Bad breath, or halitosis, is a common concern affecting approximately 30 percent of the population at some point. While it's typically temporary, caused by foods like garlic, beverages such as coffee, or habits like smoking, some individuals struggle with chronic halitosis.
Store shelves are stocked with remedies like gum and mouthwashes, but these often provide only short-term relief as they don't address the underlying causes.
The origins of bad breath can be both inside and outside the mouth. It commonly stems from bacteria on teeth and debris on the tongue, making oral hygiene crucial, says dentist Piyush Virmani, who has previously worked with many Bollywood stars as their oral healthcare expert. Conditions like gum diseases (gingivitis and periodontitis) and dry mouth (xerostomia) where insufficient saliva production leads to a parched mouth, also contribute to bad breath, he says.
Beyond the mouth, tonsillitis, respiratory infections (sinusitis or bronchitis), and some gastrointestinal diseases may also cause bad breath. Advanced liver or kidney disease, uncontrolled diabetes, and certain cancers can also lead to halitosis, often accompanied by other symptoms.
It's essential to differentiate between actual halitosis and "pseudo-halitosis," where individuals mistakenly believe they have bad breath despite not exhibiting it. Halitophobia, the fear of bad breath, is a real concern that may require counseling.
Initial evaluation by a primary care physician (PCP) involves a thorough medical and dental history, along with tests to confirm halitosis, says Virmani, This includes measuring the strength of bad breath and detecting specific compounds related to it.
Common causes of bad breath include:
Food: Particles from food breakdown around teeth can lead to bacteria and odours. Foods like onions and garlic can also cause temporary bad breath due to their compounds being carried to the lungs and affecting breath.
Tobacco: Smoking and tobacco products not only cause their own odour but also increase the risk of gum disease, another source of bad breath.
Poor oral hygiene: Not brushing and flossing allows food particles to linger, forming plaque that irritates gums and leads to gingivitis or periodontitis. Bacteria on the tongue and in dentures contribute as well.
Dry mouth: Reduced saliva production due to sleep (morning breath), medications, or medical conditions can worsen bad breath.
Medications: Some medications cause dry mouth or release chemicals on breath.
Infections: Surgical wounds, tooth decay, gum disease, and mouth sores harbour bacteria leading to bad breath.
Other conditions: Tonsil stones, postnasal drip from nose/throat issues, certain cancers, and gastrointestinal disorders can cause distinctive breath odours.
Tips to combat bad breath include:
Regular brushing: Brush teeth at least twice a day with fluoride toothpaste, especially after meals.
Avoid tobacco: Smoking and chewing tobacco worsen breath and oral health.
Alcohol-free mouthwash: Rinse before bed to reduce bacteria.
Stay hydrated: Drink enough water, especially with dry mouth, and use moisturising agents.
Dental visits: Regular check-ups are crucial for oral health.
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