Help me treat my bad breath! aka Halitosis!

Most patients' foul smell comes from their mouths, and treating periodontal or oral diseases as well as excellent dental hygiene is required to alleviate the issue. See a dentist for an oral cancer screening, dental plaque removal, and periodontal pocket cleaning. Also make sure to accomplish Twice-day brushing with a soft-bristled toothbrush and daily flossing. ​

 

 

A clean tongue is pink. A white haze can be caused by bacteria or yeast.  Tongue cleaning and other oral hygiene procedures may help reduce physiologic halitosis.  A tongue cleaner or tongue scraper can be used, or a soft, small-headed child-size toothbrush (adult toothbrushes are more difficult to tolerate).  The tongue is brushed from rear to tip, then washed with water. The posterior tongue is the most critical location to clean, however gagging should be avoided.

Patients must note that excessive washing might harm and bleed the tongue surface. Tongue scrapers and adult toothbrushes should be used with caution. Cleaning the tongue with a cleaner or scraper may lower VSC* (volatile sulfur compounds ) levels more than brushing;  however, this reduction may be temporary. Drinking lots of water and cleansing your mouth after eating dairy, meat, or fish can alleviate foul breath.

Saliva provides lubrication, oxygenation, buffering, and antibacterial activity. Increasing saliva flow and tongue activity will help reduce bad breath.

Snacking on fibrous foods like raw carrots and celery might assist too.

Mouthwashes

They can help with oral hygiene. Regular use of a mouthwash may help decrease foul breath, but only temporarily. ​ Most commercial mouthwashes just mask odours and give antibacterial effects for 30 minutes or less.

 Rinsing with water is ineffective because it lacks antibacterial characteristics and can wash away saliva, which does.

Mouthwashes work best when gargled (together with rinsing) before night. Because the person is not eating or drinking, oral rinse residues may stay in the mouth longer during sleep, when bacterial activity is high owing to decreased salivary flow.  The evidence supporting the efficacy of mouthwashes is poor due to lack of data and methodological issues.

The antibacterial action of chlorhexidine 0.12% mouthwash on supragingival plaque and the tongue appears to reduce oral malodor. Among the negative effects include taste problems and tooth discoloration (reversible). ​

If you have oral ulcers, stop using chlorhexidine mouthwash for a week. A new mouthwash or another week of chlorhexidine treatment may be tried if halitosis returns.

Two to four weeks of regular usage of cetylpyridinium mouthwash can decrease foul breath.

Cetylpyridinium inhibits VSC-producing microorganisms. ​

Zinc mouthwashes (e.g., zinc chloride) may help neutralise sulphur compounds. Zinc may convert volatile sulphur compounds into non-odorous breakdown products. Enhanced effectiveness at 1% concentrations. ​

Povidone iodine 1.0 percent mouthwash is antimicrobial and may help decrease foul breath germs. It should be avoided by thyroid patients, pregnant women, and nursing mothers. ​

Mouthwashes containing essential oils (eucalyptol) may help reduce mild bad odor.

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Clinical investigations have shown that mouthwashes containing chlorine dioxide, zinc lactate, or chlorhexidine, cetylpyridinium, and zinc are beneficial in lowering VSC  levels.

 

Other Agents

These include triclosan, hydrogen peroxide, dehydroascorbic acid, sodium bicarbonate, iminium, allylpyrocatechol and L-trifluoromethionine.

​ More large, well-designed randomised controlled studies on long-term usage of these medicines are needed to determine their significance in halitosis therapy.

 

Natural Health Care

For many years, parsley, menthol, and mint have been used to freshen breath.

Garcinia mangostana (mangosteen) may also help reduce VSC levels, but there isn't enough data to recommend frequent use of these items to treat halitosis.

 

*Physiologic halitosis is primarily due to intraoral conditions that contribute to the buildup of gram negative and anaerobic bacteria, which play a role in the overproduction of volatile sulfur compounds (VSCs) such as hydrogen sulfide, methyl mercaptan, dimethyl sulfide and other malodorous gases