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Do You Have Bad Breath??

Have you ever had a difficulty with your breath? If you have, you are not alone. In fact you are among millions of fellow Americans who have been afflicted with "Halitosis".

There are many potential causes for halitosis. These range from metabolic problems, to dietary consumption, to the most common cause which is the production of "volatile suphur compounds (VSC's) by oral bacteria.

All across the country, breath centers are being started by health care professionals hoping to cash in on this new trend. This is in part triggered by research in the 1980's which demonstrated that VSC's can be chemically neutralized and removed from the mouth. Patients are being charged from several hundred to a few thousand dollars for "treatments". It has been my experience that patients who know they have a problem with halitosis are willing to pay just about anything to be rid of this embarrassing problem. Let's review some facts and you will soon see that oral sources are often simple and inexpensive to eliminate with steps you can do at home!

Breath disorders are a very common problem. Approximately 90 per cent of all adults will complain at one time or another about a breath problem. These complaints can have more than just social consequences. Fortunately, almost all cases can be significantly improved or eliminated entirely!

Halitosis, as it is called, is the emission of unpleasant aromatic compounds from the breath. The cause must be accurately determined for an improvement to be realized.

The first determination of cause must result from classifying the source as oral or non-oral. Non-oral causes can involve multiple medical conditions for which a physician should be consulted. Diabetes, liver failure, respiratory, sinus or tonsilar infections, and gastric reflux are some examples. The most common non-oral cause for halitosis are odors that enter the breath through the lungs. The best example of this comes from the foods that are ingested. The by-products from these foods are absorbed, carried through the blood and excreted partially through the lungs. This is why patients complain of garlic or onion breath long after consumption and even after several brushings and rinsings. Additionally, persons on unusual diets may experience breath problems

Oral sources usually occur as a result of the production of "volatile sulphur compounds" or "VSC'S." They are mostly composed of three compounds: hydrogen sulfide, methyl mercaptan and dimethyl sulfide. VSC'S are molecules which are the result of bacterial activities. They are markedly offensive and easily distinguished. VSC's have been measured as being 8 to 10 times greater in patients with periodontal disease. They are produced by the bacteria which inhabit the periodontal pockets and increase in proportion to the degree of periodontal damage. They are also produced by bacteria that can reside on the upper surface of the tongue. Often the tongue will demonstrate a "coating."

Once the oral source has been determined, treatment can be instituted to interrupt the cycle. Two basic approaches may be used.

1. mechanical intervention

2. chemical intervention.

Mechanical intervention refers to the time tested oral hygiene techniques of flossing, brushing, tongue scraping, rinsing, and irrigating your mouth. If you have not had a professional dental cleaning in over 6 months, if you notice any redness or puffiness in your gums or if you have ever experienced bleeding from your gums during brushing and flossing (Bleeding gums = gingivitis or periodontitis!!) you should consult with a periodontist.

Chemical intervention refers to the use of mostly over the counter, topical agents which would be most suitable for your particular case. Proper selection of oral care products can either help you or hurt you.

There are many commercially available products which make great claims about their effectiveness. Unfortunately, most of these products merely mask the VSC'S temporarily. Their masking may last from 15 to 30 minutes, then the problem resurfaces.

Most people will notice the advertising media is saturated with products promoted to help with this condition. Most, if not all of them, really do not work very long and some make the problem worse. Alcohol based mouthwashes can, for example, dry out the tissues in the mouth and cause the tissues to worsen the condition over time. Peroxides release "free radicals" which damage tissues (the elimination of free radicals is the primary goal for using anti-oxidant vitamine supplementation). It is also unfortunate that many products people choose to use have high concentrations of sugars which will eventually lead to tooth decay. ( Do not over utilize breath mints in this manner.)

Both methods of intervention will be required to achieve your goal of eliminating halitosis, depending on your particular needs. Some products may be advised for you that directly attack the VSC molecule. Other products may be necessary to directly attack the types of bacteria which cause periodontal disease. The products, when used in conjunction with sound oral hygiene measures can help leave your breath fresh for hours and retard the progression of periodontitis

In summary, most breath disorders are of oral origin.  Most patients have experienced marked improvements after actively following their outlined regimen.

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