Bad Breath - Halitosis

Halitosis or bad breath is an unpleasant, distinctive, or offensive breath odor, usually created by a group of anaerobic sulfur-producing bacteria. According to Academy of General Dentistry; more than 80 million people suffer from chronic halitosis.  The odor can either come from an oral source or some disorders from other organs that will produce specific, characteristic odors to the breath.

Halitosis is estimated to be the most frequent reason to visit a dental office, following tooth pain, tooth decay, and gum disease.  For healthy individuals, temporary malodor may arise from consuming certain foods that are natural odor-producing such as garlic, onion; normal salivary flow will eventually eliminate the odor. Individual who has dry mouth, lack of saliva may cause a long-term halitosis. Saliva helps wash food particles and bacteria away from the mouth.  While sleeping at night, saliva glands slow down the production of saliva, allowing more bacteria to grow inside the mouth and on top of the tongue, creating bad breath in the morning.

Halitosis is a symptom of an underlying tissue, not a disease itself. Therefore;  any attempts to address the bad breath requires identifying the underlined issues that originated bad breath.  Those issues are sometimes but not always a dental origin. Halitosis patients should consult a dentist and a physician for proper evaluation of the symptom.

The research found volatile sulfur compounds (hydrogen sulfide, dimethyl sulfide, methyl mercaptan) which are generated by anaerobic bacteria are a principal malodor in chronic halitosis. The device to measure volatile sulfur compounds in a clinical setting is the Halimeter®.

Contributing factors of halitosis are:

1. Oral or dental disease - tooth decay, gum disease, odontogenic infection and mucous membrane disorders, dry mouth (Xerostomia). Food impacted inside infected gums and becomes fermented by bacteria and generates foul odor.  

2. Poor oral hygiene or improper practice of oral hygiene. Proper brushing should include: the cheeks, palate, and tongue; flossing, and use of a tongue scraper after each meal helps remove bacteria, plaque, and food particles.

3. Dentures can harbor bacteria; bacteria consume foods that trap underneath the denture and produce volatile sulfur compounds that cause bad breath.  It is important to clean the dentures using a toothbrush thoroughly after each meal, which include removing and replacing denture adhesive. Every night soaks the dentures in a denture cleaning solution for at least 30 minutes to an hour.

Some common home-made cleaning solutions for dentures that don't have metal parts are:
  • 10% Clorox bleaching agent (1 part of Clorox to 10 parts of water)
  • 50% vinegar (equal part of vinegar and water)
  • Mixture of baking soda (1 teaspoon of baking soda to 8 ounces of water)
if you have a soft liner underneath the dentures, ask your dentist for the best cleaning solution that is suitable for the soft liner.

4. Tonsilitis, tonsil stones

5. Upper respiratory tract infection or inflammation (sinusitis,  rhinitis). The common one is a sinus infection, the drainage of infection to the back of the throat yields foul odor when exhale.

6. Lower respiratory disease (emphysema, lung disease, bronchitis)

7. Digestive tract disease (gastroesophageal reflux disease - GERD, dyspepsia, peptic ulcer, Crohn's disease, ulcerative colitis).

GERD is a condition caused by an inadequate seal between esophagus and stomach due to the loose sphincter, causing food and digestive acid to regurgitate to the mouth. Foods that may change the integrity of the sphincter are spicy foods, sour food, alcohol, and coffee.  Some people may be affected by different types of food other than what mention here.  If you suspect that you have halitosis, you should keep tract of foods you eat, ask close friends or relative about letting you know if they smell bad breath right after you finish eating a particular food.

In the Journal of Medical Microbiology, a report found H.pyroli indirectly causes halitosis to some people, and the association of H.pyroli to gum disease, dyspepsia, acid reflux, peptic ulcer, and cancers.  Therefore; eradication of H.pyroli will resolve the bad breath problem and other serious condition as well.

8. Tobacco and alcohol users

9. Foods, e.g., garlic, onion, coffee, tea can be detected on an individual's breath for up to 2-3 days after consuming.  Halitosis caused by foods will resolve on its own after the foods being digested and being completely absorbed or excreted.

10. In low carbs diet, carbohydrates are not available as a source of energy.  The body uses fats and proteins as its source of energy.  As the body burns fat and proteins, releasing by-products that cause halitosis.

11. Low acid stomach, low enzymes; food cannot digest properly, leads to food fermentation inside the digestive tract, and foul odor occurs.

12. Liver and gall bladder stones; limit amount of bile to the stomach, caused improper digestion, leads to food fermentation

13. Constipation is an indirect cause of halitosis.  Food remains in the colon for a long period can cause fermentation, and create halitosis

14. In diabetic patients, the body uses fat instead of sugars as a fuel source because the body has no insulin or not enough insulin.  By-products of broken down the fat called ketones that generate a fruity odor to the breath.

15. Prolong vomiting: Breath smells like feces, especially when there is a bowel obstruction. It may also occur temporarily if a person has a tube (nasogastric tube) placed through the nose or mouth into the stomach to drain the stomach contents in place.

