Bad breath is caused by odour-producing bacteria that grow in the mouth.

Durban - Socially unacceptable breath is no modern dilemma. The Talmud warned against it in priests, Muhammad allegedly dismissed a follower from a mosque because of it, and the ancient Romans employed slaves to clean their mouths to prevent it.

In a comprehensive review of all global research on bad breath, also known as halitosis, oral malodour or foetor ex ore, Dr Curd Bollen and Dr Thomas Beikler of the University of Dusseldorf, Germany, concluded that this embarrassing health condition affects approximately 30 percent of the world population.

“Bad breath is caused by odour-producing bacteria that grow in the mouth. Without regular brushing and flossing, bacteria accumulate on the bits of food left in the mouth and between the teeth. The sulphur compounds released by these bacteria make the breath smell and, as long as this process continues unchecked, your breath gets worse and worse,” says Durban dental surgeon Dr Michael Windisch.

“Certain foods, especially ones like garlic and onions, which already contain smelly sulphur compounds, can contribute to the problem. Smoking affects oral malodour and poor dental hygiene leads to bacterial build-up on the teeth and gums, leading to gum disease which may also cause halitosis.

“A partially erupted wisdom tooth can also cause bad breath.”

Windisch goes on to explain that for healthy individuals, food odours are transitory and that normal salivary flow will eliminate it within several minutes.

“However, for those who suffer with dry mouth and consequently, lack of saliva, even minor food odours may end up becoming long term bad breath problems.”

Dry mouth (xerostomia) symptoms naturally mean less saliva. In turn, less saliva means less oxygen.

“If there is less oxygen available in the oral environment, the bacteria are now capable of making high levels of sulphur gases, which in turn make the breath and taste worse.”

Certain drugs, such as anti-depressants, high blood pressure medications and anti-histamines have also been linked to bad breath as they reduce saliva production.

Most people experience bad breath in the morning due to lack of saliva production while they sleep, Windisch explains.

“This process is perfectly normal and does not indicate any serious health condition. That is why it is important to always eat something in the morning to kick-start your saliva production as a natural way to freshen your breath. Those who skip breakfast tend to have ‘morning breath’ until they eat something.”

According to the International Journal of Oral Science (2012), in approximately 10 percent of all cases, bad breath is caused by certain illnesses, including diabetes, cirrhosis, leukaemia, uremia, metabolic disorders and cancer.

Sinusitis, pneumonia, bronchitis and polyps affect the airways and may cause halitosis.

The most common symptoms of bad breath include post-nasal drip, a bitter metallic taste, a white coating on the tongue and thick saliva.

Odour from the nose is usually a sign of dryness, polyps or sinusitis. When the odour appears upon talking, it often indicates postnasal drip on the back of the tongue.

A bad taste all day long is a sign of excessive bacterial activity on the tongue. An oral hygienist or a dentist can readily distinguish between these different common types of bad breath.

“People are frequently unaware of their own bad breath. Some have unpleasant odour without having the faintest inkling,” says Durban oral hygienist Suzette Pirow.

“Bad breath is a sensitive subject. Certainly not everyone has the gumption to tell a friend or family member that he or she has bad breath and to hope that should the need arise, they will reciprocate in kind.”

Pirow recommends the patient bring a confidant along to the appointment.

“The confidant can usually provide a clearer picture of whether the patient actually suffers from bad breath. Since bad breath can vary with the time of the day and day of the month, the odour present at the consultation may or may not be similar to the odour at other times,” she explains.

“Most important, the confidant can report to both subject and professional on the degree of improvement, since the patient is usually unable to gauge for themselves to what extent their problem has been eliminated.”

Do not despair if there is a bad smell as diligent brushing and flossing can help treat bad breath.

Dental health professionals agree that flossing is particularly important in removing rotting food debris and bacterial plaque from between the teeth, especially at the gumline.

“Gently cleaning the tongue surface twice daily is the most effective way to keep bad breath in control.Use a tooth brush, tongue cleaner or tongue brush/scraper to wipe off the bacterial biofilm, debris and mucus,” says Windisch.

“Scraping or otherwise damaging the tongue should be avoided. Brushing a small amount of antibacterial mouth rinse or tongue gel on to the tongue surface can further inhibit bacterial action. Dentures should be properly cleaned and soaked overnight.”

A healthy diet, use of certain probiotics and chewing gum or other folk remedies like fennel seeds, cinnamon sticks, or fresh parsley can also help to reduce bad breath.

If the dentist determines that the odour is not of oral origin, a follow-up visit to a specialist will be recommended. - The Mercury