What to do about bad breath
A
dental check-up is the first priority.
The British Dental Association suggests that you explain
in advance that you will be asking for advice about bad breath.
Tell the receptionist when you make an appointment, and ask
that it is noted down and that the dentist is told. Ask the
dentist for a thorough scale and polish, and ask if there
are any defects where plaque and food debris might be building
up.
Clean your teeth properly. A dental hygienist
(make an appointment via your dentist) will show you how
to clean your teeth properly, and how to use floss to clean
between the teeth.
- Give your teeth a thorough cleaning for 3 minutes twice
a day to remove the plaque, and use floss.
- Also, clean your teeth after eating protein-rich foods.
- An electric toothbrush is 11% better at removing plaque
(deposits of bacteria) than an ordinary brush. If you use
an electric toothbrush regularly, instead of an ordinary
brush, you reduce your chances of developing gum disease
by 17% (Journal of Dentistry 2004;32:197–211).
- Use floss for cleaning between the teeth, or miniature ‘interdental
brushes’, which you can buy from your dentist.
- Use disclosing tablets (which you can buy from pharmacies);
these dye the plaque on your teeth, showing the areas you
have not been cleaning properly.
- Use a toothpick after meals to remove large food particles
from between the teeth and, if possible, rinse your mouth
out after meals.
| How to clean your teeth with a brush
- Use a brush with a small head, about the diameter
of a 20p or 5c coin.
- Use only a pea-sized blob of toothpaste. Toothpaste
is abrasive and too much can wear the teeth.
- The British Dental Association recommends the ‘gentle
scrub’ method. Place the brush at the neck
of the tooth where it meets the gum and use very
short horizontal movements, at a 45 degree angle,
to dislodge the plaque. The brush can be held like
a pen to avoid excessive force.
|
Buy a tongue cleaner . This is a curved plastic scraper
like a miniature garden hoe. Stick out your tongue and place
the cleaner onto the tongue as far back as possible. Then
pull forward while gently pressing against the tongue surface.
Do not scrape too much, because if you scratch the tongue,
bacteria will get into the cracks and make the problem worse.
You can buy tongue cleaners from most dentists and some pharmacies.
If you cannot obtain a tongue scraper, brushing the tongue
with a soft toothbrush once a day may be helpful. The most
important part to clean is the back of the tongue, if you
can do this without gagging. Wet the brush with mouthwash,
then stroke from the back of the tongue in an outwards motion.
Do not overdo the brushing; the idea is to dislodge any bacteria
and flush out stagnant saliva.
Do not skip meals (especially breakfast). You need to eat
regularly to keep the saliva flowing.
Eat plenty of fruit. Pineapple is especially good, because
it contains an enzyme that helps to clean the mouth.
Drink black tea (tea without milk). Researchers at the
University of Illinois, USA, found that chemicals in tea
can stop the growth of the bacteria responsible for bad breath,
and may suppress the bad-smelling chemicals they produce.
However, to get the most benefit, the tea must be drunk without
milk.
Chewing sugar-free gum can be helpful
because it stimulates the flow of saliva and involves movements
of the jaw and cheeks. Both these factors help to remove
food debris and cleanse the mouth.
Stopping smoking will get rid of ‘smoker’s
breath’.
Mouthwashes, deodorizing mouth sprays
or tablets will mask bad breath temporarily – useful
after eating onion or garlic. Modern mouthwashes also contain
antibacterial chemicals so, in theory, they should improve
gum disease and mouth odour. Before bedtime is the most effective
time to use the mouthwash. Gargle with the mouthwash, sticking
your tongue out at the same time, and then spit the mouthwash
out. There are several types of mouthwash.
- Sarakan is a herbal mouthwash available from health
shops. It contains extract of Salvadora persica, a bush
grown in Africa and known locally as the ‘toothbrush
tree’, because twigs from it are used to clean the
teeth. Chemicals from the plant dissolve plaque. It has
a pleasant taste, flavoured with oils of peppermint, clove
and geranium, and does not contain alcohol. Tom’s
of Maine is another non-alcohol mouthwash made from natural
ingredients, but has a stronger mint flavouring.
- You can make your own mouthwash by dissolving half a
teaspoon of bicarbonate of soda (baking soda) in half a
cup of warm water.
- A two-phase mouthwash (Dentyl pH) contains three antibacterial
agents – natural essential oils, triclosan and cetylpyridinium.
These absorb, lift and remove bacteria, debris, food and
dead cells, which cause bad breath. (See the result when
you spit out.) The oil phase absorbs smelly gases. The
effect is said to last for 18 hours.
- A mouthwash and lozenge system (Colgate Neutralize)
contains compounds that neutralize the bad-smelling chemicals.
- Chlorhexidine gluconate (as in Corsodyl, Colgate Chlorohex)
is the most effective antibacterial wash, but tastes nasty
and darkens teeth slightly for a few days.
- Phenolic mouthwashes (such as Listerine) are almost
as effective as chlorhexidine in reducing gum disease,
but are too ‘zingy’ for some people.
- Cetylpyridinium chloride (as in Search, Reach, Listermint,
Macleans Mouthguard) is an effective antibacterial, but
it does not remain in the mouth for long after rinsing.
- Povidone–iodine (as in Betadine) can cause irritation,
and must not be used by pregnant women or children, or
for longer than 14 days.
- Chlorine dioxide rinses (such as Retardex) are claimed
to eliminate some of the bacteria and the sulphur chemicals
that are partly responsible for the bad smell of halitosis.
- Peroxide (as in Colgate Peroxyl) is also an antiplaque
agent.
At present, many mouth rinses are acidic, and dentists
worry that they might damage tooth enamel. There is also
a possibility that the bacteria they eliminate could be replaced
by more harmful types that can withstand the effects of mouthwashes.
Look at the label to check if the mouthwash contains alcohol.
Alcohol can dry the mouth and make the problem worse.
Herbs may help. Chamomile and myrrh are said to have antibacterial
properties. Peppermint, rosemary, sage and cloves have a
pleasant smell, which helps to mask bad breath. Pour 0.5
litres (1 pint) of boiling water onto 75–125 g (2–4
oz) of herb or 30 g (1 oz) of cloves. Leave to cool for 1
hour, then strain and use as a mouthwash (that is, swish
around your mouth and then spit out). Do not use herbs if
you are pregnant.
If you have dentures, remove them at night and soak them
in a solution of hypochlorite or chlorhexidine. A pharmacist
will be able to advise you.
