Halitosis or bad breath or oral malodour is socially unacceptable but self-diagnosis is difficult, as it is not possible to easily detect an odour from ones’ own breath. Those who have halitosis are often unaware of it and often may be informed by friends or relatives. Yet those people who have been told that they suffer from bad breath can continuously worry if an offensive smell can be detected from their breath.
Halitosis is mainly caused by excessive amount of volatile sulphur compounds being produced by bacteria in the mouth. Studies have shown that up to 50 per cent of adults suffer from objectionable mouth odour in early morning before breakfast or toothbrushing. The reason for this is that saliva incubates bacteria in the mouth during sleep (reduced saliva flow). People with periodontal disease exhibit raised odour intensity due to incubation of saliva and micro-organisms in periodontal pockets.
The plaque control and oral hygiene products aimed at controlling dental caries and periodontal disease will also help prevent halitosis. Also, treatment of periodontal disease in which periodontal pocketing is reduced will minimize halitosis. A number of systemic diseases and conditions such as diabetes mellitus, chronic renal failure and cirrhosis of the liver can give rise to particular bad odours.
There is increasing interest in the development of a reliable system that will measure the level of volatile sulphur compounds in one’s breath. This technology is making rapid progress though the cost of a reliable system remains problematical.
Reduction of halitosis is achieved in several ways. The amount of volatile sulphur compounds in the breath can vary greatly during the day in a single subject and is influenced by factors such as eating, drinking, oral hygiene and sleep and the effect these activities have on saliva flow and the washing of the oral cavity. The majority of studies done on volatile sulphur compounds concentrate on the effects which commercially available mouthwashes have on the reduction of halitosis. The reduction in mouth odour is caused by the anti-microbial influence of the mouthwash.
Some products however, mask halitosis rather than dealing with the cause of the problem. Toothbrushing, eating, chewing gum and tongue brushing usually reduce the levels of oral halitosis to acceptable levels as well but the effect is not as long lasting as antimicrobial mouthwashes. There are now tongue cleaning devices which can be effective in controlling halitosis.