Bad Breath (Halitosis)

  What causes bad breath?

Bad breath can be caused by many things, including odor-causing foods, tooth decay, periodontal (gum) disease, continued mouth dryness, use of tobacco products, sinus or respiratory infections, some medical disorders, inadequate oral hygiene or some medications.

  Is bad breath the sign of a medical disorder?

It can be. Conditions that may cause bad breath include a local infection in the respiratory tract, gastrointestinal disturbance or liver or kidney ailments. Consult your dentist if you have chronic bad breath.

  What can you do about bad breath?

If you think you have constant bad breath, keep a record of the foods you eat and medications you take. Let your dentist know about your concern, and tell them if you've had any surgery or illness since your last appointment.

Brush twice a day with a fluoride toothpaste to remove any food debris and plaque. Brush your tongue, too. Once a day, use floss or an interdental cleaner to clean between teeth. If you wear removable dentures, take them out at night. Clean them thoroughly before replacing them the next morning.

  How effective are halitosis kits?

The ADA cannot vouch for claims made by manufacturers of halitosis kits, but your dentist can answer questions about whether they may be effective for you.

  What about mouthwashes?

Mouthwashes are generally cosmetic and do not have a long-lasting effect on bad breath.

                                                                       Source: American Dental Association

 

Unkissable - If your friends won't tell you...

"WITH HER BREATH she did perfume the air," says Lucentio of Bianca in Shakespeare's The Taming of the Shrew. Sadly, most of us are more worried about our breath polluting the air--especially after too much coffee or garlic-laced food. But a pocket-sized breath analyser could soon put an end to the uncertainty.

Halitosis can be caused by various factors, from sinus trouble to poor diet, but in 90 per cent of cases the smell is caused by volatile sulphur compounds (VSCs). These are released when proteins are broken down by bacteria in the mouth.

Monitoring these compounds can reveal if you have a problem, but the detectors tend to be inaccurate and bulky--and without them it's generally impossible to tell whether your own breath smells. But now Alfredo Sanz-Medel, a chemist at the University of Oviedo, Spain, says he has worked out how to make a pocket-sized breath analyser, he reveals in the chemistry journal Analytica Chimica Acta (vol 398, p 23).

The instruments Sanz-Medel is developing are based on a simple reaction that can be measured optically. It works by measuring the fluorescence produced when VSCs react with a mercury compound. As the VSC concentration increases, so does the fluorescence. By picking out telltale wavelengths in the fluorescence, you get a measure of the "badness" of the breath.

"Other devices are not very accurate," says Mervyn Druian of the London Breath Centre, which specialises in treating bad breath. "You still need to be subjective and use your own nose. It would be wonderful to have an objective opinion," he says.

As the technique measures a change in light intensity, fibre-optic technology could be used to miniaturise the device for personal use. "We are in the preliminary steps," says Sanz-Medel, "but I am completely sure that we could shrink the device to hand-held size.

                                                                   Jens Thomas - From New Scientist, 23 October 1999

You know who you are: cure is here for really stinky breath

February 24, 1997

From Correspondent Greg Lefevre

SAN FRANCISCO (CNN) -- Bad breath can be much more than a temporary embarrassment; it can be a true medical condition, as Paul Hsia will tell you. Hsia had bad breath -- really bad breath, to the point where he said some people would cover their mouth when they were around him.

"People just back off, or step back a little bit," he said.

If you have industrial-strength bad breath, you know who you are. Some 27 million Americans suffer from, or perhaps inflict, bad breath. Their problem is nearly always the same: too much sulfur in the mouth.

Mouthwash isn't enough to wash away the extra sulfur -- Hsia went through gallons of it. And brushing is equally ineffective.

"They're at the end of the line," said Dr. Anthony Dailley, a dentist who opened the Center for Breath Treatment in San Francisco. He checks for the common causes first -- gum disease, sinus infections.

But over time he has found that the worst cases came from chronic dry mouth. Without enough saliva, the mouth cannot wash away excess sulfur, and develops that awful rotten-egg smell.