16. In individuals with chronic kidney failure; the breath may have an ammonia-like odor (also described as urine-like or "fishy")

Some Remedies for bad breath

1. Cavities
Remedy: Have the cavities filled. Brush with sea salt powder or sodium perborate three times a day. Floss after each meal.

2. Gum disease
Remedy: Have deep cleaning, rinse your mouth with Chlorhexidine or Hydrogen peroxide

3. Acidic body
Remedy:
  • Take 1/2 teaspoon of baking soda plus 1/2 teaspoon of citric acid twice a day. 
  • Have plenty of sleep for the body to restore the bicarbonate levels

4. Low stomach acid
Remedy:
  • Add 1/4 teaspoon of sea salt per liter of drinking water
  • Take betaine HCl to restore the stomach acids
    Caution: Must test for low stomach acid by the physician before taking betaineHCL.

5. Constipation
Remedy: Eat more high fiber foods. Avoid milk, sugar, all white flour snack or food, vegetable oils, margarine, and canola oils, instead use coconut oil, eat millet, whole wheat.

6. Improper blood sugar level or high blood sugar.
Remedy:
  • Take 9 mg. of the biotin per day plus one teaspoon of granulated lecithin to help the body get rid of excess fats and reduce the blood sugar. 
  • Or take Vitamin D3 or D4
    Avoid all vegetable oils, fried foods, soft drinks, starchy foods, and replace with coconut oil

7. Eating late at night
The digestive system doesn't work well during the late evening.  Stop eating late at night.

8. An imbalance of bacteria in the mouth
Remedy: a natural tree resin called mastic gum, has been shown to help improve to a healthy mouth environment by reducing acidity and promoting microbial homeostasis

9. Use tongue scraper to clean the top of your tongue every morning

10.  Use BreathRx Anti-Bacterial Mouth Rinse (33oz Bottle)
Ingredients of BreathRx:
  • Active; Cetylpyridinium Chloride
  • Inactive;
    • Citric Acid
    • Cocamidopropyl Betaine
    • FD&C Blue 1 
    • Hydrogenated Starch Hydrolysate
    • Mint Flavor, PEG-40
    • Hydrogenated Castor Oil
    • Poloxamer 407
    • Propylene Glycol
    • Sodium Saccharin
    • Sorbitol, water
    • Xylitol
    • Zinc Gluconate)

11. Use Dr. Katz TheraBreath Oral Rinse and Dr. Katz TheraBreath Oxygenating Toothpaste

12. Gum disease (periodontal disease, gingivitis) is the most common cause of bad breath.

Remedy:  Use probiotic.
  • Have your teeth cleaned at the dental office and maintain it with water pik. 
  • Rinse with probiotic mixture before bedtime or apply probiotic paste around the gum

    To make the probiotic mouth rinse; Pour the content in 2 capsules of probiotic into 1/2 cup of water and mix well. Before bedtime, gargle the mixture and keep it in the mouth for at least 5 minutes or more before emptying.  Do not rinse the mouth afterward.
     
  • For bleeding gums; make the probiotic paste by mixing the content in 2 capsules of the probiotic with water until it becomes a thick paste.  Use Q-tip or finger to apply to the area between the tooth and gums that bleed. 
13.  Abscess;  bad breath can come from a collection of pus.
Remedy: have the root canal done on the tooth or have the tooth extracted.

14. Impacted wisdom teeth; food trap underneath the gum tissue can cause bad breath.  Have wisdom teeth removed.

15. Tobacco users need to stop smoking

16. Spicy foods - stop eating food that left unpleasant odor in the mouth such as garlic and other spices

17. Acid reflux
Remedy: Use prescription drugs such as Prilosec or Prevacid

18. Systemic disease - consult your physician if you have a lung infection, sinusitis and throat infection, bowel obstruction and Other systemic diseases include acute renal failure, esophageal cancer, gastric carcinoma, atrophic rhinitis.

Temporary removing bad breath:

1. Hydrogen peroxide mouthwash can be used to remove the halitosis in many people.

Instruction for mixing Hydrogen Peroxide Mouthwash:

a. Mix equal parts of 3% Hydrogen peroxide and water and gargled for about 2-3 minutes to kill bacteria and have a fresh breath.  Rinse and gargle with water thoroughly afterward.

b. If the problem continues, repeat (a) once a week or maybe once a month.

c. If bad breath accompanied by body odor:
  • Add probiotics to the regimen.  Bad breath comes from bad bacteria in the gut. Adding good bacteria into the gut improves Halitosis condition
  • Take Dolomite tablet. Dolomite is a naturally occurring mineral (Calcium Magnesium Carbonate) in chlorophyll.  Dr. Pierre Delbet, M.D discovered how to remove body odor by modification of the intestinal flora using Dolomite.

2. Chew on parsley, fennel and caraway seeds. 

3. Rinse and gargle with parsley and cloves mixture; add many sprigs of coarsely chopped parsley and few whole cloves in boiled water, occasionally stir, let cool and strain the water for mouthwash.