Bad breath or halitosis is an unpleasant noxious odour emanating mostly from the oral cavity. Most people are not aware they suffer from the condition unless notified.
Studies have shown that halitosis is associated with an increase of specific bacteria that are the predominant producer of hydrogen sulphide (a malodour gas, which is a by-product of certain bacteria), so the amount and type of bacterial composition of saliva in a patient complaining of halitosis are critical in determining the severity of halitosis.
There are a number of conditions causing bad breath. Morning breath, an oral malodour commonly occurs on waking up in the morning usually due to low salivary flow and lack of oral cleansing during sleeping. This is rarely significant, and usually we can get rid of it by brushing our teeth, rinsing the mouth with water or eating.
Halitosis also could be a result from eating certain food such as garlic, onion and some spices, or from habits like smoking (as smoking encourage the growth of certain bacteria that produce malodour gases) and drinking alcohol which reduce the amount of saliva in our mouth and result in reduce the cleansing action of saliva and the removal of food debris.
Pericoronitis, an infection of the third molar known as wisdom tooth, or gum diseases could be the possible cause of malodour from the oral cavity. The reason could be that an individual does not take good care of their mouth including lack of brushing, not using toothpaste or any adjunct oral care.
The surface of the tongue is thought to be the location of the microbial population causing halitosis. Thus, the dental plaque (the yellowish deposits that found on the surface of the tooth if not cleaned properly) and food debris that also associate with poor oral hygiene or poorly design dentures or bridges may contribute to the severity of halitosis.
Now, we already know what is halitosis, and what are the most common causes of oral malodour, the question here how to manage the condition and how to prevent it from happening?
Initial management of halitosis requires identifying and addressing its causes and assessing the severity of the malodour. A referral to medical specialist is indicated if the oral cavity is deemed normal. A compressive examination of related body parts such as nose, tonsils, and pharynx might be necessary.
As previously mentioned, bad breath commonly originates from the oral cavity. Whenever you feel or your close friend complained of bad breath several tips can be considered to eliminate the smell. Here are some of the steps.
Bacteria that live on the tongue have shown to produce malodour gases. It could be managed by using a mouth rinse that contain chlorhexidine 0.2% for a short period of 2 weeks. Additionally, tongue brushing is recommended to remove the bacteria adhere to the tongue. Various type of tongue cleaner/scraper available in the market can also be use. Combination use of mouth rinse and tongue cleaner has been proven to control the malodour.
Lozenges that contain low concentration of Zinc can be prescribed by dental practitioners. it can reduce the amount of volatile sulphur compounds that are the main causes of bad breath. Another product called triclosan, which found and incorporated in most of the toothpastes also could be used to get rid of bad breath.
In short, good oral hygiene practice such as brushing teeth twice a day using fluoridated toothpaste with an adjunct use of floss, mouthrinse and tongue cleaner is highly recommended. Get further dental treatment of any infection that may occur in the mouth. Habits such as smoking, alcohol consumption and caffeine intake should be avoided and limited if not possible. Adequate hydration and chewing sugar-free gum to stimulate saliva are also encouraged. All these practices are ways to prevent halitosis from happening among individuals. Last but not least, if you have any doubt of having halitosis, please visit your best buddy the dentist for regular examination.
Dr Aws Hashim Ali Al-Kadhim , Dr Muhammad Syafiq Alauddin and Dr Azlan Jaafar are researchers and clinical lecturers at Faculty of Dentistry, Univeristi Sains Islam Malaysia.