Unveiled: What Health Conditions Can Bad Breath Indicate?
Bad breath, also known as halitosis, refers to the unpleasant odor emanating from the mouth that annoys others and embarrasses oneself. People often assume bad breath is simply due to poor personal hygiene and not brushing, but the reality is far more complex; bad breath can be a sign of illness! Jeffrey Speiser, an Australian dental and halitosis specialist, told Malaysia's "New Straits Times" in an interview: "There are many causes of bad breath, including personal hygiene and lifestyle habits; diseases can also cause bad breath. The treatment methods differ depending on the underlying cause." People should seek help from professional doctors instead of simply opting for a teeth cleaning or switching toothpaste. Dr. Speiser said, "Research has found that one in four people in Malaysia suffer from chronic bad breath. If left untreated, the condition will worsen with age."How Does Bad Breath Occur?
According to the American magazine "Global Dental News," there are many causes of bad breath. These include: food debris accumulating in the mouth that is not cleared in time; decay in dental cavities; inflamed or bleeding gums, or pus from a gingival fistula; and certain blood diseases and diabetes. Caused by Bacteria Decomposing Chemicals Bad breath is caused by sulfur-containing gases produced when bacteria residing on tooth surfaces and under the tongue break down proteins, peptides, and amino acids. Proteins contain two sulfur-containing amino acids: cysteine and methionine. When they decompose, they produce sulfur compounds such as hydrogen sulfide, methyl mercaptan, dimethyl sulfide, and dimethyl disulfide. Additionally, some organic acids are also associated with bad breath, such as butyric acid and propionic acid, as well as compounds like indole, methyl indole, and cadaverine. There are at least 82 microorganisms in the mouth that can produce hydrogen sulfide, methyl mercaptan, and fatty acids during their metabolic processes. These bacteria mainly include Fusobacterium, Haemophilus, Veillonella, and Treponema denticola. IgA (an antibody) in saliva can inhibit bacterial activity. Therefore, an increase in anaerobic bacteria under the tongue and on tooth surfaces may be related to IgA deficiency. The odor emitted by these bacteria also contributes to bad breath.Caused by Pathological Conditions
The diseases most closely related to bad breath are dental caries, periodontal disease, and oral cancer. Besides oral diseases, conditions in nearby organs, such as tonsil stones, sinusitis, and nasal polyps, are also common causes of bad breath. Many patients with systemic diseases have a distinctive odor in their breath. For example, diabetics may have a fruity breath, patients with renal failure may have a fishy breath, and patients with cirrhosis may have a sulfur-like smell in their mouths. It is commonly believed that gastrointestinal diseases are a significant cause of bad breath. In reality, the esophagus is closed when not eating, and gastrointestinal gas only passes through the mouth during burping. Therefore, bad breath has little to do with the gastrointestinal system, except in cases of severe stomach diseases like stomach cancer or gastric ulcers, combined with a poorly functioning esophageal sphincter, which can lead to persistent bad breath. Furthermore, saliva production decreases during sleep, and the tongue and cheek muscles are mostly at rest, which can easily lead to bad breath. People who are easily agitated, angry, or depressed often experience bad breath. Women are also more prone to bad breath during menstruation and pregnancy. Diet plays an important role in forming bad breath; foods like onions, garlic, and animal fats can cause it. Some patients also develop bad breath after taking certain medications, such as dimethyl sulfide, quinine, and antihistamines.How to Determine If You Have Bad Breath
If you're unsure whether you have bad breath, you need to rely on feedback from people you are in close contact with, or get a check-up at a hospital. According to Dr. Speiser, an Australian dental and halitosis specialist, one can be tested using a "odor line" (Editor's note: The "odor line" test for bad breath uses a gas chromatograph to measure the concentration of volatile sulfur compounds (VSCs) in the subject's exhaled breath). If the concentrations of three specific odors—methyl mercaptan, hydrogen sulfide, and dimethyl sulfide—in the patient's exhaled breath are above the "odor line," they are diagnosed with bad breath. Methyl mercaptan smells like feces, hydrogen sulfide smells like rotten eggs, and dimethyl sulfide has an odor like a mixture of cabbage, sulfur, and gasoline. "If all three gases are present, no amount of cleaning your teeth, tongue, or getting a professional cleaning will help unless the treatment addresses the specific cause," says Dr. Speiser.Treat Bad Breath by Identifying the Cause
Methods for treating bad breath are mainly divided into two categories, proposing preventive and treatment measures for simple bad breath (caused by reasons like unclean mouth) and secondary bad breath (caused by diseases in other parts of the body). Rinse your mouth after meals and brush your teeth before bed to develop good oral hygiene habits: Brush your teeth with fluoride toothpaste in the morning, evening, and after meals, while also cleaning between your teeth; clean your dentures properly, especially the plaque in the gaps; receive regular dental check-ups; avoid overeating at meals (especially dinner), don't eat snacks before bed, eat a light diet, and consume less spicy and irritating food; limit alcohol consumption and quit smoking; replace alcoholic beverages with water, and try to avoid coffee, beer, wine, and whiskey. Carry a toothbrush with you, as brushing can temporarily or completely eliminate some odors; if you can't brush, use mouthwash instead; prevent constipation and maintain regular bowel movements; to promote saliva secretion, you can chew green olives, preserved plums, eat fruits frequently, or drink tea made from Ophiopogon japonicus and licorice; drinking a glass of warm salt water on an empty stomach every morning can regulate gastrointestinal function and help eliminate bad breath. Red dates and black jujubes can eliminate temporary bad breath caused by onions and garlic; chew 1-2 after a meal. Additionally, drinking strong tea can counteract the garlic odor. Holding a vitamin C tablet in your mouth, chewing gum, using herbal toothpaste, and chewing tea leaves can also have a certain deodorizing effect. For secondary bad breath, since it originates from diseases within the body's internal systems, the above measures alone are often ineffective. It is necessary to treat the primary disease, such as timely treatment of gastritis, lung abscess, diabetes, etc. Once the primary disease is cured, the bad breath will disappear.