BAD BREATH - BIOLOGY IN ACTION
Bad breath is quite common. It is not a disease - everybody has bad breath at some time. Certain diseases are accompanied by bad breath. For that reason, persitent bad breath should be followed up in medical and dental checkups. However, in most people bad breath can be dealt with in fairly simple ways.
Most bad breath is produced by bacteria growing on the back of the tongue and upper throat. It can also be caused by medical conditions. Infections of the nasal passages and disturbances of metabolism such as diabetes, kidney and liver disease can all affect breath. The cause and treatment of bad breath overlaps both dentistry and medicine.
Most people who have bad breath, or think they have, try to treat it themselves. Self-help in the form of mouth rinses, breath fresheners, or a tongue scraper, along with regular dental visits for teeth cleaning often works. A few people have chronic bad breath no matter what they try. Others only think they have bad breath.
Ancient people in the Middle East, China and Europe left behind various forms of toothpicks. Sometimes, these were part of a set of personal cleaning items made from precious materials. From these artifacts, we learned that people have always worried about bad breath. The toothpicks were probably intended to remove bits of food stuck between teeth. Bits of food do start to smell if left in the teeth - and most likely the toothpicks solved the problem. We can still use this strategy today.
The famous Greek doctor Hippocrates described toothpowders and mouth rinses 2500 years ago. His own mouth rinse formual came from India. The medieval herbalist Hildegaard von Bingen described using fennel as a breath sweetener. Other natural remedies for bad breath include peppermint, parsley leaves and cardamon seeds. Still, focusing too much on bad breath can lead to unnecessary social isolation. Everyone has a bit of bad breath sometimes.
CAUSES OF BAD BREATH...
One of the main causes of bad breath is the production of volatile sulphur compunds (VSC's) by bacteria that grow naturally in the mouth. The bad odour of rotten eggs comes from VSC's bacteria produce when digesting proteins in the egg. The same bacterial process happening on the tongue causes bad breath in our mouths. For some reason, human noses are sensitive to VSC at such low concentrations that they are measured as parts per billion. Our noses can clearly detect breath containing no more than 200 to 300 parts per billion of VSC. Natural amines produced by bacteria breaking down amino acids in the mouth also cause breath odours. The names of these amines - cadaverine and putrescine - indicate their foul smell. However, the nose cannot detect these amines with nearly the same sensitivity as VSC.
So-called "morning breath" consists largely of VSCs on the tongue. Bacteria grow well overnight, as saliva flows very slowly during sleep. This dries out the back of the tongue, encouraging VSC production. Since the area is not flushed out by saliva, the odour becomes more noticeable. Control the smell by staying hydrated and cleaning your teeth and mouth well first thing in the morning. Remember to brush or scrape the back of your tongue as far back as you can manage, but do not overdo this.
A few people have breath odour most of the time. A minority are healthy and have healthy mouths. In people with persistent bad breath, there seems to be an imbalance in growth of oral bacteria. More bacteria associated with VSC production appear. We do not know how or why this imbalance occurs. Research has tried to identify molecules in saliva that might be different in these people. Part of treatment encourages the growth of normal bacteria in the mouth. Such treatment does not involve simply overcoming or "knocking out" oral bacteria, because sometimes that approach causes bad breath.
In fact, in New Zealand, normal oral bacteria in the form of a strain of Streptoccus salivarius were developed as a probiotic treatment for bad breath. Other such probiotic treatments are underway, but are still in the clinical trial stage. Simple remedies can involve gentle suppression of anaerobic bacteria in the mouth - the ones most closely associated with bad breath. Other remedies involve trying to bind VSC's in the saliva, so they do not come out of the mouth in air. All breath remedies on the market use either or both approaches to managing bad breath. Using a remedy like peppermint can also cover bad breath for a while. Thanks to all the research in this area, we know more about why people get bad breath. One group of people likely to have bad breath are those with active or extensive gum disease (periodontitis). Bacteria associated with poor gum health produce VSC's. The bacteria also grow on the back of the tongue. One form of gum disease produces an odour generally described as "metallic". This condition is called acute ulcerative gingivitis and is usually associated with painful gums. People with inflamed tonsils may also have breath odour that contains lots of VSC's.
