What is Bad Breath?Medically, bad breath is known by the name of halitosis. It is a term used for noticeably unpleasant odors exhaled while breathing. Bad breath is estimated to be the third most frequent reason for which people seek dental advice. Halitosis is a common problem, not only in teens, but also in adults. While some types of bad breath can be considered fairly normal, others can be indicative of underlying disorder. In most of the cases, bad breath originates from the mouth itself; however, the intensity of the foul odor differs during different times of the day. At night, mouth gets less oxygen and is quite inactive. Plus, body makes less saliva at night and mouth becomes dry, and dead cells stick to tongue and to the inside of cheeks. When bacteria use these cells for food, they produce a foul odor. This morning odor comes from "morning mouth", and is very obvious. On the other hand, in daytime, consumption of certain foods is more, like onions, garlic, fish, meat, etc. along with smoking and drinking. During the day, saliva washes away decaying food and odors.
More than 70 percent of teenagers consider bad breath to be an instant turnoff. While bad breath can be treated and avoided, one doesn't even know if one has it. It may be transient, often disappearing following eating, brushing one's teeth, flossing, or rinsing with specialized mouthwash. Bad breath may also be persistent, which is a more serious condition. So, let us know what causes bad breath and how can you get rid of it. Bad breath can not only put you down in a social situation, but can even send signals of your poor oral hygiene and health. It may indicate that your mouth has turned into a safe playground for the bacteria.
Causes of Bad Breath
Let us have a look at some of the causes of bad breath.
On an average, there are over 600 types of bacteria found in the mouth. Several of these can produce high levels of foul odors. The odors are produced mainly due to the breakdown of proteins into individual amino acids, followed by the further breakdown of certain amino acids to produce detectable foul gases. Therefore, bacteria can said as one of the prime causes of bad breath.
Certain medications cause the user to have foul smell from the mouth. Some medications form a film-like coating over the tongue and react with stomach acids to expel smell, which can result in bad breath. Generally, discontinuing such medications shoos the bad breath away.
Generally, postnasal drip streams down the back of throat during colds, allergies, and sinus infections. This drip can result in bad breath.Sometimes, tiny food nuggets lodge in the crypts of your tonsils or on the tongue and cause a foul odor. Also, at times, the air exiting the nostrils has a pungent odor due to sinus infections or foreign bodies. Such bad breath ceases to exist once the infection or problem is cured.
Poor Oral Hygiene
In large number of cases, bad breath comes from the gums and tongue as a result of poor oral hygiene. Some bacteria in mouth produce compounds that result in foul odor because the individual does not brush or floss frequently enough. Infrequent or improper brushing and flossing, allows food to stick between the teeth and decay inside the mouth, which, in turn, promotes the bacteria. Generally, bacteria that build up on the back of tongue or in between teeth are the main culprits. Poor oral hygiene can eventually lead to gum disease, which also result in bad breath.
Foods items like garlic, onions, etc. not only leave lasting odors in mouth, but also get absorbed into the bloodstream. The odors are then expelled from the lungs. Unless these foods are eliminated from the body, measures like mouthwash, chewing gum, and toothpaste can mask the odors.
Xerostomia (Dry Mouth)
Some people develop dry mouth that can result from taking antihistamines for allergies or a cold, or from antidepressants. In fact, a large number of prescription and over-the-counter medicines cause dry mouth. Dry mouth results in bad breath. Bad breath can also result from localized infections, diabetes, gastrointestinal disturbances, or liver or kidney ailments.
Tobacco and Tobacco Products
Most of the tobacco products cause bad breath. If one smokes or even chews tobacco, there are fair chances of that person having bad breath.
The most common location for mouth-related halitosis is the tongue. Tongue bacteria account for nearly 90% of all cases of mouth-related bad breath. Large quantities of naturally-occurring bacteria can be found on the posterior dorsum of the tongue. There bacteria stay relatively undisturbed by normal activity in the mouth, like mastication, brushing, etc. Most of the times, this part of the tongue is poorly cleansed. The convoluted microbial structure of the tongue dorsum provides an ideal habitat for anaerobic bacteria, which flourish under a continually-forming tongue coating of food debris, dead epithelial cells, postnasal drip and overlying bacteria, living and dead. When left on the tongue, the anaerobic respiration of such bacteria yield either putrescent or "rotten egg" smell. Therefore, it is cleaning the tongue properly is the most widely known method to get rid of bad breath. While methods like mints, sprays, mouthwash, etc. may temporarily mask the odors, cleaning the tongue using a tongue cleaner or toothbrush proves to be highly effective.
Parts of the mouth like inter-dental and sub-gingival niches may contain huge amount of bacteria, resulting in bad breath. In addition to this, faulty dental work, abscesses, unclean dentures, and lesions caused by viral infections like Herpes Simplex Virus may also contribute to bad breath.
