Bad Breath (Halitosis)

Bad Breath

Is your breath on the doggy side? Do work colleagues reel back and dry retch when you ask where the stapler is? Even if things aren’t this dire, bad breath or halitosis is a condition that is a source of embarrassment and self-consciousness.

Symptoms

  • Bad breath is usually a symptom of an underlying cause.
  • The tongue, particularly towards the back of the mouth, may have a thick coating that is cream-coloured through to green and brown.
  • Bad taste in your mouth.
  • Friends who now prefer to Zoom and text when you used to meet up for coffee.

What causes it?

  • Blocked sinuses. If sinuses become clogged with mucus after a cold, sinusitis or an allergy, bad breath may result. (see also sinusitis)
  • Post-nasal drip (PND) is when mucus draining from the sinuses, drips down the back of the throat. (see also sinusitis)
  • Helicobacter pylorus, the stomach bacteria responsible for stomach ulcers can also result in bad breath.
  • Reflux also known as gastro oesophageal reflux disorder (GORD), is where stomach acid and undigested food are regurgitated up into the throat. Although many people are aware of the symptoms of GORD or heartburn, you can also have silent reflux where there are no symptoms. (See also reflux)
  • Constipation. A lengthened transit time means faeces takes a long time to travel the length of the colon. As a result, products of fermentation and putrefaction are released into the bloodstream and eliminated via the lungs, causing bad breath. See also constipation.
  • Low stomach acid production (hypochlorhydria) means your stomach is not able to properly break down protein bonds.  Symptoms of low slow stomach acid include burping, bloating, feeling full after eating normal amounts of food. 
  • Bad bugs. The entire gastrointestinal tract, from mouth to anus is home to over 2 kg of microflora, collectively known as the microbiome. Most of these resident bugs are bacteria. The metabolic by-products of bacteria are often gas, and depending on the variety of bacteria, smelly gas that may be the cause of your smelly breath.  SIBO (Small Intestine Bacterial Overgrowth) and Candida (a fungal overgrowth see Candida) may also be responsible. 
  • Gingivitis (gum disease) is a common cause of bad breath. Gums may look red and swollen and bleed during tooth brushing. The bacteria that cause gum disease are very likely also causing your bad breath. (See also Gingivitis.)
  • The other dental cause of bad breath is inadequate cleaning of dentures, braces and plates, with rotting food debris causing the odour. 
  • Water. Simply not drinking enough fluids can cause bad breath.
  • Medicine. Particularly if you have an ‘odd’ or metallic taste in your mouth along with the bad breath, it could be a side effect of medication. Worth asking your doctor about.
  • Stress. Bad breath can be a symptom of stress.
  • Coffee. For some people drinking coffee (and sometimes tea) causes bad breath.
- Dairy sensitivity. Lactose intolerance (intolerance to milk sugar) and or dairy sensitivity (allergy to milk protein) may cause bad breath.
  • A throat or tonsil infection may be the source of the problem.
  • Dry mouth. Insufficient saliva impacts on good bacteria that may result in bad breath. Insufficient saliva can be due to Sjogrens syndrome, some medication, medications, diabetes and mouth breathing.
  • Smoking tobacco or marijuana.
  • Underlying conditions including lung, kidney, liver or gastrointestinal disease. 

What To Do

Bad breath is not a disease, but a symptom of something awry. Finding out why your breath is on the skanky side may take a bit of detective work but the alternatives such as sucking on peppermints or using mouthwash will just give you minty bad breath.

Diet

  • The following foods may cause bad breath, but only for a few hours after consumption; Cheese, particularly blue, deli meats such as salami, strong curry spices, garlic and onions.
  • Eat prebiotic and probiotic foods. Prebiotics encourage the growth of beneficial microflora in the mouth and all points south. Prebiotic foods include; asparagus, Jerusalem artichokes, leeks and onions, legumes such as baked beans, chickpeas and lentils and supplementary fibres including psyllium, pectin, guar gum and slippery elm. Probiotic foods include fermented foods; yoghurt, miso, sauerkraut, kefir, natto, tempeh and the Korean delicacy kimchi.
  • Avoid sugar as sugar feeds bad breath bacteria.
  • Avoid dairy foods for one week including milk, cream, cheese, ice cream, chocolate and yoghurt. If your bad breath disappears then reduce these foods in your diet, and make sure you eat plenty of calcium-rich foods to make up for any deficiency. High calcium foods include nuts (especially almonds) and seeds, green leafy vegetables, tofu, parsley, salmon and sardines (canned), dried figs.
  • Drink 2 litres of water daily in addition to other fluids.
  • Avoid coffee and tea for one week. Again these might be the cause. Resume if your bad breath is still with you after the week-long abstinence.
  • If you are constipated make sure you are eating plenty of fibre rich foods including vegetables, wholegrains and legumes. (See also Constipation.)