To be continued.....
Most bad breath is produced by bacteria growing on the back of the tongue and upper throat. It can also be caused by medical conditions. Infections of the nasal passages and disturbances of metabolism such as diabetes, kidney and liver disease can all affect breath. The cause and treatment of bad breath overlaps both dentistry and medicine.
Most people who have bad breath, or think they have, try to treat it themselves. Self-help in the form of mouth rinses, breath fresheners, or a tongue scraper, along with regular dental visits for teeth cleaning often works. A few people have chronic bad breath no matter what they try. Others only think they have bad breath.
Ancient people in the Middle East, China and Europe left behind various forms of toothpicks. Sometimes, these were part of a set of personal cleaning items made from precious materials. From these artifacts, we learned that people have always worried about bad breath. The toothpicks were probably intended to remove bits of food stuck between teeth. Bits of food do start to smell if left in the teeth - and most likely the toothpicks solved the problem. We can still use this strategy today.
The famous Greek doctor Hippocrates described toothpowders and mouth rinses 2500 years ago. His own mouth rinse formual came from India. The medieval herbalist Hildegaard von Bingen described using fennel as a breath sweetener. Other natural remedies for bad breath include peppermint, parsley leaves and cardamon seeds. Still, focusing too much on bad breath can lead to unnecessary social isolation. Everyone has a bit of bad breath sometimes.
CAUSES OF BAD BREATH...
One of the main causes of bad breath is the production of volatile sulphur compunds (VSC's) by bacteria that grow naturally in the mouth. The bad odour of rotten eggs comes from VSC's bacteria produce when digesting proteins in the egg. The same bacterial process happening on the tongue causes bad breath in our mouths. For some reason, human noses are sensitive to VSC at such low concentrations that they are measured as parts per billion. Our noses can clearly detect breath containing no more than 200 to 300 parts per billion of VSC. Natural amines produced by bacteria breaking down amino acids in the mouth also cause breath odours. The names of these amines - cadaverine and putrescine - indicate their foul smell. However, the nose cannot detect these amines with nearly the same sensitivity as VSC.
So-called "morning breath" consists largely of VSCs on the tongue. Bacteria grow well overnight, as saliva flows very slowly during sleep. This dries out the back of the tongue, encouraging VSC production. Since the area is not flushed out by saliva, the odour becomes more noticeable. Control the smell by staying hydrated and cleaning your teeth and mouth well first thing in the morning. Remember to brush or scrape the back of your tongue as far back as you can manage, but do not overdo this.
A few people have breath odour most of the time. A minority are healthy and have healthy mouths. In people with persistent bad breath, there seems to be an imbalance in growth of oral bacteria. More bacteria associated with VSC production appear. We do not know how or why this imbalance occurs. Research has tried to identify molecules in saliva that might be different in these people. Part of treatment encourages the growth of normal bacteria in the mouth. Such treatment does not involve simply overcoming or "knocking out" oral bacteria, because sometimes that approach causes bad breath.
In fact, in New Zealand, normal oral bacteria in the form of a strain of Streptoccus salivarius were developed as a probiotic treatment for bad breath. Other such probiotic treatments are underway, but are still in the clinical trial stage. Simple remedies can involve gentle suppression of anaerobic bacteria in the mouth - the ones most closely associated with bad breath. Other remedies involve trying to bind VSC's in the saliva, so they do not come out of the mouth in air. All breath remedies on the market use either or both approaches to managing bad breath. Using a remedy like peppermint can also cover bad breath for a while. Thanks to all the research in this area, we know more about why people get bad breath. One group of people likely to have bad breath are those with active or extensive gum disease (periodontitis). Bacteria associated with poor gum health produce VSC's. The bacteria also grow on the back of the tongue. One form of gum disease produces an odour generally described as "metallic". This condition is called acute ulcerative gingivitis and is usually associated with painful gums. People with inflamed tonsils may also have breath odour that contains lots of VSC's.
To be continued.....
