Bad breath – Diagnosis and treatment
Bad breath or oral halitosis is the third most common complaint patients report when they visit the dentist. This condition is usually caused by the increased number of microorganisms that produce volatile sulfur compounds, desquamated cells on the surface of the tongue, the presence of dental caries, periodontal disease, dental cavity, tonsilloliths, the patient’s diet, his or her social habits (smoking, drinking alcohol) or other underlying medical conditions that the patient has.
Patients having bad breath or complaining to have one can also suffer from a lack of confidence and public humiliation. Aside from these psychological effects, having this condition can also signify an underlying medical or dental condition that the patient might be suffering from that should be addressed immediately.
Diagnosis
In 2019, Kapoor et. al. published a systematic way of diagnosing halitosis as seen in the image below:
A patient who comes into the clinic with a chief complaint of halitosis would undergo a thorough medical history, dental history, social history, and halitosis history interview. This is done to rule out transient or physiological halitosis (morning breath) that normally occurs in all human beings.
Once this step is done, the patient would then go through Breath Sampling through an Organoleptic Test in a clinical setting where patients would exhale or count from 1 to 10 while the dental care provider examines the air 10 cm away from the patient’s mouth. Clinicians could also ask the patient to exhale through a brown paper bag and examine the air from the bag or they could also conduct the wrist lick test. If the patient does have bad breath, he or she would go through an oral screening or a dental examination to verify that there are no intraoral pathologies causing their bad breath. If there are intraoral pathologies present, then the patient would be referred to a dental health care provider that would render the best service to treat his or her condition.
However, if the patient has halitosis but has no intraoral pathologies present, he or she would have to go through ENT and Gastroenterologist to rule out respiratory tract infections or infections in the patient’s gastrointestinal organs. If there are still no systemic diseases from those organs that would cause oral halitosis, further laboratory examinations would be conducted.
If halitosis is not present, the patient would have to go through advanced diagnostic
tests like Gas chromatography or the BANA test. If the results still came out negative, the dental practitioner should consider delusional halitosis.
Cure for Bad Breath
As a patient, one should understand that like any other oral disease, oral halitosis is a multi-factorial disease as well. There are many factors that may cause this, and, more often that not, the presence of one factor could amplify the effect of the other. Hence, the patient should consider doing the following:
Lifestyle change
If you smoke, you eat whatever you like, or are always stressed, there is a high chance that you would actually have bad breath.
Smoking is one of the common causes of bad breath. The chemicals present in tobacco products can leave a lingering odor in your mouth and throat. In addition, smoking can also dry out your mouth, reducing saliva production, which plays a crucial role in neutralizing bacteria and keeping your breath fresh.
Diet can also impact your breath. Certain foods with strong odors like onions, garlic, and spicy foods can temporarily cause bad breath. When you consume these foods, the odor-causing compounds are absorbed into your bloodstream and carried to your lungs, resulting in temporary bad breath. Additionally, eating a diet high in sugar and processed foods can contribute to the growth of bacteria in your mouth, leading to bad breath over time.
Stress can indirectly affect your breath as well. When you’re stressed, you may breathe through your mouth more frequently, which can cause dry mouth. As mentioned earlier, a lack of saliva can lead to bad breath because saliva helps cleanse the mouth by washing away bacteria and food particles.
Improve oral habits
You may have the money to pay for the best dentist that you can find, or have a full-mouth rehabilitation, but if you still don’t brush your teeth properly at least three times a day, if you still don’t floss, or if you don’t use the mouth rinse that your dentist prescribed for you, your bad breath will persist.
For proper toothbrushing and flossing instructions, you can watch this video:
Use of Mouth Rinse
Although there are no actual scientific studies that prove that diet change could, without a doubt, get rid of bad breath, there are studies though, that concretizes the claims that the use of antibacterial mouth rinses could stop the production of volatile sulfur compounds (VSCs).
In addition to this, it is also proven by a Cochrane systematic review that mouth rinses that contain Chlorine dioxide and Zinc can neutralize VSCs that cause halitosis.
Another substance that could help with halitosis is Triclosan. In the study of Hu, et. al, by using toothpaste with Triclosan or tongue scrapers that are impregnated with Triclosan, organoleptic scores, and oral sulfur levels are significantly reduced.
Go to the dentist
Going to the dentist might be too expensive, or even scary, but having your mouth checked by an actual expert can drastically improve your condition. If you’re concerned about persistent bad breath, it’s a good idea to consult a dentist or healthcare professional. They can assess your oral health, identify any underlying issues, and provide appropriate guidance and treatment.
Does drinking water help breath smell?
Yes, drinking water can help improve the smell of your breath. Bear in mind that xerostomia or dry mouth, is one of the many causes of bad breath. When you’re dehydrated, your mouth tends to produce less saliva. Saliva plays an important role in maintaining oral health as it helps wash away food particles, bacteria, and dead cells in your mouth. This helps reduce the chances of bad breath.
Drinking water helps keep your mouth moist and encourages saliva production. By staying hydrated, you promote a healthier environment in your mouth and reduce the risk of dry mouth, which can contribute to bad breath.
In addition to keeping your mouth moist, drinking water can also help rinse away food particles and bacteria that may be present in your mouth. Swishing water around in your mouth after meals can help dislodge any lingering debris and dilute the concentration of odor-causing substances.
Tooth Be Told
Bad breath does go away, but if halitosis is caused by a bigger underlying problem, you should definitely consult a dentist or a dental hygienist to help you out.
