HALITOSIS
Halitosis, commonly called bad breath, is estimated to affect 50% of the populace. In about 90% of the cases, the source of the bad odor is within the oral cavity. The usual sources include poor oral hygiene, periodontal disease, coating on the tongue, impacted food and throat infections. Systemic sources can be due to lung infections, peptic ulcer infection, liver disease, kidney disease, cancer and diabetes.
The majority of bad breath in the mouth area is due to sulfur gases produced by bacteria in the mouth. Food can stick between teeth or metal braces. Food particles can also lodge in small cavities in the tonsils or tongue. This provides a ready source of nourishment for bacteria. The two gases most responsible for bad breath are hydrogen sulfide and methyl mercaptan. Exposure to these gases can be damaging to the delicate gum tissue.
The most effective way to prevent most bad breath is through daily tooth brushing and flossing. For people with large spaces between teeth or metal braces or partials, a mechanical irrigator can keep the teeth clean. The tongue can be brushed or scraped with a commercial tongue scraper. An ultrasonic toothbrush can help keep plaque and tartar from accumulating on the teeth.
Low saliva production promotes bacterial growth and halitosis. Common causes of low saliva are medications, mouth breathing, radiation therapy for head and neck cancer, dehydration and certain diseases. Measures to increase salivary flow include drinking more water, chewing sugarless gum and using artificial saliva liquids.
Mouthwashes or toothpastes containing stabilized chlorine dioxide can diminish bad odor by breaking down sulfur containing compounds. Supplemental zinc has been shown to also lower sulfur compounds.
Nutritional supplements to treat or prevent periodontal disease include vitamin C, vitamin E, zinc, coenzyme Q10 and folic acid. The oils from the herbs thyme and eucalyptus have proven activity against bacteria. Other herbs such as peppermint, clove, tea tree, sage and myrrh may also be beneficial.
Daniel Blodgett MD