Dear Evil Breath,

Alice is certain everyone has, at one time or another, cupped a hand over her/his mouth to check whether her/his breath is fair or foul. When it comes to social situations, it is not uncommon for many Americans to be consciously aware of the way their breath smells to others. It can be embarrassing to have bad breath, particularly when you are conversing with someone face-to-face. You don't want to turn them off, or be faced with watching them back away, making negative facial expressions, and/or turning up their noses, every time you open your mouth.

Seriously, bad breath is a common enough concern that it has helped boost the businesses of manufacturers of over-the-counter breath freshening products. However, you are right to point out that bad breath does not disappear with the use of breath mints, gums, sprays, mouthwashes, and the like because they only temporarily mask bad breath odors. So, instead of popping a mint in your mouth every five minutes, what are the more long-lasting alternatives?

Before Alice gets to these tips, let her first talk about the possible culprits of bad breath. For a temporary case of bad breath, it can be caused by the foods we eat, such as garlic and onions, whose aromatic substances are absorbed into the bloodstream and exhaled through the lungs as smelly breath odors (so, the odors that can emanate from the stomach via a burp are fleeting and not considered the true source of most bad breath problems). Tobacco use can also result in short-term, foul mouth odors. The bad breath odors caused by these substances pretty much disappear once the body has gotten rid of them.

Other factors play a role in a more persistent or chronic case of bad breath, also known as halitosis. For a few cases of halitosis, the cause is a medical condition, such as a liver or kidney disorder, diabetes mellitus, cold- or allergy-induced postnasal drip, and respiratory and sinus infections. Poor dental health, such as advanced periodontal, or gum disease and cavities, can also cause persistent bad breath. Dry mouth (xerostomia), caused by certain medications (i.e., antihistamines, decongestants), by breathing predominantly through the mouth than the nose, by salivary gland problems, or by not drinking enough fluids, can also contribute to the development of bad breath. This is because there is less saliva in the mouth to help clear out potentially odor-causing food particles and bacteria. If any of these conditions describe your situation, then attending to them will help resolve your bad breath problems. For example, to reduce postnasal drip, try an over-the-counter saline nasal spray; and, to help with dry mouth, be sure to drink plenty of liquids and have some sugarless candy to keep your mouth moist. For the other medical/dental conditions, Alice recommends that you see your health care provider or dentist, if you haven't already.

More likely, it is how you take care of your mouth, teeth, gums, and, particularly, tongue, that will usually determine whether your breath will smell fresh and sweet, or offensive and unspeakable. This is because the mouth offers a favorable environment for bacteria to flourish since it is moist, warm, and dark. The presence of these bacteria are the source of the problem for most sufferers of halitosis, because the bacteria react with sulfur-containing proteins in the mouth to help generate the release of volatile sulfur compounds, which are gases that smell like rotten eggs.

So, what does Alice recommend to kiss bad breath away? Good oral hygiene, such as brushing your teeth at least twice a day and flossing daily, will help get rid of food and odor-causing bacteria in the mouth, gums, and in between teeth, where food particles can rot and bacteria can accumulate; and, thereby, both can contribute to bad breath if not removed.

More importantly, however, is the daily practice of tongue scraping, particularly the very back of the tongue, where bacteria like to grow. If tongue scraping has not been a part of your regular oral hygiene regimen, adding it could mean a substantial improvement in your breath odors. Unfortunately, tongue scrapers are not yet readily available, so ask your dentist if s/he knows of a manufacturer or distributor where you can order one. Otherwise, dentists recommend using a moistened toothbrush, or, for better reach, a spoon, such as a plastic one, or a metal spoon that has been bent for even easier access to the very back of the tongue. If you do not scrape the very back of the tongue, in particular, bad breath problems will continue to persist. Of course, the first few times you try this, you may gag; but, with continued practice, you'll stop gagging because you become accustomed to the gentle scraping procedure.

Some people with halitosis will require extra help in the form of a prescription antibacterial rinse, chlorohexidine gluconate, in addition to the tongue scraping, to more effectively combat their bad breath problems. There is also chlorine dioxide, a germicide that can be applied directly to the tongue, that, unlike chlorohexidine, does not impair taste with long-term use, does not require a prescription, and can be ordered by mail, or through your dentist.

Alice hopes these suggestions will help you to stop holding your breath and breathe easier!!

Alice

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