Bad Breath

I have bad breath. How should I clean my mouth?

Bad breath, also referred to as oral malodor or the medical term halitosis, is common. For many people bad breath is transient, occurring at certain times, such as upon waking; for others, it is persistent and recurrent. It affects people of all ages. The most common cause is poor oral hygiene where the bacteria in dental plaque produce odiferous by-products when allowed to grow undisturbed. The malodor can also originate from the nasal passages and sinuses, the stomach or the lungs in exhaled air.

About Bad Breath

Bad breath is very difficult to detect yourself. Most people only discover they have bad breath when a family member or close friend breaks the news, or they notice the reaction of other people in close encounters. Bad breath can be embarrassing and lead to social isolation, and thus affect the quality of life.

Figure: Detecting one’s own bad breath can be almost impossible.

How is it caused?

There are several possible causes. Most commonly, the odor is caused by microorganisms residing in the mouth, the throat or the nasal passages. These microorganisms produce volatile sulfur compounds that have a characteristic smell similar to bad eggs and ammonia. In addition to the bacteria, putrefying food particles, dead cells shed from the lining of the mouth and stagnant saliva will all contribute to unpleasant odors. Bad breath can also be caused by volatile foodstuffs such as onions, garlic, and spices. Tobacco use and alcohol consumption may also give rise to distinct and unpleasant odors.

How can I stop it?

First, make sure you are maintaining the best oral hygiene you can, brushing all your teeth and in the spaces between them with interdental brushes or dental floss. Most bacteria in the mouth live on the surface of the tongue so cleaning the tongue on a daily basis is important.

Figure: The surface of the tongue is made up of numerous grooves and ridges that trap bacteria and food debris – a common source of bad breath.

Some people are able to clean their tongue by brushing it with a toothbrush, for others it is too sensitive, soft, or ticklish, so a specially designed tongue-cleaner should be used. These are designed for the soft surface of the tongue and can remove bacteria from the folds and crevices on the top surface of the tongue. Select a tongue cleaner with a combination of bristles and scrapers for optimum effect.

If you do not notice any improvement in the odor, and this is difficult to detect yourself, consult your dentist and dental hygienist to check out your oral hygiene and tongue cleaning and to rule out other dental causes. Your dentist may refer you to a physician for further assessment of any medical causes such as diabetes, stomach disorders, or liver and kidney problems.

Therapeutic mouth rinses may provide some benefit if the cause is bacterial. Many mouth rinses do not have anti-plaque or antibacterial benefits and will merely mask the odor temporarily. Ask your dentist or dental hygienist to recommend an anti-plaque or antimicrobial rinse.