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Bad Breath: Help for Halitosis

Everyone has bad breath sometimes, but if the people around you keep getting whiplash every time you open your mouth, you could have a more serious problem. Many people with bad breath are blissfully unaware of it, which is pretty amazing, considering that the source of the problem is right under their noses.

Halitosis is the official medical term for seriously bad breath. You’re allowed to have bad breath if you’ve been snacking on garlic cloves, but if your breath smells like dirty socks no matter what you eat, you’ve probably got halitosis. And it’s not your fault—the bacteria inside your mouth are responsible for the offensive odor.

Bacteria love your mouth. It’s warm. It’s dark. It’s moist. It’s Utopia for germs. There’s plenty of leftover food on your tongue and between your teeth to snack on. As bacteria break down proteins in food particles, they produce stinky sulfurous gases similar to the gases released by rotten eggs. The smell can make your eyes water.

Most people put a serious dent in the bacteria population on their teeth and gums when they brush and floss. But even the most militant brushers and flossers tend to neglect their tongues, especially the part at the very back. The bacterial inhabitants of the back of your tongue are thought to be responsible for about 80 percent of breath odor.  If you don’t get rid of the bacteria, you can’t get rid of the smell. The solution seems simple—just scrub the back of your tongue while you’re brushing your teeth.  But if you’ve ever tried it, you know it’s not that easy. The bristles of your toothbrush feel like giant push brooms at the back of your throat, making you gag and choke before you even get started.

Enter the tongue scraper, a specially-designed device that effectively scrapes the gunk off your tongue without gagging you in the process. Tongue scrapers can be found at pharmacies and dentists’ offices.  If you’re on a budget, a plastic spoon turned upside down works just fine. Hopefully your tongue-scraping efforts will pay off, but there are a few more ways to detoxify your breath. You should definitely make friends with your dentist, and drop by for a visit at least twice a year. Decayed teeth and diseased gums create cozy hidey-holes for bacteria and their families. Your dentist can help evict the bacteria, and prescribe an industrial-strength mouthwash to keep them from coming back.

Watching what you eat can also improve your breath. Most food odors dissipate from your breath in about ten minutes. But odors from smelly foods like peanut butter and chilidogs can linger for hours. The odiferous reminders of garlic, onions, and alcohol stick around even longer. Their odor-producing compounds migrate to your bloodstream after digestion, and they’re exhaled through your lungs with every vile breath.

If you’ve indulged in a malodorous meal, you might try to reverse the damage with a specially formulated candy, spray, or rinse. And there are plenty to choose from. The quest for minty fresh breath has spawned a multi-billion-dollar industry with an impressive lineup of breath aids. Most of them aren’t really effective, but at least they’re tasty.

Some over-the-counter products do more harm than good. Too many sugary breath mints can rot your teeth, and the alcohol in most mouthwashes can dry out your mouth. At best, over-the-counter breath fresheners add a minty fragrance to your breath for about 10 minutes, and give you a sense of false confidence.

Saliva is just about the best breath freshener around, and it’s a lot cheaper than a jug of Lavoris. Saliva washes food particles and odor-producing bacteria out of your mouth and into your stomach. The more saliva you have in your mouth, the less likely you are to have bad breath. But sometimes saliva is hard to come by, and your mouth can dry out.  Mild dehydration is one of the main causes of a parched palate, so you should be sure to drink your mandatory eight glasses of water every day.

Medications can rob your mouth of saliva. Antihistamines and decongestants are notorious for leaving you dry, but at least 300 drugs list dry mouth as a side effect.

With a little work, there’s hope for people with halitosis. If you’re not sure how your breath ranks, just ask the people closest to you. If they start doing the Limbo, you’ve still got some work to do.

Rallie McAllister, MD, MPH