Medically Reviewed by Dr. Elisabeth Vincent Hamelin
What is that?
Bad breath (halitosis) is a fairly common problem. In normal conditions the smell of the oral cavity can register variations in its intensity and typology according to some variables such as age, sex, eating habits, time of day. The emission of unpleasant odor from the breath (generally from the mouth but sometimes also from the nose) upon awakening, as well as after a particularly “tasty” lunch or dinner is a normal thing and does not require special precautions. In fact, during the night, when the production of saliva decreases and the movements of the mouth are very limited, the bacterial decomposition process, the main cause of halitosis, is further enhanced. Even a particularly abundant meal or based on foods such as garlic or onion easily causes halitosis: these foods are rich in volatile sulfur compounds which are eliminated through the respiratory tract. In other cases, halitosis can be due to prolonged periods of fasting: this condition also reduces the production of saliva, an important mechanism of self-cleaning of the mouth. However, if the bad breath is persistent and continuous, the causes could be different (dental and/or gingival, digestive or respiratory).
What are the causes?
The main cause of halitosis is poor (or inappropriate) oral hygiene, which involves the formation of bacterial plaque, made up of millions of bacteria that proliferate on the tongue and teeth. The bacteria react with food residues and, through a chemical decomposition reaction, release gases which give a characteristic sulfur smell to the breath. Over time, bacterial plaque turns into tartar, which in turn is responsible for infections of the oral cavity, such as periodontitis and gingivitis which in turn causes halitosis. Other factors that can contribute to the onset of halitosis are smoking (cigarettes, pipes, cigars, snuff or chewing tobacco) and taking certain medications, including some antidepressants, antihistamines, antihypertensives, diuretics, anxiolytics as they can reduce saliva production. More rarely, halitosis can be caused by disorders affecting the digestive system (gastritis, dyspepsia, reflux, hiatal hernia) or the respiratory system (sinusitis, chronic rhinitis, tonsillitis). In all these cases it is necessary to consult your doctor.
What are the remedies?
- Scrupulous oral hygiene is the first intervention to combat halitosis: use dental floss at least once a day and brush your teeth thoroughly after each meal. It is important to dedicate a few minutes also to cleaning the tongue, especially at the level of the posterior third, where bacterial proliferation is greater and where natural plaque removal is more difficult due to the presence of the soft palate. For this operation, a normal soft bristle brush or special scrapers that allow mechanical removal of the plaque can be used.
- If it is not possible to brush your teeth after a meal, at least rinse your mouth and chew a sugar-free chewing gum, which helps to remove any fragments of food on the surface and from the interdental spaces.
- The regular use of mouthwashes based on substances with antiseptic action (e.g. Curasept, Elmex), gargling for at least 30 seconds, allows to improve the situation, even if the effect is rather short (a few hours at most), with high variability from person to person.
- Try to limit the consumption of foods known to be able to cause halitosis such as onions, garlic, certain spices, peppers, smoked meats, some fish, some cheeses and drinks such as coffee, beer, wine and spirits. Those who have dry mouth problems (xerostomia), if the causes cannot be removed, can benefit from specific saliva substitutes (e.g. Biotene, Oralbalance, Secriva) and drink often.
- It is advisable to eliminate or reduce tobacco consumption.
- For wearers of fixed prostheses (or bridges) and orthodontic appliances, etc. the use of (Broxo Jet and Water pik), particular equipment which, thanks to a jet of water, allow the cleaning of the interdental spaces which are difficult to reach, can be useful.