Dear Dr. Peg,
How can someone know if they have “clinical bad breath” or halitosis?
Dear Hal,
If anonymous well-wishers leave bottles of mouthwash around your room, and the police call you on a regular basis to help disperse crowds, you might take a hint. But otherwise, do you have a really good friend? Or a sibling who won’t punch you? Go breathe in their face and see what they say. I’m actually serious about that last suggestion.
It is very hard to detect our own odors. Our noses get used to what we smell like, so it might take a brutally honest friend to let us know when our aromas are less than pleasing. Or you can spring for a device called a Halimeter, which detects toxic gases in your breath. Yes, they really make such a thing. Who knows, one of these days I might even be able to answer your question with, “There’s an app for that!”
Foul breath has been around ever since cavemen gnawed raw bones. It is discussed in the Jewish Talmud, the Christian Bible and ancient Greek and Roman writings. Other terms for bad breath are fetor oris and oral malodour. The term “halitosis” was actually made up by the
Listerine company from Latin and Greek words back in 1921. Do you think they succeeded in creating a market for their product?
We all have unpleasant breath at times, but some people think they do when they actually don’t. This is a real condition called halitophobia, or fear of bad breath. This could be you, Hal. Again, ask your pals.
Bad breath has a number of possible causes. When air passes into our bodies and back out, it goes through the mouth and nose into the lungs, where it exchanges gas with the blood, trading oxygen for carbon dioxide. Then it flows back out through the nose and mouth. Any of these sites can be a source of stench. Let’s take them one at a time.
The most common cause of bad breath is bacteria in the mouth. I’m talking about the nasty kind of bacteria, with 5 o’clock shadows and mismatched socks. These grungy outcasts don’t even breathe oxygen. That’s why your breath is worse in the morning; they’ve been partying in your closed mouth all night. First they root through the alleys between your teeth, munching on stuck chunks of proteinaceous leftovers. Then they kick back in the lowlife lounge at the back of your tongue, slurping postnasal mucous, and having a contest to see who can emit the most noxious gases. Charming, eh?
Now if that doesn’t get you to brush and floss, I don’t know what will. Brushing and flossing removes the food and protein debris from your mouth, so the bacteria have nothing to thrive on. Do it twice a day. Demolish the lowlife lounge, too, by cleaning your tongue with a soft brush or a tongue scraper. Finish up with a hearty deep throat gargle to wash away the last of the wreckage. Mouthwash, gum and mints might
temporarily cover up odor, but you have to mechanically remove the rubble to really freshen your breath.
Beyond regular everyday bad breath, a dry mouth or a diseased mouth or nose can be a problem. Infection of tooth, gum or sinus will cause halitosis. Drink plenty of water, stay as healthy as you can and treat infections properly. Consider rinsing your sinuses on a daily basis like you do your mouth. You can get a sinus rinse bottle or a neti pot at any pharmacy.
Getting back to the journey of air into and out of the body, the lungs themselves can be a source of bad odor. This is because the lungs get blood, and blood gets everything. If you eat garlic or onions, they get absorbed into the blood, which delivers their unique aroma to the lungs, which outgas it to your friends through your breath. Same with other foods — alcoholic drinks, coffee and some medications. You’ll be glad to hear, however, that there is evidence that a high-fiber diet can improve your breath. Hit the salad bar and fruit bins often.
Besides the blood, there are the lungs themselves. Smoke in, smoke out. Tobacco smoke might taste good to you on the way in, but it reeks on the way out.
Lastly, since breath, via the blood, contacts every part of your body, diseases of other body parts can give you the vicious vapors. Diabetes, cancer and maladies of the lungs, gastrointestinal system or kidneys can all be culprits.
Good luck, Hal, and thanks for writing.
Peggy Spencer is a board-certified family physician. She has been a UNM Student Health physician for 17 years, and a Daily Lobo contributing columnist for 3 years. She is co-author of the book 50 Ways to Leave Your 40s, released in March 2008.
Drop your questions into her box in the lobby of Student Health and Counseling, or e-mail her directly at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.
