At one time or another, most of us have had bad breath. Usually, it's a short-term problem quickly mediated by a good brushing of the teeth and tongue, or popping a mint or stick of gum. But for some, the problem isn't easily fixed; the foul smell continues for weeks, if not months.
There are several causes of bad breath, although the most common is known as bacterial putrefaction. A variety of bacterial species with names such as Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucelatum eat up a variety of nutrients from food, saliva and dying cells, then produce several waste products known as volatile sulphur compounds (VSC), diamines and short chain fatty acids. All of these are quite pungent in smell and can easily emanate from the mouth into a nearby nose.
The process of putrefaction is normal and happens in all ecological environments. The difference between the open field and the mouth, however, is the volume of air ventilating the area. Because the oral cavity is essentially a cave, the air cannot easily disperse and has to escape through one of only two access points, the nose and mouth. As a result, the stinky chemicals rise in concentration and are eventually expelled such that anyone within a few feet can detect the byproducts.
While understanding the cause of long-term bad breath, also known as halitosis, is great for awareness, figuring out why some people have this condition over the long term has been a bit of a mystery. After all, we are told brushing, flossing, using mouthwash and other oral hygiene methods can be an effective way to combat bad breath. But when it doesn't work, we're left with more questions than solutions.
Now there may be a possible answer. Last week, an international team of researchers revealed how bacteria in the oral cavity may be able to withstand even the hardest toothbrushing. Their research showed just how stable certain species can be and suggested the cure may require a more ecological approach.
The team examined five individuals over the course of one week. At four-hour intervals over the course of one day, saliva samples were taken to get an understanding of the daily changes happening in the mouth. The same process was performed a week later to offer some perspective on the stability of certain species in the mouth.
Once a sample was collected, it was analyzed at the genetic level to determine which bacterial species were present. The names were then catalogued and compared to other samples from the same person and others. The goal was to determine which bacteria had the ability to stick around in the saliva over the long term, and whether this was specific to an individual or was more human population based.
The first results revealed the microbial population is specific to one person. Each person has a different salivary bacterial fingerprint. This was not surprising. Every person has a unique microbial population whether it is in the gut, on the skin or in the mouth.
Yet even with this result, there were some trends worth noting. Most of the species were able to survive not only the 24-hour period, but also the week interval in between. While the tested individuals had no history of halitosis, some of the stable species isolated had significant bad-breath potential. This meant these particular microbial species could sustain themselves all the while forming the rather noxious outputs.
The outcome of the study may seem disheartening but there was one hint of shining light. In one of the cases, the microbial population changed over the course of one week. When the researchers tried to figure out what happened, the individual confessed to changing toothpaste brands. This revealed the potential impact of oral hygiene in at least helping to change the population.
Of course, there are interventions to assist in ridding the mouth of those odours. The usual go-to options are antibiotics. Yet in light of antibiotic resistance, this may not be the best option.
Another possible route involves the changing to ecology using less odorous bacteria to outcompete the olfactory offenders. In the lab one particular bacterium called Streptococcus salivarius as revealed to be a possible natural route to stop bad breath. By supplementing the mouth with this bacterium, not only halitosis but a variety of other oral health concerns.
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Pass the tissues -- and some gum, please. When a cold prevents you from breathing through your nose, you're forced to inhale and exhale through your mouth. This dries out the tissues and reduces the flow of saliva -- the mouths built-in cleanser, which not only rinses away food particles but also neutralizes decay-causing acids and acts as a natural antiseptic to keep bacteria in check. The less saliva, the more bacteria -- and the more potent the odor. An easy remedy (for your breath, if not your cold): Chewing gum -- as long as it's sugarless -- has been shown to increase the flow of saliva.
Bacteria have a sweet tooth, too. When you eat sticky candy like gummy bears, cherry vines and even mint chews, the bacteria "has a party," says Kimberly Harms, DDS, the consumer adviser for the American Dental Association. It feasts on the sugar and spreads to all areas of your mouth -- including hard-to-reach areas in the grooves of the teeth. But here's a surprise: Dentists have started recommending chocolate as a more healthful alternative to candy. Harms says that chocolate not only dissolves relatively quickly but also has less sugar than other candy, as well as a small amount of calcium to protect enamel.
Yep. Many brands of mouthwash and antibacterial mouth rinse contain alcohol -- sometimes accounting for as much as 27 percent of total ingredients -- that dries out your mouth, leaving a stale smell after the minty freshness wears off in an hour or so. Look for brands with no or little alcohol and save them for first dates or job interviews (or when recommended by a doctor).
After a rice-free sashimi dinner or an all-you-can-eat Brazilian barbecue, your body is tasked with metabolizing a high amount of protein. This produces a by-product of ammonia, which, among other places in the body, is released in your breath (fortunately, your dining companions will suffer the same condition). Eating this way on a regular basis -- by following a high-protein diet, for example -- requires your body to constantly excrete these by-products, as well as molecules called ketones, which can cause your breath to smell in a way thats described as rotten fruit -- or just rotten.
Of all the different types of bacteria that live in your mouth, the most pungent, by far, are a kind called "gram-negative." Not only do they produce gassy-smelling sulfuric compounds, but they also have an extra cell layer that makes them especially resilient. They burrow down below the gum line and hide out in the crevices of the tongue. Flossing helps remove them, but another option is brushing your tongue, which has been shown to reduce bad breath by 70 percent. Clean your entire tongue, especially the back where more there are more peaks (or papillae) and valleys, as well as the cheeks, recommends Gary H. Westerman, DDS, a professor of dentistry at Creighton University. You can also use a toothbrush or a drugstore tongue-brush, but an Orabrush -- yes, the thing you've seen on YouTube -- has longer, softer bristles as well as a scraper to collect the bacteria once it's been dislodged.
Your heart is pounding, your palms are sweating, you're practically panting with stress -- and your mouth is probably not smelling that great (argh, dry mouth again!). In addition to taking a few calming inhalations, remember to take several rehydrating, breath-freshening sips of water.
Finally, a cure for garlic breath that doesn't involve forcing your partner to eat the offender with you. Drinking milk can lower the concentration of odor-emitting compounds from garlic in the mouth (and nose), Ohio State University researchers recently discovered. Whole milk seemed to be slightly more effective than skim (due to the absorbent fat) and had the most noticeable results when it was consumed during a meal (although drinking a glass afterward can help, too).
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