We all get up in the morning with smelly bad breath. Most of us solve this problem by simply brushing our teeth, but for the rest, an unlucky ten percent of the population, the smell stays all day long. Bad breath, or halitosis, is a common occurrence and it can be socially debilitating. It affects many people and, unfortunately, you can be unaware of its presence. The average mouthwash works to cover any unpleasant smells rather than destroying the sulphur compounds that cause bad breath. Treating it usually requires a multifactorial solution and all causes should be investigated for successful treatment.

From time to time the cause of bad breath is situational. It might be after you have eaten a meal that is full of garlic or onions. It may be from cigarettes, cigars or alcoholic beverages. Many people suffer from bad breath at one time or another but it is actually quite hard to smell your own breath. One good trick is to lick the back of your hand wait for 30 seconds and then smell then it, or you could just ask a close friend.

In most cases, the bacteria living on the hairs on the back of the tongue is the cause of the odour. They produce chemicals called volatile sulphur compounds or VSC. If you look at the back of your tongue you will notice it is rougher and it has more hairs.

Halitosis is usually worse in the morning because saliva production slows during the night and your mouth dries out. Saliva is effective because it washes away the bacteria and food particles and chemically slows down the activity of the bacteria.

You can treat this by using a tongue scraper to remove the bacteria from the back of the tongue. For the best results this should be done once a day and your tongue scraper should be replaced at least every six months.

Dental Hygienist Kristy Bernie explains: “Some people mistakenly believe that brushing your tongue will have the same effect as scraping but the reality is to have a clean mouth and fresh breath, you need to brush, floss, scrape and rinse, in that order, and make sure you use a well-designed tongue scraper that is safe and effective”.

You must ensure that you brush your teeth for five minutes or more. Any less time and you are not reaching all the places in your mouth that could cause bad breath. If you do not have one already, invest in an electric toothbrush which get your teeth a lot cleaner than the old traditional way. The electric vibration is much faster than your hand movements, vibrating tens of thousands of times per minute, meaning that dirt and bacteria are much more effectively dislodged from your teeth.

Remember, just like with normal toothbrushes, the heads of electric toothbrushes wear out so you must replace them every few months, otherwise the toothbrush’s effectiveness at cleaning may be dramatically reduced.

However, one danger of electric toothbrushes is that people do not change them as often as they should. Just like with normal toothbrushes, the heads wear out. While electric toothbrushes obviously do not require you to buy a whole new toothbrush every few months, you do need to keep buying new heads, otherwise the toothbrush’s effectiveness at cleaning may be dramatically reduced.

You also need to realise that not all toothpastes and mouthwashes are created the same. Use mouthwash containing chlorine dioxide that neutralises the VSCs and kills the bacteria that produces them.

These types of mouthwash does not contain alcohol, which most other preparations do, therefore will not dry the mouth and reduce saliva flow, which can make bad breath worse if used over a long period of time.

Advanced or chronic periodontal disease can cause the same smells. The bacteria are living in pockets down between the tooth and gum and this does need to be treated by your dentist.

In about five per cent of cases the smell can be caused by sinus infection and post-nasal drip, with similar types of bacteria involved. This an area for your medical practitioner if it is chronic, so see your doctor if this is a regular occurrence for you. In about three per cent of cases a long-term infection in your tonsils can be the cause of bad breath. If you have eliminated all other causes then again check with your doctor.

Checklist

• Scrape the back of the tongue as a matter of routine once a day
• Make sure you have the correct brushing technique and inter dental cleaning technique
• See your dentist to eliminate the possibility of gum disease
• Drink plenty of water to keep you mouth moist and saliva flow normal
• Chewing sugar-free chewing gum will increase your saliva flow. Be careful as this can increase jaw/joint problems.
• Use a mouthwash once a day to reduce bacteria numbers and eliminate VSCs.