Hocus Pocus Halitosis

by CHALISA PRARASRI

illustration by ANNIE THERIAULT 

illustration by ANNIE THERIAULT 

A guide to combating the unfortunate dis-odor of bad breath.

Bad breath, often referred to as halitosis in the scientific world, is surprisingly common. Based on a number of studies conducted between 1991 and 2006, scientists estimate that 30 to 50% of the population has bad breath, which means that in a room of ten people, three to five of them are likely to have bad breath (and one of them could be you!). To help prevent this embarrassing incident, here are six things you may not know about the smell of your mouth, along with ways to keep it under control.

1. 80-90% of bad breath cases are localized in the mouth.

Other possible origins of halitosis include the respiratory and gastrointestinal tracts. Oral halitosis cases are generally caused by gingivitis, periodontitis, dental cavities, or poor oral hygiene. When food or other particles are not effectively removed in a timely manner, they can get stuck in spaces between the teeth or attach to the surface of the tongue. Over time, these particles are broken down by the bacteria in the mouth to form smelly substances.

 

2. The degrees of bad breath is related to the quantity of bacteria present on the tongue.

This occurs primarily in the back portion of the tongue, where the majority of food particles and anaerobic bacteria build up and create odorous compounds. If you look at the back of your tongue in the mirror, you can see a white film coating it. You may think that this film represents the halitosis-causing bacteria, but that is not always the case. Some of the odor-causing bacteria found in your mouth may actually be transparent, so how your tongue looks may not be an accurate indicator of how your breath smells.

 

3. The smells emanating from people with bad breath are hypothesized to be caused by some nasty compounds.

These substances, produced from processes discussed in #1 and 2, include hydrogen sulfide, methyl mercaptan, skatole and putrescine, cadaverine, and isovaleric acid, which are responsible for the smells we associate with rotten eggs, feces, decaying meat, rotting corpses, and sweaty feet, respectively.

 

4. There is such a thing as bad-breath phobia.

Halitophobia, also known as pseudo-halitosis, is an exaggerated fear of having bad breath. People with this condition go to great lengths to keep people from smelling their breaths, such as covering their mouths when they speak, keeping their distance from people, and maintaining meticulous oral hygiene. Despite these actions, halitophobics continue to believe that they have bad breath even when they do not.

 

5. We can’t objectively judge our own breath.

According to a study published by The Journal of the American Dental Association in 2001, how we perceive our oral odors is actually more strongly correlated with self-image than truth. That is, if you’re afraid that you have bad breath, you will tend to smell your breath and think it smells bad, regardless of how it actually smells. Similarly, if you don’t think you have bad breath, you will tend to smell your breath and think it’s fine, even if it smells awful to an impartial judge.

 

6. There are two reasonably good ways for you to find out if you have halitosis:

Have someone close to you judge your breath (after all, it’s how other people perceive your breath that matters!).

Lick the back of a spoon (or otherwise get your saliva on something), allow it to dry, and then judge the smell. According to the study mentioned in #5, the participants were able to achieve partial objectivity in assessing the smell of their breath by smelling their saliva when it was removed from their mouths.

 

TIPS FOR AVOIDING HALITOSIS

Commonly used breath management solutions (like chewing minty gum) may not be enough to keep halitosis at bay. According to a review article published by Oral Diseases in 2012, mint, parsley, clove, and fennel seed concoctions only mask mouth odors without eliminating them. To really get rid of that bad breath, try changing either your habits or your diet.

 

HABITS

Keep good oral hygiene

It may seem obvious, but great oral hygiene is one of the best ways to keep halitosis at bay. Since such a large portion of bad-breath cases are localized to the mouth, it makes sense that keeping that area clean and disease-free with regular brushing and flossing will help breath issues. Brushing your teeth twice a day helps to remove the biofilm produced by the oral bacteria that develops in the mouth. The initial buildup of this biofilm is not harmful and can easily be removed on a daily basis. It’s when this biofilm is allowed to accumulate longer that it becomes more harmful, causing dental caries and periodontitis--two very common sources of halitosis. Visiting your dentist on a regular basis is also important for maintaining good oral health. Your dental professional can give you objective feedback on your breath and provide advice to help combat halitosis.

Gently clean the back of your tongue

Gently removing some of the bacteria on the back of the tongue while brushing may be helpful in achieving better breath. Removing plaque and bacteria from the back of your tongue can be done with a toothbrush or tongue scraper. Be careful with tongue scrapers, however, as they provide too much stimulation and cause gagging.

Stay calm and happy

According to a study published in Life Science in 2006, anxiety is linked to an increased amount of volatile sulfuric compounds (like hydrogen sulfide, responsible for the smell of rotten eggs), which play a large role in bad breath. Additionally, in a 2008 study published in Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, depression was related to patient complaints of halitosis.

Avoid smoking and alcohol

Tobacco contains volatile sulfuric compounds, which have been linked to bad breath. Additionally, tobacco is a risk factor for hyposalivation and gum disease, which may also lead to halitosis. Alcohol drinking has been linked to bad breath as well. According to a 2007 study published in the Journal of Dental Research, chronic alcohol drinkers were more likely than non-drinkers to have bad breath, possibly because alcohol in the mouth breaks down into smelly compounds and because alcohol can lead to a dry mouth.
 

DIET

avoid odorous foods, such as onions, garlic, cabbage, cauliflower, and radish

when you want good breath. This tip speaks for itself. Smelly foods will very likely create a smelly mouth. Additionally, some of these odorous compounds might enter your bloodstream to be secreted out of your mouth and nose through your lungs. Don’t avoid these foods altogether though, since they all have their own health benefits.

complement garlic with milK

According to a study published in the Journal of Food Science in 2010, adding milk (especially whole milk) to garlic was able to help deodorize the smell of garlic in the mouth.

stay hydrated

Hyposalivation, or having too little saliva in the mouth, is a factor linked to bad breath. Since saliva performs the function of washing out the mouth, too little saliva leads to an accumulation of food particles and other matter which decomposes and causes bad breath.

chew some eucalyptus or cinnamon gum

In a 2010 study published in the Journal of Periodontology, gum containing eucalyptus extract was found to reduce bad breath, probably because eucalyptus has antibacterial properties against certain bacteria that cause bad breath. Additionally, in a 2011 study published in the Journal of Clinical Dentistry, gum containing cinnamon extract and sugar was able to temporarily kill bad-breath bacteria in the mouth just as well as sugar-free cinnamon gum.

eat some licorice

In a 2012 study published in the Journal of Breath Research, a compound found in licorice was able to reduce the amount of smelly compounds produced by three strains of bacteria that are associated with halitosis.

drink green tea

In a 2008 study published in the Journal of Nutritional Science and Vitaminology, green tea was found to inhibit the production of smelly compounds in saliva. According to a 2012 study published in the Archives of Oral Biology, green tea may even be able to counteract bad breath caused by smoking. Be careful, though, because green tea extract-containing chewing gum was also found to cause discoloration of the teeth.

 

Winter 2013 | Vol. 13 | Issue 3