Remedies

  • The specific probiotics for good oral health and sweet smelling breath are Lactobacillus salivarius and Lactobacillus gasseri. If you cannot find a supplement containing these specific bugs, choose a good multi probiotic containing other lactobacillus strains. Take a dose before breakfast each day.
  • Herbs for sinusitis or postnasal drip include eyebright, golden seal, echinacea, elder, andrographis, golden rod, horseradish and garlic. Vitamin C is also good.
  • Gum disease. Once a day squeeze out the contents of a 100 mg CoEnzyme Q10 capsule onto the gums, and massage it in with a soft toothbrush. In addition, swill and gargle a mixture of one or more of the following herbs, made from tincture or tea, making sure it stays in contact with the gum tissue for at least a minute. Calendula, golden seal, echinacea, myrrh, propolis (bee product). You can also swallow the mixture as it is good for the immune system as well as healing to gums, but be warmed, the taste is deadly. Suck on Vitamin C and zinc tablets, taking one three times a day.
  • If Helicobacter pylorus is the culprit, take the appropriate antibiotics (or see a herbalist), and afterwards top up with a course of probiotics.
  • For constipation, take digestive bitter herbs before meals, and dietary supplements such as psyllium husks and chia seeds.
  • Reflux. Take a teaspoon of slippery elm powder in water, banana or yoghurt with each meal.
  • If hypochlorhydria is the cause, take supplements that improve stomach acid formation including betaine hydrochloride, glutamic acid and pepsin.  Herbal bitters before meals will also help. 

Other

  • If you suffer from sinusitis or post-nasal drip use a Neti pot each morning.

Very much like a take-away version of being dumped at Bondi beach, the Neti pot (an Indian invention), is used to treat and prevent sinusitis. Looking like a small teapot with a phallic shaped spout, the Neti is used for an intra nasal douche. Into a Neti, pour about 250 ml warm water (about blood temperature) and one teaspoon of sea salt. Stand over the sink holding your head to the left side. Slowly pour a little of the warm, salty water up your right nostril. Within a couple of moments your left nostril should drip, then flow. Gently blow through the nose to clear out water and mucus. Then swap sides. Using a Neti pot is a pleasant experience – trust me. Neti pots can be bought from yoga studios, some pharmacies and online. A small teapot may be used in the absence of an authentic Neti pot. At your next tea party, just don’t let your guests know what you do with the pot when you are not serving them tea.

  • If you have insufficient saliva, chew on sugarless gum, particularly after meals.
  • Breathe through your nose. Mouth breathing contributes to a dry mouth and bad breath.
  • If your bad breath is due to gum disease, ill fitting dentures or other mouth related matters, be diligent about regular visits to the dentist, dental hygienist and periodontist. Save your teeth and gums, while sweetening your breath. Brush and floss regularly.
  • Buteyko breathing help reduce gum disease, mouth breathing and reflux, all potential causes of bad breath
  • Use a tongue scraper in addition to brushing and flossing. Tongue scrapers have been used for centuries and are recommended in the Ayurvedic approach to health and wellbeing. They are ergonomically designed to scrape away bacteria, plague and fungi all of which may cause bad breath.
  • Stop smoking. I know, easier said than done. But yet another incentive. 
  • Is it really a thing? Pseudohalitosis is a condition where someone believes they have halitosis, yet it is not the case.  Ask someone you trust, to tell you, Truly Ruly… do you have bad breath? 

At a glance

Diet

  • Drink 2 litres of water daily.
  • Avoid dairy foods, coffee and tea, or at least trial a week without them to see if they are contributing to your bad breath.
  • Eat prebiotic and probiotic foods. Prebiotic – asparagus, Jerusalem artichokes, leeks and onions, legumes. Probiotic – yoghurt, miso, sauerkraut, kefir, natto, tempeh, kimchi

Remedies

  • Take probiotics daily.
  • Sinus problems and post-nasal drip take the following herbs – eyebright, golden seal, echinacea, elder, andrographis, golden rod, horseradish and garlic.
  • Gum disease – rub in the contents of a 100 mg CoQ10 capsule each day and gargle and swallow the following herbs – calendula, golden seal, echinacea, myrrh, propolis.

Other

  • Regularly use a Neti pot and tongue scraper.
  • Regular visits to the dentist and periodontist – and don’t forget to floss.
  • Only breathe through your nose… close that mouth!
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