In the final part of our halitosis (bad breath) review -- we discuss diagnosis and offer tips of prevention

Halitosis (Bad breath)

Part 2

Diagnosis in severe cases

It is rare that someone must get diagnosed with halitosis as they will be aware of it themselves or those close to them will make them aware of it and the steps described in this article will ease symptoms in most cases

Specific diagnosis tools are only used in rare cases where halitosis is so severe and persistent despite simple and well recognised steps including improved dental hygiene and improving diet.

In this situation, three methods for measuring halitosis are:

1. Organoleptic measurement
2. Gas chromatography
3. Sulphide monitoring.

Organoleptic measurement has shortcomings but is still the gold standard method to assess halitosis in severe cases.

Interventions to stop bad breath

Improving oral hygiene is the number one step to improving bad breath. Some of the other interventions described below in addition to the usual oral hygiene interventions like regular brushing and flossing may be considered if bad breath persists despite good oral hygiene.

• Regular brushing: Brushing teeth morning and night with fluoride and anti-microbial toothpaste. Do not rinse the mouth out with water straight away after brushing as this will rinse away the fluoride and anti-microbial benefits of brushing in the minutes after brushing.
• Dental flossing: Should be done daily using the proper technique.
• Regular dental check-ups: A dental check-up with dentist once a year and cleaning with dental hygienist every 6 months.
• Dental mouthwash daily: There are also specific brands of mouthwashes on the market specifically designed to tackle bad breath
  • The gold standard was traditionally chlorhexidine but there are many others with other ingredients and work by reducing volatile sulphide compounds (VSC) by reducing bacteria
  • Side effects of mouthwashes may include staining of teeth (more in the case of chlorhexidine), a burning sensation and changing sense of taste
• Balanced diet: Eating a healthy balanced diet limiting sugary foods and drinks
• Drinking water: regularly throughout the day. An average of two litres per day for adults is advised.
• Chewing sugar free gum. Chewing gum loosens food and dead cells from teeth, gums, and tongue and promotes saliva production. Sugar-free gum sweetened with xylitol is very effective for easing bad breath because xylitol inhibits mouth bacteria. To get the full benefit of chewing xylitol-sweetened gum, aim to chew it for at least five minutes after meals.
• Probiotics: This is less proven, but some research in Japan found that consuming sugar-free yogurt with probiotic bacteria twice a day for six weeks reduced bad breath by reducing levels of odour-producing sulphide compounds. One Japanese study found that eating yogurt with the probiotic strains of streptococci and lactobacilli bacteria has the best effect.
• Avoid crash diets: Apart from the many other negative effects of crash diets, a low-carbohydrate diet breaks fat into ketones to create ketosis. These ketones accumulate in urine and saliva and can cause bad breath. The effect of ketones in the mouth is a metallic taste in the mouth and a smell that is described as sweet, fruity or like the smell of nail polish remover. Drinking plenty of water will dilute the concentration of ketones thus reducing bad breath from ketones.

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore). Email queries to info@whelehans.ie. Find us on Facebook.