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Bad Breath: An Anatomy

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Bad Breath May Indicate More Than What You Had for Lunch

Recent studies have shown up to 90% of all cases of halitosis (bad breath) can be contributed to harmful bacteria that are not removed by brushing, flossing, or gargling alone.

The American Dental Association News recently reported that halitosis experts agree that the dominant cause of bad breath is the bacteria on the tongue.

The bacteria release odorous byproducts (known as Volatile Sulfur Compounds, or VSCs – similar to the gasses released by a rotten egg) as they thrive on the tongue. These stinkers also arise from active gum disease. In fact, according to recent research, VSCs may even be the first factor in initiating gum disease.

As plaque is to the teeth and gums, coating is to the tongue. Brushing alone does not solve the problem.

Our ;normal hygiene routine doesn't work against the bacteria on the tongue because we simply are not properly cleaning our tongues.

Primary Cause of Halitosis

The diagram illustrates how the bacteria hiding under the coating of the tongue lead to bad breath and plaque:

The tongue is a rough surface that provides the bacteria with plenty of hiding places. When we eat, debris left over from food and normal mucus production build the coating on our tongues. This coating provides the bacteria with a safe hiding place. Why is it safe? Because the bacteria are anaerobic – oxygen is lethal to them. So the bacteria, hidden in the safety of the tongue's coating, do their dirty work releasing odorous gasses in the process.

This is the primary cause of halitosis. It also leads to increased risk of decay (especially root surface decay), and a decreased sense of taste.

Some companies would have you believe that bad breath is caused by a sour stomach. This is true only in about 1 of 10 people, and that type of bad breath is temporary.

Self Test for Halitosis (Bad Breath)

Cup your hand over your nose and mouth and exhale. Do you smell anything?

If you do, you have probably eaten something today that is causing the odor. As mentioned above, this type of halitosis is usually temporary (lasting from a few hours to a few days).

If you do not smell an odor, there are two possibilities:

  1. You do not have bad breath
  2. You have bad breath, but your nose has desensitized itself (just as one gets used to an odor in a room after being in it for some time).

Self-testing simply is not reliable for this reason. You can risk it (and your social life)… or you can be safe.
According to the ADA News, tongue cleaning is the most effective weapon dentists can offer to fight halitosis. And, tongue cleaning yields numerous oral hygiene benefits.

Still dying to know if your breath is offensive? The nose (not yours!) knows. Ask a close (honest) friend, or your dentist or hygienist. You can also watch for these clues. Do people tend to…

  • Stand far away from you in conversation?
  • Turn their heads away when you are speaking?
  • Kiss you on the cheek (instead of the lips)?

If so, you may have halitosis (bad breath).

A recent study showed that mouthwashes (even antibacterial brands), gums, and breath mints merely mask the problem. They only work for a short time (an hour at most) because the bacteria are still alive and well. Even if you are using an antibacterial mouth-wash, the bacteria are comfortable lurking in the safety under the coating of the tongue.All of the mouthwashes currently available over the counter add to the compost pile on the tongue, instead of reducing it.

The key is to remove the coating on the tongue.

There is one type of mouthwash that works in conjunction with tongue cleaning for optimum hygiene. Ask your dentist for a mouthwash containing chlorine dioxide. Use it after you clean your tongue.

Many people ask me if brushing the tongue with a toothbrush is enough to remove the coating. Although brushing the tongue is a step in the right direction, it merely loosens the coating. It does not remove< it. Removing the coating is crucial to killing the bacteria that cause bad breath.

There are tongue cleaners available today on the market. They are devices that glide gently along the top of the tongue and remove the coating.

I recommend that my patients clean their tongue when brushing the teeth. Once or twice daily is best. You should first clean your tongue, then brush, floss, waterpik, and rinse with the special mouthwash if you have it.

Although tongue cleaners have been used around the world for centuries as part of regular oral hygiene, tongue cleaning is new to the United States. Many cultures feel that toxins in the body are released through the tongue as evidenced by the coating.

Today, tongue cleaners may still be hard to find, however, I expect them to be as common as the toothbrush or dental floss in the next decade. In addition to freshening breath, tongue cleaning reduces the risk of decay and improves the sense of taste.

When purchasing a tongue cleaner, look for the following:

  • Effectiveness
  • Durability
  • Strength
  • Ease of Use

I do not recommend plastic tongue cleaners. In addition to being expensive (the companies recommend that you replace the cleaner monthly, or every 3 months at least), the flimsy plastic will not remove the coating. In short, they are ineffective.

I prefer the tongue cleaners made of stainless steel because they are durable, keep their shape and have an effective edge for cleaning. Make sure that the cleaner you choose has a narrow tip that can easily reach the back of the tongue – the favorite hiding place of VSC-producing bacteria. I would again recommend BreathaidTM because it meets these important criteria.

Remember that tongue cleaning is essential to preventing bad breath and maintaining optimum oral health.

W. Biggins, DMD

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