Let me start by saying WE ALL HAVE SOME DEGREE/LEVEL OF HALITOSIS OR MOUTH ODOUR OR BAD BREATH. It’s like our finger print, like our unique signature, even some families have such running amongst its members, but depending on what time of the day, with or without activity, the intensity of the smell people or you perceive, can range from say a scale of 1 to 10.
So, if you had just woken up, after having slept several hours, you are sure to get something tending towards 10, while even without brushing, and you eat, it is most likely to drop to something far less than you would’ve recorded earlier, because you would’ve worked your saliva, which was STALE, since it was stagnant, while you slept.
Halitosis is a difficult subject to discuss, especially when a patient presents with such to a dentist, because there are many factors that determines how people come to know they have halitosis. The thing is, if you look for halitosis, you will find it, even when it isn’t easily observable by people very close to you, while those with noticeable odour from a mile off, usually tend not to be aware of their precarious situation, and many times are wont to throw their “blessings” on others without provocation, and at will.
The causes of halitosis are a myriad, and knowing and understanding them is key to understanding how to go about solving it. Some of causes are associated with the mouth and its immediate environment, while others have to do with sites elsewhere in the body but manifesting in the mouth as unpleasant odour (infact, many systemic diseases are routinely discovered for the first time during visits to the dentist). The most challenging of the causes to treat are those that border on the psychological.
A major culprit for halitosis in an otherwise clean mouth is SALIVA. Stagnant saliva in someone that has been sleeping, or people working at activities/jobs were speaking isn’t a requirement tend to keep lots of saliva in the mouth, and it takes a while after they resume speaking for the level to drop to less unpleasant levels even without doing anything besides swallowing their saliva. Such people could ensure that they drink some water in between periods of quiet (that is when they aren’t sleeping), or find other ways to work their saliva, thus preventing a situation whereby their saliva is stagnant.
Chewing gum used to be an option, but even sugar-free gum which is less likely to cause dental caries (cavity/hole in tooth), can cause the teeth to wear off the first layer, exposing the second layer, which is more sensitive, thereby causing the problem of hypersensitivity (treated with a desensitizing paste for instance) while trying to solve halitosis, hence it is now widely disregarded as one of the solutions for halitosis.
Consumption of bland fruits are also an option here and may stand in the place of just food in order to WORK THE SALIVA, while you should note that the consumption of odoriferous fruits and food substances will leave behind, in the mouth, their signature odours, which contribute their own quota to increasing the persons’ halitosis levels closer to the “10” extreme we have set for the purpose of this write-up.
For the early morning situation, it is advisable to brush in the morning after breakfast rather than before, and the last thing at night, if one can manage that. However, for the rest of the day, simply rinsing the mouth, after every meal should suffice, even when one intends to drink the water following a meal it is not a bad idea to rinse the mouth with the water, before sending it in!
Cleaning the mouth mustn’t include just brushing, but also FLOSSING the spaces between teeth, to remove food debris stuck therein, which on decaying also contributes to halitosis, and most importantly the regular visit to the DENTIST for a SCALING & POLISHING in which areas that can’t be reached by brushing or even flossing can be cleaned using the appropriate manual or automated dental instruments. The use of ANTIBACTERIAL MOUTHWASHES should not be an alternative to brushing using a FLUORIDE containing TOOTHPASTE, the physical brushing activity goes a long way in keeping the teeth clean and free of food debris, while the mouthwashes usually clear the mouth of BACTERIA, leaving the other oral flora of VIRUSES and FUNGI to roam unimpeded with the peculiar challenges that may follow from that.
Food debris, left in the mouth for long, especially those abundantly laced with sugars (processed or not), serve as nidus for oral microflora to feed on, releasing products of metabolism which are capable of breaking down tooth surfaces leading to cavities, that hold further food debris, and microorganisms that continue the degradation of tooth substance till a huge and deep hole is formed, that may lead to pain when the nerves become involved, besides its contribution to halitosis because of the debris, and consequent inability to properly brush the affected side due to pain or swelling associated with the tooth of and by the individual in question. These can be combated by the dentist who may place a filling on the tooth, or carry out a ROOT CANAL TREATMENT or an EXTRACTION, as the case may dictate, and in so doing reduce level of halitosis.
The gum may become swollen and less apposed to the teeth in reaction to certain drugs such as those used by HYPERTENSIVE individuals and EPILEPTICS. Such individuals may have to see their physicians for a modification of their drugs to something less reactive on the gum. The gum may also swell at the margins, where the gum meets the teeth because of the presence of deposits such as PLAQUE, which when CALCIUM from SALIVA is attached becomes the hardened CALCULUS, which is not easily removed by brushing, but during Scaling and Polishing by the dentists. Apart from causing halitosis, uncontrolled growth of calculus can separate the teeth from the gum and surrounding periodontal/attachment tissues, such that in very bad cases, removing long-standing calculus might even make the teeth mobile.
Outside of the mouth are a myriad of systemic diseases with oral manifestations such as halitosis. KETOSIS BREATH is associated with individuals with TYPE-1 DIABETES, where sufferers appear to many like they might have had lots to drink, when they had infact been sober. ANOREXICS may also present with halitosis because of the frequency of vomits, which also has the effect of burning the surfaces of teeth, because of the acidic content from the stomach.
Apart from the illnesses which have presentations such as these, there are also the reaction of the tissues in the mouth to the medications used for their treatment, resulting in halitosis as I have briefly mentioned above.
Habits such as consumption of certain odoriferous fruits, stimulants, food substances, as well as smoking, drinking of alcohol, even of sweet fizzy drinks with bitter aftertaste, all contribute their own quota to halitosis, and may have to be curtailed or modified if one is to fight halitosis.
When all the precautions have been taken, and regular visits to the dentist, and to the physician for the management of systemic conditions (manifesting as halitosis in the mouth) have been complied with, without let, and the situation remains, or the individual still feels that there hasn’t been any improvement, even when the dentist can tell that the situation has improved considerably (as there will always be that latent signature odour you will find when you hold your palm against your mouth, to direct the air from your mouth to your nostrils, even seconds after brushing), then it has moved to something psychological, for which (s)he may now have to see a shrink for some sessions on SELF ESTEEM and SELF WORTH.
All that I have touched on, in the above, does not nearly cover the whole gamut of halitosis and related issues, but I believe it is enough to spur you on the path to working towards reducing your level of halitosis, on our adopted scale.