Bad breath: all the time, foods, what to do?

L’halitosis is the medical name given to the bad breath, causing a strong odor coming out of the mouth, when exhaling or talking. Bad breath comes from volatile sulfur compounds (CVS) that form in the mouth when food debris breaks down. “If the teeth and tongue are not properly brushed, food debris can remain nestled in the oral cavity and macerate, which promotes the proliferation of bacteria and the production of these volatile sulfur compounds, responsible for bad breath“, explains Dr Edmond Binhas, dental surgeon and president of the Dentéon Santé group.

Symptoms to know if you have bad breath

A healthy tongue should be light pink in color.

“People suffering from halitosis don’t necessarily realize ithence the difficulty of implementing suitable solutionssays Dr. Binhas. One of the first warning signs: lingual coating, which corresponds to a whitish deposit on top of the tongue“. A healthy tongue should be light pink in color, if it is whitish, it is not brushed well enough and there is a risk of bacterial proliferation. If there are other symptoms such as pain or bleeding, this may be a sign of tooth or gum disease (gingivitis, periodontitis) and you must consult a dentist without delay.

What causes bad breath?

► 70% cases of halitosis are of intraoral origin. This may be due to:

• poor oral hygiene
• to conditions of the teeth, gums or tongue “that we tend to neglect when brushing“.”Bad breath can come from gingivitis, periodontitis, deep decay which turns into an infection of the pulp… which then represent real bacterial centers with very active germs which can be responsible for bad odors. A defective reconstitution (broken filling for example) can also alter the breath“, warns the dental surgeon. Bad breath can also come from oral fungus or a loaded tongue.

► 30% of cases of halitosis are of general origin. In other words, halitosis can develop even with good oral hygiene. This may be due to:

• to food: “Garlic, onion, cheese, anchovies or certain spices transform, once they are digested, into odorous components which pass into the blood, enter the lungs and cause odorous breath“, explains Dr. Binhas
• to the consumption of alcohol or coffee
• gastric pathologies (ulcer, gastroesophageal reflux, etc.), ENT disorders such as sinusitis or tonsillitis, metabolic disorders (hyperglycemia for example), liver diseases, etc.
• when taking certain medications (certain antidepressants for example)
• at the cigarette shop
• to pregnancy, “period which is characterized by a higher level of hormones which can lead to an overproduction of dental plaque and promote the appearance of bad breath“, specifies our interlocutor.
• At “Skipping meals and not drinking enough is also a possible cause“, adds Dr Yves Fouré. When fasting, the mucous membranes dry out, which can cause bad breath.
• has “a bacteria called helicobacter pylori, responsible for gastroesophageal reflux disease (GERD), which is suspected of being one of the causes of bad breath. But this needs to be confirmed by other scientific studies.“, says Dr. Binhas.

When and who to consult?

“As soon as you notice that you often have bad breath, or that loved ones notice it, you have to go and consult“, insists Dr Fouré. The dentist is the appropriate specialist: he will ensure that no oral pathology is involved.

“The diagnosis of halitosis is done in a manner organoleptic, therefore by smell. It is the dentist who will evaluate the smell based on a grid: can the smell be felt at 10 cm, at 30 cm, at 1 meter? When the breath is felt at a meter, we speak ofsevere halitosisdescribes our dental surgeon. On the other hand, there is an objective diagnostic measure: a halitometer, a device that measures the amount of volatile sulfur compounds by gas chromatography.“

Bad breath in babies and children

Halitosis in babies can have different causes: teethingoften accompanied by hypertrophy of the lymphoid organs of the cavum (vegetations, tonsils, etc.) responsible for the fetid odor, an infection such as nasopharyngitis, tonsillitis or anginaOr poor digestion caused by a diet too rich in fats and sugars. To limit halitosis in babies, brush their teeth (if they have any) and clean their mouth with a diluted mouthwash solution. Ask your doctor or pharmacist for advice on using a mouthwash. Furthermore, you should avoid excessive “nose washing” which tends to promote bad breath.

Treatments and solutions

In adults as in children, good oral hygiene can significantly reduce the risk of halitosis. We recommend consulting a dentist at least once a year for him to carry out descaling and that he checks for the absence of oral and dental conditions. If the dentist does not find intra-oral causes, he will refer you to a doctor (a gastroenterologist for example) to carry out further examinations. There are multiple causes of bad breath that will need to be treated: nose and throat infections (angina, rhinitis, sinusitis, etc.), digestive problems (gastroesophageal reflux, gastric hyperacidity, pulmonary infection, etc.).

In addition, To avoid having bad breath, you must:

• Maintain good oral hygiene by brushing your teeth at least twice a day for at least two minutes (ideally three times a day) after meals. Using dental floss or a dental water flosser allows you to deeply clean the oral cavity and eliminate residual food debris that nestles between the teeth.
• Hydrate and drink well at least 1.5L of water per day to prevent drying of the mucous membranes. For example, you can finish your meal with a large glass of water to rinse your mouth thoroughly and remove some of the food debris. “It is necessary to hydrate throughout the day to avoid drying out the oral mucous membranes and causing bad breath. Proper hydration of the mouth also helps prevent oral and dental infections.“, indicates Dr Fouré.
• Use the back of your toothbrush (if it is equipped with a scraper. If not, do not use the bristles of your brush to scrape your tongue: this risks creating micro-lesions on the tongue and promoting the proliferation of bacteria) or a tongue scraper (from back to front) to remove small food debris embedded in the tongue.
• Limit your consumption of alcohol, coffee, tobacco or foods that cause bad breath.
• Chewing sugar-free chewing gum remains a troubleshooting solution : this masks odors and increases saliva production, which promotes the elimination of dental plaque and reduces the formation of volatile sulfur compounds. On the other hand, it does not cure the problem responsible for bad breath and in no way replaces good oral hygiene.
• Good food hygiene, with meals taken at regular times, helps reduce the risk of bad breath.

The best mouthwashes for bad breath

Use over a short period (two weeks maximum without medical advice) a mouthwash based on chlorhexidine (available without a prescription, to be used only in children over 6 years old and adults) which is an effective antibacterial; Or CB12© mouthwash (available freely in pharmacies to be used only for children over 12 years old and adults), a fluoride-based product which is recommended by the French Union for Oral Health and which has a beneficial action against bad breath by neutralizing acid gases that can form in the mouth. In all cases, do not use mouthwash without the advice of a dentist, a general practitioner or a pharmacist because used over the long term, they can have irritating effects and cause discoloration of the teeth.

Thanks to Dr Edmond Binhas, dental surgeon and president of the Dentéon Santé group and Yves Fouré, general practitioner.