Bad breath, also called halitosis, is a very common oral health problem. People of any age may have halitosis which is mostly caused by sulphur-producing bacteria that normally live on the surface of the tongue and in the throat. Sometimes these bacteria start to break-down proteins at a very high rate and odorous volatile sulphur compounds (VSC) are released from the back of the tongue and throat.
Apart from the sulphur-producing bacteria that colonise the back of the tongue, the other major causes of halitosis are:
Dental factors – such as gum disease or poor oral hygiene
Dry mouth – caused by medicines, alcohol, stress or medical conditions
Smoking – which starves the mouth of oxygen
Less common causes of halitosis include:
Acid and bile reflux from stomach
Post-nasal discharge – for example, due to chronic sinusitis
Foods – such as onion, garlic or cauliflower, which induce certain odours. However, these effects are only short-lived.
Having halitosis can have a major impact on a person. Because of bad breath, other people may back away or turn their heads. This can cause a loss of confidence and self-esteem.
There is no one treatment for halitosis. The treatment will depend on what is causing the problem. Avoiding dehydration and practicing good oral hygiene, including brushing and flossing, are very important. Some mouth-washes, lozenges and toothpastes can assist in fighting halitosis. Gentle but effective tongue cleaning may also be required. A variety of tongue brushes and scrapers have been produced in recent years. The tongue should be brushed in a gentle but thorough manner, from the back towards the front of the tongue, keeping in mind that the hardest to reach back portion smells the worst. People with chronic sinusitis may find the regular use of saline nasal spray helpful. A course of an antibiotic, effective against anaerobic bacteria (such as metronidazole, to reduce the overgrowth of sulphur-producing bacteria), may also help.