"A good analogy that I use with my patients is that if you go down to the water's edge in a marshy area and the tide's up, typically there is no odor. But when the tide goes and things start to dry out a bit, we all know what it smells like," Dailley said.

St. Louis dentist Dr. Marvin Cohen was the one to discover the sulfur connection. "The cure is there. The help is available. And the people who are so afflicted have to go out and find the people who can provide that help," the halitosis specialist said.

New bad breath centers are popping up around the United States at the rate of about one a month. Eventually, consumer advisor Christine Dumas of the American Medical Association predicts that the technology used in these specialized centers will be "in every dentist's office in the country."

Such technology includes temperature probes, which Dailley uses to look for infections, and a sulfur "sniffer," which calibrates what his nose has already told him. He treats sulfur-related halitosis by adding a tongue scraper and a special mouthwash solution to the usual routine of brushing and flossing. The new gargle, chlorine dioxide, neutralizes the sulfur.

Dailley's services aren't cheap: he charges $500 for curing industrial-strength bad breath. But, patient Paul Hsia said, "If you think $500 is a lot of money, then you don't have the problem."

For Hsia, it was worth every penny: he doesn't have the problem anymore.

The Seattle Times Company Dec. 30, 1996

Bad breath is getting more than lip service

by Melinda Voss
Des Moines Register

Don't look now, but bad breath is finally being taken seriously.  Recently, the editor of the American Dental Association suggested that dentists should consider the treatment of bad breath as an accepted procedure.  Is this big news?  Absolutely, says Dr. Henry Crossetti, a Chicago-area periodontist and pioneer in the treatment of chronic halitosis.  And now there's a scientifically based treatment.  No one is talking about ordinary bad breath here. Chronic halitosis is different from "morning breath," a sensation most people experience when they wake up, Crossetti says. And it's not caused by eating garlic, onions or spicy foods.  Chronic bad breath has a distinctive odor of rotten eggs or sewer gas. "If you have ever smelled it, you won't forget it," he says. And the smell won't go away by brushing your teeth or using mouthwash.  An estimated 25 million Americans are afflicted with the problem, he says.  In the dental association journal, editor Dr. Lawrence Meshkin writes that dentists encounter about 500,000 halitosis patients a week. "With at least 85 percent of bad breath originating in the oral cavity, it should respond readily and successfully to treatment," he adds.  Traditionally, dentists haven't done much about chronic bad breath, Crossetti says. Most didn't know what caused it or how to treat it. Crossetti includes himself in that group.  Some years ago, he stopped routinely asking patients if they had bad breath because he didn't believe he could help them. For patients who complained, Crossetti suggested mouthwash, even though he knew mouthwash only masks the odor briefly.  But in the last few years, research - including two world symposiums on the subject - has shed new light on the problem. Scientists now have concluded chronic bad breath is caused by bacteria that grow and collect far back on the tongue and generate foul-smelling sulfur gases.

"The old tales that it is caused by poor dental hygiene, dental disease, sinus problems or stomach conditions are rarely true," Crossetti says. And the good news is chronic halitosis can be cured, Crossetti says.  A treatment for halitosis has been developed by Dr. Jon Richter, a Philadelphia periodontist. But it is still so innovative that few dentists use it, according to Crossetti. Dentists who use Richter's method must get training and buy some equipment, including a halimeter, a machine that measures volatile sulfur compounds, says Crossetti, who advocates Richter's method.  The method has not been approved by the American Dental Association, but that doesn't mean it doesn't work, notes Chris Martin, an association spokesman.  Tried on about 6,000 patients, Richter's method has had an almost 100 percent success rate, Crossetti says. The method involves testing for the condition, treating it and re-testing to make sure halitosis has been eliminated, Crossetti says.  Chronic bad breath stems from a coating on the tongue and inside of the mouth. Once a patient has been diagnosed, the Richter method calls for the dentist to use a chlorine dioxide solution to rid the mouth, teeth, tongue and cheeks of the coating.  The patient is then instructed on how to brush the teeth, cheeks, lips and palate for 1 minute with a mouth rinse Richter has developed. This is followed by flossing, then cleaning the tongue with a tongue blade and a final 30-second rinse of the mouth with the mouth rinse. The procedure takes about 2 minutes.

