Your action plan to overcome halitosis
Does someone you know have breath that smells worse than a dead possum trapped in the roof in summer? How can you politely mention it?
Perhaps you’ve noticed people turning their heads away when they speak to you. Could your breath be more fetid than flowery?
In a world not afraid to discuss all manner of private things, bad breath (halitosis) may be the last frontier of social taboos.
Who gets bad breath?
Bad breath is about as non-discriminatory as you can get. Ancient Greek and Roman writings mention it. It affects all cultures, ages and both genders.
Many cultures have remedies for bad breath: parsley (Italy), cloves (Iraq), guava peels (Thailand) and eggshells (China).
(If anyone knows more about the rational behind the eggshells I’d love some insight.)
How do I know if I have bad breath?
It’s challenging to self assess bad breath. Holding your hand up in front of your face and exhaling is ineffective. Slightly more reliable is licking the back of your hand (to get a sense of what’s on your tongue), counting to 10 and having a good sniff. Wash your hands afterwards!
Testing for halitosis
A more reliable way is to find a trusted person with a good sense of smell and get their opinion. I assess breath in the clinic by standing around 15-30cm away from the person and asking them to count out loud to 10.
Bear in mind this is still a subjective test. Everyone’s perception of what constitutes an unpleasant smell will be different.
Should I worry about bad breath?
Halitosis impacts our social interactions, diminishes self-confidence and may negatively influence our mental health.
It’s also a symptom of an imbalance in your body. Rather than just trying to mask the smell, it’s worthwhile investigating to find and treat the underlying cause.
Why do I get bad breath?
Smelly breath can be transient such as when you first wake up in the morning or when you’ve got a throat infection. It can also be a more chronic condition.
Around 80% of halitosis originates from the mouth/throat and sinuses. Just like your gut, your mouth has a microbiome. These microbes will act on food debris, old cells from your tongue and mouth and other body fluids to produce volatile sulphur compounds. These are what emit the odour.
You can also get smell breath from eating certain foods. The odours of which get exhaled from the lungs. E.g., garlic breath.
Less commonly, halitosis is a sign of systemic issues including advanced liver, kidney disease, digestive problems or diabetes.
In rare cases, a genetic defect causes trimethylaminuria which gives the breath a fishy or ammonia smell.
To successfully sweeten your breath, find and treat the underlying cause/s.
Some underlying causes of bad breath
Upper respiratory tract: mouth, throat, ear, nose
- Poor dental hygiene
- Gingivitis and periodontal disease
- Tonsil stones
- Nasal polyps
- Mouth breathing – common in toddlers with smelly breath
- Postnasal drip
- Alcohol consumption
- High sugar diet
- Sulphur vegetables: garlic, onion, cauliflower, broccoli
- Picked foods, certain spices
- Low carb or ketogenic diets
- Low stomach acid
- Helicobacter pylori infections
- Liver issues – usually only in advanced disease
- Bowel obstruction
- Uncontrolled diabetes – ketoacidosis
- Menstrual cycle. Just before ovulation, there is an increase in volatile sulphur compounds – “menstrual breath.”
- Trimethylaminuria – rare genetic condition
- Ethyl alcohol
- Some cancer medications
** Please don’t alter your prescribed medication without first discussing this with your doctor.
- Stress and anxiety
- Autoimmune conditions such as Sjogren’s Syndrome affecting salivary glands
- Cystic fibrosis
- Chronic kidney disease
Treatment for bad breath
Brush up on your oral hygiene
- Clean your teeth after meals. To be effective, this should take 2-3 minutes.
- Floss – get out any food debris stuck between your teeth
- Gargle – this can be especially helpful to prevent food debris from getting stuck in tonsil crypts and developing into tonsil stones. Due to differences in anatomy, some people are more susceptible to this than others. Make a simple and effective gargle by dissolving one teaspoon of salt in some warm water. Gargle after meals.
- Use a tongue scraper to remove any thick coating at the back of the tongue.
- Book an appointment with your dentist to check for gingivitis, periodontal disease and cavities.
These include mints and mouthwashes and xylitol based chewing gum. They can be useful to temporarily (around 1-3 hours) disguise the odour. You’ll still need to identify and treat the underlying cause.
Commercial mouthwashes usually contain around 20% alcohol. While they may provide short-term benefits, extended use can feed into the problem as alcohol dries up saliva. Chlorhexidine mouthwashes are prescribed to treat gum disease. Chlorhexidine is an antimicrobial. Unfortunately, it kills the good, and bad bugs indiscriminately so can end up being part of the problem if used long term.
- A herbal combination I use with my clients is equal parts myrrh, sage and propolis tinctures. If you don’t have access to tinctures, you could make a strong infusion of dried or fresh sage. Make it fresh every one to two days as it won’t keep.
- Essential oils: tea tree, peppermint, sage or clove can be useful. These are strong. Only use 1-2 drops in ¼ cup water and use as a mouth rinse. Don’t swallow.
Adequate saliva is an essential component for a healthy mouth. It helps flush debris from the mouth and contains odour fighting microbes.
Things which can sabotage saliva include:
- Stress and anxiety
- Try relaxation breathing to switch your nervous system into parasympathetic (or chill out) mode. After about three minutes of breathing of this, you should observe an increase in saliva.
- Mouth breathing
- Practice nasal breathing. “The nose is for breathing; the mouth is for eating”. Breathing through your nose creates nitric oxide. This not only helps you get more oxygen, but it also contains natural antibacterial compounds which can help improve the smell of your breath.
- Some medications/illicit drugs. Antihistamines are a big one here. Discuss with your doctor if there are alternatives or look into treating the underlying cause, so you don’t need or require less of the medication.
- Review your diet and see if any foods are contributing to the problem. It could be just about reducing the quantity rather than eliminating food groups all together.
- Reducing sugar and refined carbohydrates as they encourage the growth of harmful bacteria, plaque and dental cavities.
- Including foods high in chlorophyll such as parsley and leafy greens will also assist as chlorophyll may help neutralise odours.
- If you have chronic sinusitis issues, nasal polyps or postnasal drip, the smell could be coming from your nasal passages.
- Try daily nasal rinses.
- Get a referral to an ear nose and throat (ENT) specialist for further investigation.
Probiotics for bad breath
Some oral probiotics are specially formulated for the mouth and throat. These can be useful to reset the balance of healthy mouth flora.
The next steps
If your breath is still not improved by these suggestions, it’s time to work with your health care provider to determine if it’s due to some of the more systemic causes mentioned above.
Although no-one wants to be the breather of bad breath it can, with a little detective work, be resolved. Plus it may provide you with an opportunity to improve your overall health and wellbeing.
Have you ever experienced chronic bad breath? What worked for you? Leave me a comment below.
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Norelle Hentschel is an experienced naturopath with a clinic in Crows Nest, Sydney who enjoys supporting her clients to reach their health goals.
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