Periodontal disease is a common cause of bad breath. Waste products from bacteria growing below the gumline have a foul odor and have been found to produce a very intense bad breath. Removal of the subgingival calculus and friable tissue using different techniques like subgingival scaling, etc. can improve mouth odor considerably. Root planing and irrigation with an antibiotic mouth rinse can also help a great deal.
Putrefaction from the tonsils contributes to nearly 5% bad breath cases. Small number of population also suffers from tonsilloliths. These smell extremely foul when released and can cause extreme bad breath.
When the valve between the stomach and the esophagus does not close properly due to any reason (hiatal hernia, GERD, or any other), it allows acid to enter the esophagus, which causes the gases to escape to the mouth, which, in turn, results in bad breath. In addition to this, Zenker's diverticulum may also result in bad breath.
Some of the patients seeking advice on bad breath suffer from halitophobia - a delusional halitosis resulting from manifestation of Olfactory Reference Syndrome. The condition is also known by the name of pseudohalitosis, at times.
Few systemic medical conditions can also cause bad breath. Some of these conditions are:
- Fetor hepaticus - A rare type of bad breath caused by chronic liver failure.
- Bronchial and lung infections.
- Renal failure and renal infection.
- Trimethylaminuria, also known as fish odor syndrome.
- Metabolic dysfunction.
Symptoms of Bad Breath
One may not always know that he/she has bad breath. It is because the olfactory nerves (odor-detecting cells) in the nose eventually get used to the smell and do not let the person know of anything odd. But, other people come to notice this foul odor instantly. One can get make a judgement that he/she has bad breath if he/she notices people stepping away while one are speaking. Also, it can be easily judged from peoples' reaction, if they are uncomfortable talking because of one's bad breath.
Home Remedies for Bad Breath
Below are some home remedies to keep bad breath at bay.
Spices in kitchen are natural breath enhancers, especially cloves, anise seeds, fennel, etc. can be consumed after odoriferous meals to keep away bad breath. These spices have strong fragrances of their own and overpower the foul smell of bad breath. It is also advised to carry a tiny plastic bag of spices along whenever out of home.
Brush Your Tongue
Tongue has several hair-like projections which acts as room to harbor plaque and bacteria along with the things we eat. All of this can result in bad breath. Therefore, it is advised to clean tongue thoroughly with a tongue cleaner every time you brush your teeth. Doing this on a regular basis will keep bad breath away.
Avoid Certain Beverages
Beverages like coffee, beer, whiskey, wine, etc. are at the top of the list of offenders. Each of these beverages leaves a residue that can attach to the plaque in mouth and infiltrate the digestive system. Each breath you take spews traces back into the air. Therefore, it is advised to avoid these aforementioned beverages to keep away bad breath.
Brush After Every Meal
Some odors can be eliminated if you brush immediately after the meal. Bad breath is largely result of soft, sticky film of living and dead bacteria on teeth and gums. At any time, there are about 50 trillion microscopic organisms in mouth. Therefore, it is advised to brush thoroughly after every meal to keep the concentration of these bacteria on a lower side, and avoid bad breath.
Mix extracts of sage, calendula, and myrrh gum in equal proportions and gargle with the mixture at least four times a day. Keep the mouthwash at room temperature in a tightly sealed jar.
Rinsing frequently flushes out the bacteria from mouth and keeps their concentration low. Even when you can not brush, just go ahead and rinse your mouth thoroughly. Take a sip of water after meals, swish it around, and rinse thoroughly to wash the smell of food from your mouth.
Parsley is known to be a breath saver as it contains chlorophyll, a well-known breath deodorizer. Add more of parsley in your regular diet and chew it thoroughly. Alternatively, you can also sip parsley juice to refresh your breath.
Mint or Some Gum
Like mouthwash, a breath mint or minty gum is just a cover-up, good for a short interview, a short ride in a compact car or a very short date. You can also try sugarless gum or candy to keep your mouth moist and fresh.
Baking soda is a great way to clean your teeth and get fresh breath. It works by changing the pH (acidity) level in mouth, thereby limiting the growth of the bacteria in mouth. For fresher breath, sprinkle some baking soda into your palm, dip a damp toothbrush into the baking soda, and brush.
Vegetables like carrots and celery fight plaque to keep bad breath away for good time. Add more of fresh vegetables to your salad.
Taking black or green tea in the morning instead of coffee can help get rid of your morning breath. Also, consuming it 3 to 4 times in middle of the day will keep mouth fresh and healthy. Black and green teas contain polyphenols, which are powerful antioxidants. These polyphenols fight bacteria in mouth, thereby improving the breath.
