Most adults will suffer from some degree of bad breath at some time in their lives. Myths abound on its cause and treatment.

Myth 1 : It's easy for one to tell if their breath smells. FALSE - We cannot smell our own breath because we become accustomed to our own smell.

Myth 2 : Bad breath comes from the stomach FALSE - In only rare cases does stomach and digestive problems contribute to bad breath. Most bad breath come from the back of our mouths.

Myth 3 : Toothbrushing will always eliminate bad breath FALSE - Good brushing and flossing habits will help reduce bad breath. However, most people do not brush their teeth properly as it takes nearly 3 minutes to do so and most spend 45 sec to 1min. Further more, bad breath can come from bacteria residing deep within crevices on the back of the tongue therefore a tongue scraper is required.

Myth 4 : Mouthwashes are effective in treating bad breath FALSE - Mouthwashes will only provide temporary relief from bad breath. In fact, most mouthwashes contain alcohol, which has a drying effect in the mouth allowing bacteria to grow better. However, there are newer mouthwashes without alcohol. There are also mouthwashes which have compounds that react with, and neutralize odour-causing volatile sulphur compounds produced by bacteria in the mouth.

Myth 5 : To prevent bad breath we should focus on the food we eat FALSE - Temporary bad breath most commonly comes from the foods we eat like onions, garlic and cabbage which will produce high amounts of sulphur compounds. The digested sulphur compounds are absorbed and carried by blood into the lungs where they are exhaled to produce bad breath. However, chronic bad breath is most commonly caused by bacteria, which break down food debris left in the mouth.


What are the causes of bad breath?
Bad breath is a common problem that can be due to many causes
1. odour-causing foods
2. tooth decay
3. periodontal (gum) disease
4. continued mouth dryness
5. use of tobacco products
6. sinus or respiratory infections
7. inadequate oral hygiene
8. medications e.g. anti-depressants, diurectics (used for high blood pressure)
9. medical disorders e.g. oesophageal-gastro reflux, chronic tonsil infections
10. certain bacteria that produce foul-smelling compounds

Most commonly, the smell is a result of breakdown of proteins by various bacteria in the mouth. For example, volatile sulphur compounds and other substances like cadaverine and putracine are produced by certain anaerobic bacteria . From our diet, foods like garlic, onions and some spices as well as tea and coffee can contribute towards bad breath. Poor oral hygiene from infrequent brushing of teeth or cleaning of dentures will lead to food debris left in the mouth, around teeth, on dentures, tongue and cheek surfaces, which will be broken down by bacteria resulting in unpleasant breath. The bad smell can also come from the back of the surface of the tongue. The scraping obtained by the dentist from this portion of the tongue may suggest that this may be the primary source of bad breath in the individual. In such cases, it will help to use a tongue scraper daily to clean the tongue surface and reduce and prevent the accumulation of bacteria and foul-smelling, bacterial products.


What about gum disease and decay in relation to bad breath?
Gum disease and tooth decay will often have accumulations of bacteria that can cause bad breath in the affected areas. If there is gum disease or tooth decay, then treatment should be sought to eliminate these problems first. Your dentist will be able to examine you, and take some quick radiographs (X-rays) to check for the presence and extent of such problems. Early detection, diagnosis and treatment of gum disease and tooth decay will help keep teeth functional for life. Preventive maintenance is essential to ensure continued good oral health.

Problem Possible Cause
Odour after fasting, dieting, prolonged speaking, exercise, sleeping, taking medications

Dryness in the mouth caused by insufficient saliva flow
Gums that bleed and bad breath Gum disease caused by poor cleaning between teeth

Odour upon talking Postnasal drip on back of tongue

Small whitish stones with foul odour appearing on tongue

Tonsilloliths from crypts in tonsils
Odour appears suddenly form mouth of young children

Onset of throat infection
Odour in denture wearers Dentures kept in mouth all night or, not cleaned properly

Odour from nose Sinusitis, polyps, dryness, foreign body, hindered air or mucous flow

Bad taste all day long Poor oral hygiene, gum disease, excessive bacteria on tongue surface



Can bad breath be treated?
The key for effective treatment and management of this condition is proper diagnosis. Recent research has enabled dentists to understand the causes of bad breath and therefore treat it more effectively. The main problem is accepting that one has bad breath as most individuals cannot smell their own breath. Asking friends or seeking other's opinion is usually the best way. Dentists usually begin by checking for the presence of oral disease or conditions that can contribute to bad breath.

The DO's and DON'Ts in bad breath

Do's

Visit your dentist
Have your teeth cleaned regularly
Floss and clean between your teeth as advised by your dentist
Brush your gums and teeth using the proper technique
Practice regular cleaning of your tongue
Drink plenty of liquids
Chew sugar-free gum especially when your mouth feels dry. Alternatives include parsley, mints, fennel seeds
Clean your mouth after eating or drinking milk products, fish and meat
Keep your dentures clean and soak them overnight in antiseptic solution
Check with family or friends on the status of your bad breath
Use a alcohol free mouthwash regularly
Eat fibrous vegetables and fruits because this stimulates saliva flow and reduces build-up of food

Don'ts
Don't ignore the problem if you have bad breath
Don't drink too much coffee
Don't forget to floss and clean between your teeth
Don't forget to clean your tongue - use a scraper with a suitable mouthwash
Don't let young children use mouthwash as they tend to swallow it
Don't rely solely on mouthwashes, practice good oral hygiene and eating habits
Don't let your concern about bad breath affect your life adversely

back