Fresh approach: Public faced with multitude of causes, cures for bad breath

Tuesday, March 26, 2002 | 8:25 a.m.

Not sure if your mouth smells like a hog farm?

Don't rely on friend for that information. Friends rarely will inform you if your breath has the aroma of a sewer; they simply keep a safe distance. The only hint that there may be something rotten in Denmark might be when the eyes of the person next to you begin to water.

You can ease that uncertain feeling about the quality of your breath with a BreathAlert, a product released in 2000 by the Tanita Corporation of Tokyo.

Simply blow into the palm-sized, battery-operated meter (which sells for about $30) and it discreetly will tell you what your friends won't that it's time to pop an Altoids or Tic Tac or one of hundreds of other candy-like breath fresheners.

Whatever the method, with all of the products on the market today there's no need to risk offending with bad breath.

"Your friends won't tell you," said Tracy Ransdell, a Las Vegas dentist who operates the Fresh Breath Centre at 6136 W. Sahara Ave. "You need to ask your loved ones, or your dentist."

While the average person may find bad breath repulisive, Ransdell has become accustomed to it over the years.

"At first you think about it, but you get used to it and it doesn't bother us," said Ransdell, who also performs cosmetic and general dentistry. "A lot of people have bad breath and don't realize it. Most of our dental patients could benefit from breath treatment."

Bad breath isn't something to feel embarrassed about, she says. However, thanks in part to advertising campaigns that have turned malodor into one of the deadly sins, experts estimate that people are spending a billion dollars a year on mints, gums and mouthwashes.

Ransdell and other dentists point out that most of those products are short-term fixes that can actually hide a more serious underlying medical or dental condition.

"Masking is not solving the problem," Ransdell said. "Most of the over-the-counter products are masking products. Ten minutes later, the same odor is starting to come back."

The problem could be caused by a number of variables, she said, including gum disease, tooth decay, bacteria under crowns, plaque buildup on tongues, a sinus condition or food that has not been properly broken down in the digestive tract.

But oral hygiene -- or the lack of it -- is one of the most common causes. Some people don't brush often enough. Or use dental floss. Or scrape their tongues with toothbrushes or scrapers that are now available on the market.

Those who are serious about proper oral hygiene (perhaps members of the International Society for Breath Odor Research), are turning to dental-care systems that sell for $40 and more.

For example, the Breath RX Breath Management System includes mouth rinse, brushing gel, tongue conditioning gel, a tongue scraper, breath spray, breath mints and chewing gum.

The Biofresh Breath Management System also includes a brushing gel, mouth rinse and tongue cleaner.

Enfresh has a tongue brush, tongue gel and mouth rinse.

"If the odor lingers, then you have an underlying issue, and most of the time it's gum disease," Ransdell said.

He says concern over bad breath seems to have increased over the past five years.

"It's part of the overall concern we have of how we look and how others perceive us," she said. "Marketing by the companies of their products is also part of it."

One new product attacks two of our greatest fears -- bad breath and obesity.

Sugar-free Slim Mints not only contain a mint to freshen your breath, but also natural ingredients that the company says help you lose weight.

Breathtaking research

The Journal of the American Dental Association reported last year that every person is susceptible to a negative breath-odor self image, which can reach the level of severe psychopathology.

According to the article, which appeared in the May issue of the JADA, self-perception of breath odor is closely related to one's body image and psychological profile.

In an earlier issue, the journal noted that good hygiene does not necessarily mean a person won't have bad breath. You can have good oral hygiene and still have a problem with bad breath, Dr. Louis Malcmacher noted in an October 2000 issue of the JADA.

"Many patients who I see with bad breath have the cleanest mouths you'll ever find because they are trying to fight their bad breath," Malcmacher noted. "All they do is brush their teeth and floss and use mouth rinses all day long. It's a misconception that all people with bad breath have poor oral hygiene."

Malcmacher said everyone, at some point, may have a problem with malodor.

"Studies show about 25 percent of the population has a chronic problem with bad breath that they are constantly trying to fight," he wrote.

Not surprisingly, 90 percent of bad breath originates in the mouth. There are certain kinds of bacteria that exist in the mouth, which produce volatile sulfur compounds (VSCs). If there is enough of a buildup of these sulfur compounds, the result can be clinically bad breath.

"Everyone has these bacteria," Malcmacher said. "But, with most people, it's more or less in check. However, the people with bad breath have a higher number of these bacteria in their mouths."

One halitosis victim, who asked not to be identified, said she was bothered by her bad breath but there was nothing she could do about it because she can't afford the dental work.

"My teeth are just barely hanging in," she said. "But until I have the money, I'll just keep using mouthwash."

Siemon says ...

Dr. Fred Siemon, a dentist from San Jose, Calif., wrote the book on bad breath.

It's called "The Bad Breath Book," (Library Research Associates; $15.95). The 187-page book is available online at sector.com/drsiemon, or through Amazon.com.

Siemon says chewing sugarless gum or sugarless candy mints can be of some benefit. While Certs, Dentyne and similar products may only provide short-term relief from the immediate problem of bad breath, they also increase saliva production.

Saliva kills the bacteria that produce volatile sulfur compounds.

"Sulfur can be smelly," Siemon said, "like rotten eggs."

Buildup of bacteria on the back of the tongue is one of the most common causes of bad breath.

The body produces about a quart of saliva a day, Siemon said. The saliva kills bacteria and also helps prevent dry mouth, another sign of bad breath.

"When you go in for an interview and are nervous and tense and your mouth is dry, you may be developing some bad breath," he said.

Nervousness is one of many causes of halitosis. So are diet and age. And young people tend to have less of a problem with bad breath.

"Their systems are up and running," Siemon said. "They have a higher metabolic rate, so bacteria does not have a lot of food to deal with. In older people, everything slows down, so there is a greater tendency for bad breath."

Also, what you eat can be a factor -- anchovies, broccoli, fish, red meat, curries, peanut butter and coffee are among the edibles that may create bad breath.

Those foods are among those that contain chemicals easily broken down by bacteria to produce sulfur.

"Not everybody that eats horseradish will have bad breath," Siemon said. "But there is a better than even chance if you eat it, you will get it."

Medical conditions rarely cause bad breath, Siemon said, but it does happen.

You might be masking gum disease if you put Binaca or TheraBreath Powerdrops on your tongue. Forty percent of the population suffers from the condition, according to Siemon.

"A good, ripe case has a distinctive aroma a dentist can pick up," he said.

Even if your mouth is fresh as a daisy, you may suffer from the delusion that you have halitosis.

"There is a psychological component," Siemon said. "Often, people think they have it, but they don't really. They become neurotic about it. People even have committed suicide because they couldn't resolve the problem. They smelled it, but others didn't.

"It needs to be taken seriously. People obsess, probably more now because of all those mouthwash ads. Everyone is crazy about looking good, feeling well, being attractive to others."

Siemon says a good quick fix to bad breath is eating an orange.

"It reduces the alkalinity in the mouth, and it puts extra liquid in the mouth," he said.

For a more lasting solution, Siemon said, rinse your mouth out with hydrogen peroxide.

"It knocks out any bad breath," he said. "You know it's working because you can feel the bubbling."

Other tips include drinking lots of water to keep the mouth moist; snacking on carrots, celery or other vegetables to keep plaque from forming; and brushing teeth and gums with baking soda.

"The good news is that at any given time, not more than 1 percent of the population suffers from bad breath," he said.

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