DR ELLIE CANNON: Rinse away rotten breath,

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Bad breath is far from uncommon - but speaking about it is. For despite the  fact that many of us will be affected at some point, halitosis, as it is medically known, remains a massive social taboo. Yet it can be a symptom of serious illness, and in severe cases can impact on self-esteem, jobs and social relationships.

Isn't bad breath just from eating pungent food?
Not always. Although certain foods such as garlic and radishes cause bad breath transiently, some people suffer constant bad breath no matter what they eat. This can be due to bad dental hygiene but also mouth disease and other illness.

Bad breath: It can be a symptom of serious illness, and in severe cases can impact on self-esteem and jobs

Is getting rid of it  just a case of brushing your teeth more carefully?

In most cases, the cause is poor oral hygiene and the bacterial breakdown of food debris left in the mouth. But regular, diligent teeth-brushing is only the first step. Flossing, anti-bacterial mouthwash and tongue-brushing can all help. The back of the tongue can be a breeding ground for bacteria. Tongue-scrapers are available to help. A trip to the dentist is a must, as gum and dental disease worsen the problem.

My oral hygiene is excellent but still I have bad breath. What else can I do?

Make sure you are using an anti-bacterial mouthwash containing chlorhexidine or triclosan. A mouthwash can remove odour-forming bacteria. Have a think about your diet;  as well as the obvious pungent foods, sugary and acidic drinks encourage bacteria and tooth decay. I have seen patients cut their diet drinks habit and see their breath odour improve. Water, tea and coffee should not be a problem. Giving up smoking is essential. If your mouth always feels dry, chewing sugar-free gum will improve saliva production.

 

Is it worth speaking  to my GP?

Absolutely. Halitosis is  not always due to oral problems, and your doctor will be able to assess this. Chronic infections in the throat, sinuses and the lungs can contribute. People with stomach problems such as reflux or a hiatus  hernia can suffer due to food regurgitation. Certain medicines can contribute, such as immunosuppressants. These causes account for only about one in ten cases but are worth considering. Very rarely,  halitosis can be a symptom of a nasal polyp or a tumour in the throat or windpipe, but this is unusual and you would have other symptoms.

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