Good news about bad breath

Hey dragon mouth, can we talk about your breath?

Three Sterling Heights dentists are doing more than talking they've teamed up to start treating, ah, how do we say it, the root causes of bad breath.  Advances in medical technology have triggered this latest trend in dentistry, which addresses a problem that afflicts millions and reaps millions for mouthwash and toothpaste makers.  "We're just getting off the ground, said Steven Raitner, who has opened The Fresh Breath Centre in Sterling Heights with fellow dentists Linda Weberman and Douglas Shiffman as part of their family dental practice.  The key to treatment is a device called a halimeter, a machine that looks and acts like a Breathalyzer.  The machine is able to identify the source of bad breath and where it is in the body by measuring volatile sulfur compounds, or VSCs, the gases that create halitosis.  VSCs, the bad boys of bad breath, are found in three areas: the nose, mouth and stomach.

"Most people's bad breath problems are temporary, Weberman said.  "If you eat a coney dog or garlic, well, you're going to have a problem for a few hours or maybe a day or two.  "We're not trying to treat that, Weberman said. "We're interested in the causes of someone's chronic halitosis.  The halimeter uses a strawlike tube that sucks air from a patient's mouth, analyzes it and flashes a digital reading.  Once the halimeter has done its job, the dentists prescribe a treatment using the other bad breath breakthrough stabilized chlorine dioxide, a compound that neutralizes VSCs.  The substance, mixed with gels, liquids or tablets, can even be used to treat your dog's doggy breath.  "Really, you mix some in their water and it works, Weberman said.

Is the treatment a breakthrough or just another fad?  Dr. Ronald Scheele, a dentist from Fort Wayne, Ind., who has conducted preliminary studies on stabilized chlorine dioxide, believes it's a breakthrough.  "It's able to break apart these sulfur compounds so that the odor isn't just temporarily masked but rather wiped out, Scheele said.  Scheele, with Las Vegas dentist Dr. Duff Kaster, studied 27 patients with halitosis.  Scheele and Kaster reported a 30 percent reduction in VSC levels in the group with the worst halitosis after one week of treatment with a chlorine dioxide rinse.  Dr. Ellen Folbe, an Auburn Hills dentist, doesn't plan to start treating patients any time soon, although she's intrigued.  "I'm kind of waiting and seeing, she said.  "I'm curious to see if this is just another fad.  In their Sterling Heights office, Weberman and Raitner treat the affected areas using a combination of rinses, gels and tablets laced with stabilized chlorine dioxide.  Up to 80 percent of bad breath is born in the mouth, and 80 percent of that comes from the tongue.  The remaining 20 percent is divided between the nose and the stomach, Raitner said.  It's an easy treatment usually involving only one follow-up visit but one that the dentists say makes a huge difference in people's lives.  "We all have this problem at one time or another, Weberman said.  "It's a sensitive issue. People are reluctant at first. Wives come in and mention their husbands. Mothers come in and mention their kids.  "It seems to take a little while for them to make a commitment, but once they do, they want the appointment right now, today.

How to make sure your mouth isn't foul.  Think you've got bad breath? Most people never know. "One way to find out is to floss your teeth and then smell, said Sterling Heights dentist Steven Raitner. "That will give you a clue. There are other hints:  If you've got a bad taste in your mouth, you've probably got a breath problem.  Smoking dries your mouth, letting bacteria flourish.  If people react strongly face to face. If you're still not sure, ask your spouse or a close friend.  These steps reduce the risk: Brush your tongue and the roof of your mouth, not just your teeth. Keep your mouth wet. Drinking water helps keep your mouth fresh. Avoid mouthwashes or rinses with alcohol, which dries the mouth.

Remember that most toothpastes and mouthwashes provide only temporary relief. "All they do is mask the problem, said Raitner's partner, Linda Weberman.

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Last modified: October 17, 2007