garlic, onions, and spices, such as curry. Blue cheese, Camembert, Roquefort and Limburger cheeses, canned tuna and anchovies and highly spiced deli meats should be avoided. These products can be smelled for up to 24 hours after ingestion.
Caffeinated beverages like coffee and tea are both very acidic and a change to clear water or organic peppermint teas may suffice in eliminating the halitosis.
There are a great deal of natural, home remedies that may be utilized in reducing or eliminating bad breath.
Food and Drink
- Chew mint leaves, basil or parsley for refreshment and cleansing of the breath.
- Drink a cup of hot unsweetened tea.
- Chew sunflowers seed at meals with a glass of water.
- Increase daily intake of water.
- Chew cloves or cardamom seeds after meals.
- A daily addition of yogurt for six weeks may eliminate the source of the bacteria.
- Drink either pineapple juice or a glass of water with the juice of a half of a lemon added.
- Eat apples. Apples can help freshen the breath.
- Coriander, rosemary, thyme, wintergreen, cinnamon bark, fennel or anise seeds can be slowly chewed as a breath freshener.
- Drink a glass of water with a teaspoon of apple cider vinegar mixed in before meals.
Other Home Remedies
- Before brushing, rinse mouth with hydrogen peroxide.
- Gargle with a mixture of baking soda and water.
- Gargle with warm salt water. An additional salt technique is to brush the tongue and teeth with sea salt at bedtime. Regular salt may lead to bloating. If an individual has issues with water retention, there are light salt formulations that can be substituted.
- Clean your toothbrush daily and replace it every month.
Tea Tree oil is a powerful disinfectant with antiseptic compounds. It can be found either in a tea tree enhanced toothpaste or an individual can simply put a few drops of the oil directly on their toothbrush, either alone or with regular toothpaste.
Natural gums with essentials oil of spearmint and peppermint are available in health food stores. It makes fresh breath easier to maintain while oral hygiene supplies are not available.
Lavender oil can be used as a gargle. A simple wash can be made with 4 ounces of water with 10 drops of lavender oil added. Lavender helps neutralize the odors.
A vitamin deficiency could be the cause of halitosis. A lack of Vitamin B can be corrected with 50 mg of niacinimide with meals. Supplemental high potency B complex and 50 mg of B6 daily can also be taken to help eliminate the problem. Vitamin C of 1,000 mg a day will help flush bacteria and mucus from the system.
A deficiency in zinc has been linked to halitosis. However, a daily zinc dosage of 30 to 60 mg should not be taken for more than ten days without a physician’s supervision. Zinc can potentially interfere with the absorption of copper.
There are traditional ayurvedic treatments available for the treatment of bad breath. Practitioners encourage the eating of areca nut and betel leaf as a remedy for bad breath. However, the betel nut can stain the teeth bright red when chewed. The Ayurvedic treatment of halitosis is aimed at treating and correcting the known cause for this condition. Skilled practitioners may treat dental hygiene issues as an outward manifestation of an internal condition. Infections of the gastro-intestinal and respiratory tracts may be treated with distilled tinctures and mouthwashes as well as powders and pastes.
Practitioners of acupuncture believe that halitosis is an imbalance in the body. The traditional Chinese medicine believes that bad breath is a sign of “Stomach Heat” which is an imbalance of the digestive system. As the name would suggest, stomach heat is too much heat in the stomach. This imbalance causes bad breath, gum disease, frontal headaches and mouth ulcers.
As is most treatments of acupuncture, extremely thin needles are inserted into various parts of the body to balance the yin and yang of creation and release blocked energy of the Qi force.
Myths and Misconceptions
A list of ineffective home remedies was released by the American Academy of Periodontology. While they may bring temporary relief, they do not remove the cause of the bad breath. These remedies are to be avoided.
- Alcohol-based mouthwashes.
- Sugary gums and chewing tobacco.
- Vodka martinis and sour mash whiskey. They are a drying agent for the mouth.
- Do not rinse the mouth out with kerosene.
- Tongue piercing increases the production of bacteria on the tongue.
- Colonic or gastric washes.
Favorite and recognizable mouthwashes may not be the best remedy for the individual with bad breath. Alcohol-based mouthwashes like Scope and Listerine can contribute to dryness of the mouth and actually acerbate the halitosis. It is recommended that all mouthwashes containing dyes be avoided.
Look for these ingredients in a mouthwash. If cetylpyridium chloride, zinc, sodium chloride or chlorine dioxide is listed on the label, these elements may act as an antibacterial agent that controls anaerobic bacteria in the mouth. Natural mouthwashes will generally contain essential oils for the control and retardation of anaerobic bacteria. In addition, a new water-oil two-phase mouthwash has proven effective in reducing bad breath in clinical studies.
While halitosis can be embarrassing, it is important to remember that the human body is engineered to recoil from certain smells because it detects some diseases and infectious conditions by this fashion. There is no shame in seeking help and resolution with an issue that may make an individual feel rejected or alone. Many of the remedies for halitosis are easy to obtain and simple to perform.