Halitosis
- You have bad breath
Bad Breath - Though it may wound your pride, your darling grandchild may
actually be doing you a favor by announcing so bluntly: 'Yuck -- you
have bad breath.' Strangely enough, people who have halitosis are
usually the last to know. The good news is, you don't have to put up
with it any more.
'There's a way to control it,' says Dr. Barry Cash, a dentist
who's operated the Fresh Breath Center in Toronto since 1995. 'It's
certainly not a cure -- it's like having diabetes --there's only
control for the disorder, not a cure for it. But as long as you
maintain whatever program you're on, you'll be able to keep it under
control.'
It starts with careful brushing and daily flossing to remove food
particles and plaque. A WaterPik or electric toothbrush can be
particularly useful for people with restricted hand coordination. A
tongue scraper removes the gunk that's accumulated on the back of
your tongue; then you rinse with an appropriate mouthwash.
Mouthwashes ineffective
on bad breath
Over-the-counter potions though, generally won't do the
trick. In the U.S., anxiety over bad breath has spawned a mouthwash
industry with sales worth $850 million, in spite of the fact that
they're largely ineffective because they don't get to the root of
the problem.
Most bad breath originates in the mouth, so if the verdict of
your nearest and dearest is your current program of oral hygiene
isn't doing the job, it's time to consult a mouth specialist, your
dentist. After carefully examining the teeth, gums and the rest of
the oral cavity, the dentist may suspect the source of the problem
lies elsewhere and refer you to a medical practitioner. Problems in
the airways, lungs or even liver disease or other serious illness
can promote halitosis; bad breath that arises suddenly and gets
worse usually indicates the presence of an infection.
When chronic foul breath is the sole complaint, it's most likely
the mouth is the source of the problem.
Sulphur compounds the culprit
But phew! Just what is it that smells so darned bad? The
offending odor occurs when sulphur-containing amino acids (the
building blocks of protein) are broken down by anaerobic bacteria
(germs that thrive in an oxygen-free environment), producing a mix
of malodorous gases. These volatile sulphur compounds (VSC) include
hydrogen sulphide, methyl mercaptan and dimethyl sulphide.
The
protein that supplies the amino acids attacked by the bacteria comes
from several sources in your mouth: dead cells from the lining of
your mouth, food particles, bacteria (dead or alive), blood-derived
compounds including white blood cells. People with periodontal
disease tend to have higher levels of VSCs than those with healthy
gums, but they're not the only ones with the condition.
Treatment of gum disease and repair of broken teeth will help
maintain the fresh mouth. Your dentist will also start you off with
a thorough cleaning of all the tissues of the mouth.
Tongue collects bad gases
'The tongue is a major area where the gases can collect,' says Cash.
'If you've ever seen the tongue under a microscope, you know it's
certainly not a smooth, flat part of the body -- it's got these
fissures in it. The papillae (taste buds) stick up and the gases
will sit in there.'
To determine the area of greatest concentration of odors, Cash
uses an instrument called a Halimeter that measures these gases in
parts per billion. Later, after the patient has been on a treatment
program, a repeat test can confirm how well it's working or whether
some adjustment needs to be made to control unexpected periods of
bad breath.
Using a straw that's connected to tubing, the instrument pumps away
a sample of the patient's mouth breath, measures the VSC content and
provides a reading. (For the most accurate response, the patient is
asked to refrain from eating before testing, cleaning teeth or using
breath fresheners, and is required to avoid the use of perfumes or
aftershaves that could interfere with the instrument.)
Since the action of anaerobic bacteria produces the offending
VSCs, regulation of the problem is directed at controlling these
organisms.
Bad
bacteria and bad breath
'They're the bad bacteria,' notes Cash. 'You want the aerobic
bacteria [that live in an oxygenated environment to flourish over
the anaerobic bacteria. The products we use are actually
antimicrobial. They'll destroy the anaerobic bacteria.'
Most control programs include the use of a toothbrush and a
tongue scraper (to strip debris off the tongue), as well as a mouth
rinse and a gel product formulated to provide oxygenation. These
products are purchased through your dentist.
'The gel is basically used at night when the mouth is
stagnant," explains Cash. 'It keeps the mouth oxygenated and it
actually promotes salivation so that you don't have a dry mouth when
you wake up. We suggest people use it underneath their dentures, for
the oxygenation process at night.'
Smoker's breath
- bad breath
Ever wonder why a smoker's breath is so unappealing?
'Smoking causes xerostomia, which is drying of the mouth,' says
Cash. 'Dryness promotes the growth of bad bacteria that will cause
odors. I tell my patients that smoking is probably one of the worst
things for your gums, though you never read about it because of
the concern about smoking related to the heart and lungs and blood
vessels... Nobody ever talks about the deleterious effects of
smoking on the mouth.'
