The medical term of bad breath is halitosis. In fact, any unpleasant odor exhaled into the air is referred to as “halitosis”, whether its coming from the mouth or not. Anyone suffering from bad breath can feel uncomfortable and have a bad quality of life. Without doubt, it can cause embarrassment and anxiety all the time. As a matter of fact, the causes of bad breath can be plenty ranging from bad oral hygiene to an underlying cause. While the latter needs medical help and diagnosis to be treated, the first can be solved by simple hygiene measurements.

What causes bad breath?

Insufficient dental hygiene:

• When you ignore brushing and flossing after eating daily, you directly tell the bacteria to live in your mouth rent-free. Since food particles stay on your tongue and around your teeth, microbial decomposition occurs on a large scale giving you sulfur breath.

Tongue coating is a major cause of bad breath:

• This is a very likely cause of bad breath. In other words, bacteria, food, leucocytes and desquamating of the tongue all causes halitosis. The papillary structure of the tongue dorsum gives a large capacity for such matter to stick on. Besides, the bacteria present on the tongue are not different from subgingival plaque ones at all.

Periodontitis:

• It’s obvious that the bacteria responsible for bad breath are is close association with periodontitis. To illustrate, oral bacteria are often degrading food leftovers which results is volatile sulfur compounds, these compounds are what gives a foul odor. Having periodontal pockets gives bacteria a shelter, and the deeper the pockets are the more volatile sulfur compounds are released.

Morning breath:

• Due to the decrease in saliva production at night, anaerobic putrefaction will take place leading to common bad breath. As a matter of fact, women encounter such thyroid dysfunction more than men, and it’s not clear why.

Dry mouth:

• A decrease is salivary flow means an increase in teeth and tongue plaque. The less the saliva, the less antimicrobial activity is present and Gram-positive bacteria transforms into Gram-negative species. Aging, dehydration, mouth breathing, radiation therapy, thyroid dysfunction, diabetes mellitus, nephritis and autoimmune diseases can all reduce saliva secretion.

Smoking:

• As a result of smoking, people get smoker’s breath. That is to say, they obtain unpleasant mouth odor which results from tobacco chemical compounds mixing with their saliva. Besides, the smoke scent sticks in the throat and lungs which gives horrible breath.

Other causes of bad breath:

• Somatitis
• Exposed tooth pulps
• Tooth extraction wound
• Oral neoplasia
• Teeth crowding
• Oral ulcers
• Herpetic gingivitis
• Peri-implantitis
• Peri-coronitis

Bad breath diagnosis:

• History: Your dentist would ask you about your diet, smoking history, and medication consumption. Moreover, it’s important to check with the patient some respiratory illnesses including lower and upper respiratory tract infections, and gastrointestinal illnesses such as heartburn, weight loss, fever, cold, cough, and indigestion pain. Finally, checking for diabetes mellitus and hypertension family history is necessary.
• Periodontal screening: This is meant so your dentist evaluates your gum and bones to rule out an inflammation, bleeding and receding gums.

Of course, there’s certain methods to detect bad breath such as gas chromatography but most of them are meant for research; However, it’s obvious that bad breath detection is very easy and doesn’t any special methods or tools.

Treatment of bad breath:

• Brushing and flossing: The best way to stop bad breath is brushing at least twice and flossing at least once a day. In addition, your dentist will recommend you a toothpaste with built-in antibacterial compounds that will eliminate the bacteria causing you plaque. Notably, it’s important to remove the tongue biofilm by tongue scrapers or toothbrushes.
• Mouth rinse: Without doubt, these contain antimicrobial agents such as zinc, cetylpyridinium chloride, triclosan and chlorexidine. More importantly, the last is the most efficient to cease volatile sulfur compounds produced by bacteria.
• Treating periodontist: This is done by professionals who are trained to clean teeth pockets in order to remove plaque and bacteria.
• Thinned-young apple polyphenols: Researchers found that treating halitosis-related bacteria with polyphenols from thinned-young apples induced their rupturing. That is, the integrity of the bacterial cell membrane diminished due to increasing concentration of the apples’ polyphenols.

Lifestyle hacks to get rid of bad breath:

• Brush after you eat: After each meal brush your teeth to limit any possibility for plaque. Precisely, you can keep a tooth brush in your bag even if you’re at work or school.
• Avoid foods that dry the mouth: These include caffeine including drinks (coffee), alcohol and soft drinks. Indeed, decreasing saliva production limits the elimination of food remnants and the antimicrobial activity.
• Avoid some foods: Onions, garlic and other strong-smelling foods goes into your blood stream and then your lungs to give a bad breath.
• Stop smoking: Smoker’s breath can be reversed by smoking cessation.
• Hydrate well: This is a nearly perfect method to stop bad breath, where hydration leads to appropriate saliva production and washes off food remnants from your teeth and tongue.

References:

-Bollen CM, Beikler T. Halitosis: the multidisciplinary approach. Int J Oral Sci. 2012 Jun;4(2):55-63. doi: 10.1038/ijos.2012.39. PMID: 22722640; PMCID: PMC3412664.

-Kauss AR, Antunes M, Zanetti F, et al. Influence of tobacco smoking on the development of halitosis. Toxicol Rep. 2022;9:316-322. Published 2022 Mar 6. doi:10.1016/j.toxrep.2022.02.012

-Tungare S, Zafar N, Paranjpe AG. Halitosis. [Updated 2021 Aug 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534859/#_NBK534859_pubdet_

-Liu T, Shen H, Wang F, et al. Thinned-Young Apple Polyphenols Inhibit Halitosis-Related Bacteria Through Damage to the Cell Membrane. Front Microbiol. 2022;12:745100. Published 2022 Feb 23. doi:10.3389/fmicb.2021.745100

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