Drink Plenty of Water
Drinking water can help flush bacteria out of mouth and prevent bad breath. Keep a glass of water by bedside at night and drink plenty before you go to bed and after waking up to prevent stinky morning breath.
Apple Cider Vinegar
Apple cider vinegar can be used as a highly valuable mouthwash as it fights the problem of bad breath. Just add half a tablespoonful of apple cider vinegar into a glass of water and gargle for around 10 seconds. Rinse.
Tea Tree Oil
A toothpaste with tea tree oil added to it can be an effective remedy for bad breath. Just add a drop of tea tree oil to toothpaste before brushing. You can also prepare a mouthwash with tea tree oil by adding 3 drops to a cup of warm water. Gargle this solution for two to three times daily after each meal, if possible.
Citric acid present in citric fruits stimulates the saliva, which in turn, aids in the suppression of smell-causing bacteria in mouth. Do not allow your mouth to dry as dry mouth often causes bad breath. Fruits like orange, lemon, and Indian gooseberry can help a great deal.
Avocados yield better results in comparison to the mouth lotions or any other solutions available in the market. The fruit works by removing intestinal decomposition which is a known cause of bad breath. Include avocados in your regular diet to keep bad breath away.
Unripe guava is rich in tannic, phosphoric, oxalic and malic acids. It is a great remedy for bad breath (halitosis). The fruit also contains vital minerals like manganese, calcium and oxalate that promote teeth and gum health. Not only it can cure bad breath, but also can be an effective solution for bleeding gums.
Chewing small stem of fresh spearmint, rosemary, tarragon and parsley for up to a minute can help alleviate bad breath for considerable time period.
Chew some sunflower seeds and drink a glass of water after meals. This is a good natural remedy for bad breath.
Fenugreek (Methi) Tea
Fenugreek seeds are an effective remedy for bad breath. Tea prepared from fenugreek seeds can be consumed to fight bad breath. Just add one teaspoonful of seeds in half liter of cold water and boil it for around 15 minutes on low flame. Strain the seeds and consume as tea.
Hydrogen Peroxide Rinses
Rinsing mouth with hydrogen peroxide before brushing is a great home remedy for bad breath. Hydrogen peroxide causes the bacteria to die and keep mouth fresh and germ-less. It is a great remedy for bad breath.
Myths Regarding Bad Breath
There are a lots of myths about keeping bad breath away. Here are some that do not hold true.
Myth No. 1 - Mouthwash will make bad breath go away.
False. Mouthwash can only get rid of bad breath temporarily. Go for an antibacterial mouthwash that kills the smell-causing bacteria. Make sure the mouthwash has been approved by American Dental Association.
Myth No. 2 - As long as you brush your teeth, you will not have bad breath.
Conditions apply! To clean all the surfaces of your mouth thoroughly, you should brush for at least 2 minutes, and at least twice a day. While most people only brush their teeth for 30 to 45 seconds, it fails to kill and remove all the bacteria. Also, make sure you brush your tongue and floss every time you brush. If done thoroughly, there are fair chances you would not have bad breath because of any dental causes.
Myth No. 3: If you breathe into your hand, you'll know when you have bad breath.
False. When anyone breathes, he/she does not use the throat in the same way as he/she talks. Talking brings out the odors from the back of the mouth, which exhaling does not do. Also, because we tend to get used to our own smells, it is hard for a person to tell if he/she has bad breath.
Preventive Measures and Other Treatment Options for Bad Breath
Practice Good Oral Hygiene
Try to brush and floss after every meal, or at least twice a day. Thorough brushing involves brushing the tongue, cheeks, and the roof of the mouth to remove bacteria and food particles. Flossing removes plaque, bacteria, and food particles trapped between teeth. Clean the tongue using a tongue scraper. Use a quality antibacterial mouthwash after you are done with brushing.
Retainers and Braces
If you wear a retainer or any other kind of removable appliance, clean it thoroughly each time you brush. Take extra time and care to clean all the nooks and crannies if you have braces.
Chew Sugar-free Gum
Sugar-free gum helps stimulate saliva, which, in turn, helps cleanse the teeth and gums and prevents mouth to dry.
Avoid, rather stop, using tobacco and tobacco products. Tobacco is one of the big causes of halitosis and mouth cancer. Getting professional help right now will reap benefits in future.
Never wear your dentures to sleep. Clean them thoroughly and leave them out until morning.
Staying in stress causes mouth to dry, which can cause bad breath.
Avoid Alcohol-Based Mouthwashes
Alcohol-based mouthwashes can cause the mouth to dry out, which can result in bad breath.
Avoid following foods:
- Onions, hot peppers and garlic
- Coffee, beer, wine and whiskey
- Refined carbohydrates like white sugar, white bread and products prepared with them
- Meat and eggs
- Some fishes like anchovies and seaweed