What You Need To Know About Halitosis

We have all encountered people with halitosis, otherwise known as chronic bad breath. The moment they open their mouths, the foul breath that escapes is undeniable. But since we are not able to smell our own breath, what if WE have been living with bad breath for a while now?

Do not panic, there are several self-testing methods to find out if you have bad breath. One way is to lick your wrist, wait about five seconds, then smell it; another is to use a piece of cotton gauze to wipe the surface of your tongue near the back of your mouth, then smell it. Of course, the most obvious way to find out if you have bad breath is to ask someone you trust to be brutally honest with you.

The causes of halitosis aren’t as simple as poor dental hygiene. It’s time we learn more about halitosis from the expert, Dr Daylene Leong, dental specialist in periodontics at Specialist Dental Group.

“For starters, it’s prudent to know that this condition can be emotionally and psychologically debilitating for the sufferer. In my personal experience, about six out of 10 patients with periodontal disease experience halitosis. Although not all of them complain specifically about having bad breath, some of them get really bothered by it. They feel embarrassed about their condition and tend to get extremely self-conscious when talking to others.

According to the American Dental Association, halitosis affects more than 50 percent of the general population in the country, as stated in Jan-Jun 2013 issue of Journal of Natural Science, Biology and Medicine. While there aren’t any statistics on halitosis in Singapore, it isn’t an uncommon condition here either. Persistent bad breath is one of the signs of gum or periodontal disease, which is prevalent in 85 percent of adults aged 20 and above here, according to a 2003 survey by Health Promotion Board. That’s why it is accurate to infer that halitosis is relatively common in Singapore.

Understanding the root causes of halitosis

Unlike the occasional bad breath that everyone experiences – often caused by bits of food that are left in the mouth (e.g. garlic, onion, tuna, coffee, etc.) or lack of saliva – halitosis is caused by a range of more serious issues:

• Presence of gum disease – foul, odorous breath and unpleasant taste in the mouth are some of the main symptoms of gum disease
• Localised dental problems – infection (a tooth starts to decay), cracked fillings or unhygienic dentures
• Xerostomia, a medical term for dry mouth condition where a person’s unstimulated and stimulated salivary flow rate depresses to a certain level – due to medications, hormonal changes, side effects of medical treatments such as radiation and chemotherapy and/or constant smoking
• Tonsil stones – tonsil stones are calcified white or yellow globules that develop inside the tonsillar crevices located in the back of the mouth, directly behind the lower molars or wisdom teeth. Tonsil stones consist of food, mucus and biological debris. Anaerobic bacteria, which excretes volatile sulphur compounds that contribute to halitosis, flourishes in low-oxygen conditions such as the environment found in and around tonsil stones.
• Medical problems – Diabetes, ear or nose infections, chronic lung infections, or some forms of cancer. Digestive system problems can also cause halitosis; gastroesophageal reflux disease (GERD) is a condition caused by the backward flow of stomach contents and acids into the oesophagus, causing a burning sensation in the chest or throat. This regurgitation of stomach contents can cause a bitter or sour taste in one’s mouth, and lead to halitosis.

Another distinguishing factor between the two lies in the ease of elimination. The occasional bad breath can be eliminated after an individual starts on certain corrective measures. Halitosis, however, can only be corrected with the help of a dental or medical professional, depending on the underlying cause.

Eliminating halitosis

To treat the condition, you have to first identify its root cause.

If the cause is traced back to food particles that are trapped in misaligned or crowded teeth, the dentist may recommend seeking orthodontic treatment to straighten the teeth. Impacted wisdom teeth that do not have enough room to erupt can also be food traps and one may want to consider wisdom teeth removal as a preventive measure.

If it’s due to the presence of gum disease, visiting a periodontist for comprehensive gum treatments and regular periodontal maintenance subsequently will help.

However, if bad breath persists despite practicing good oral hygiene habits, it could point to certain underlying medical conditions, in which case it’s best for you to consult your dentist who will refer you to the appropriate medical specialist.

Preventing halitosis

Barring underlying medical conditions, halitosis can be prevented since two of its potential root causes are gum disease and localised dental problems. The key to avoiding them has been preached tirelessly, yet it still seems to fall on deaf ears – practice good oral hygiene. It really isn’t difficult; simply follow the rule of 2-2-2: brush your teeth twice daily for at least two minutes each time, and visit your dentist twice a year. And don’t forget to floss!”