Curing Halitosis: A Dentist’s Guide to say Goodbye to Bad Breath

halitosis

Before talking about curing halitosis, let´s learn what is it

As dental professionals, we refer to “bad breath” as halitosis. This foul and disagreeable smell emanates from the mouth and can be caused by various factors, including poor oral hygiene, oral illnesses, or consumption of certain foods. Halitosis is something that individuals certainly want to steer clear of as it not only causes physical discomfort but can also lead to social, interpersonal, and psychological issues when left untreated.

Halitosis is a highly stigmatized condition in our society, making it challenging to discuss with partners or friends and find a solution. However, fret not! This blog was created with you in mind. We understand that the experience of bad breath can be uncomfortable and embarrassing, and we are committed to assisting you in resolving it at its source using safe and effective methods without resorting to dubious remedies or unproven concoctions.

Remedies for Curing Halitosis

My aim with this article is to provide you with a comprehensive guide to finding a definitive cure for halitosis. While it is essential to seek professional guidance, my goal is to empower you to take control of your condition and understand what steps to take. If, for any reason, you do not receive a complete solution from a specialist, do not lose hope – it may simply mean that you need to seek out a different approach or consult another professional. It is crucial not to become discouraged on your journey towards finding a cure. Rest assured, you are much closer to solving the problem than you may think. The first step in curing halitosis is to identify its origin. Unfortunately, many patients believe in myths and engage in activities that only worsen their situation. To avoid making the same mistake, I will outline what you should NOT do:

Primero que todo,

  • One of the biggest mistakes that people make when dealing with halitosis is consuming candies, chocolates, halls, tic tac, and other similar items to cover up the smell. This is a clear and unequivocal NO if you wish to change your condition. In fact, doing so can make your situation worse, even if your halitosis was mild to begin with. While these candies may provide an initial burst of pleasant aroma in your mouth, they are usually packed with sugar. This sugar creates a perfect breeding ground for the microorganisms that cause bad breath and bacterial plaque in your mouth, allowing them to flourish and become even stronger. This is precisely what we want to avoid at all costs.
  • Another common mistake people make in trying to combat halitosis is chewing gum with sugar all day long. This is a BIG NO, and I am specifically referring to gum that contains sugar. (I will address sugar-free gum in another blog post.) Chewing gum with sugar not only exacerbates the problem of bad breath, but it also contains harmful gums that can damage the surface of your teeth. Since you may feel the need to chew gum more frequently to mask the odor, it can lead to weakened enamel, making you more susceptible to cavities, dental sensitivity, and if you already have bruxism, this repetitive movement can make it worse. It’s like a workout for your mouth, making the muscles stronger and increasing the likelihood of severe dental wear.

And how is Curing Halitosis?

Curing Halitosis

To begin with, it’s important to understand that there are three types of halitosis: genuine halitosis, pseudohalitosis, and halitophobia. Halitosis is typically multifactorial, meaning that in order to control it, several underlying issues may need to be addressed simultaneously.

Real halitosis

Genuine halitosis refers to a condition where bad breath can be objectively verified and perceived through the sense of smell. It is further categorized into two types: transient halitosis and pathological halitosis.

Transient royal halitosis

Transient halitosis is a type of genuine halitosis that occurs in the morning or after consuming certain foods, such as garlic, or drinks like alcohol. It can be easily treated by maintaining good oral hygiene, like brushing teeth and tongue, or by avoiding the consumption of those substances. Similarly, bad breath caused by cigarettes can also be eliminated by quitting smoking.

Pathological royal halitosis

We will focus our attention on pathological halitosis, as it requires more attention from the dentist, and sometimes even requires intervention from medical specialists to address respiratory or gastric diseases that patients may not realize are linked to their bad breath.

Halitosis due to oral problems

1. Halitosis due to poor oral hygiene

The first step in treating pathological halitosis is to consult with a dentist. It’s surprising how common it is for people to not brush their teeth properly, and they continue to do so every day without realizing it. This may be due in part to the fact that oral hygiene is a taboo subject and people may not feel comfortable asking their friends how they brush their teeth. In some cases, oral hygiene education from a trusted dentist may be necessary. After receiving education on proper oral hygiene techniques, the next step is to undergo a deep dental cleaning using ultrasound. Even with diligent brushing, there may be stubborn buildup that cannot be removed by brushing alone. It is important to have a thorough cleaning every six months in order to eliminate halitosis caused by poor oral hygiene.

2. Halitosis due to dental calculus and inflammation of the gums

In some cases, the stones in our teeth can grow larger and cause inflammation in the gums, which can create a favorable environment for the bacteria that cause bad breath to thrive. To address this issue, in addition to deep cleaning and oral hygiene education, it may be necessary to trim the gums to remove overgrowth and use medicated mouthwashes. However, it’s important to note that mouthwashes containing chlorhexidine, while effective at eliminating bacteria, can cause significant dental staining if used for more than a week, so caution is advised.

3. Maladaptive dental treatments

Recently, maladaptive smile designs have become increasingly relevant, which is why it is crucial to review with whom the smile designs are made. Unfortunately, I have had patients who have received mismatched designs from expensive, cheap, and prestigious dentists who attend celebrities. These designs cause dental plaque to accumulate in hard-to-reach places, making it almost impossible to clean. To solve this problem, it is essential to seek ethical professionals who can perform polishing and maintenance on mismatched resins or replace them if necessary. Additionally, leaving old restorations in the mouth without maintenance, such as crowns or implants, can also contribute to the proliferation of bacteria that cause bad breath.

4. Halitosis due to tongue problems

There are some tongue conditions, like geographic tongue, where the surface of the tongue appears to have grooves and a map-like appearance. This can be resolved with proper oral hygiene, including regular brushing to remove dead cells and bacteria from the affected area. Medicated mouthwashes can also be beneficial in treating these conditions.

5. Halitosis due to caries

When cavities penetrate the dental enamel, they can grow quickly and provide a breeding ground for bacteria that cause halitosis. It is crucial to promptly address cavities to prevent further issues such as pain, tooth loss, and abscesses.

6. Halitosis due to periodontal disease (of the gums)

To address this issue, seeking treatment with a periodontist is recommended. The periodontist will start by examining x-rays to evaluate the gum’s condition. Subsequently, they will perform a more comprehensive cleaning procedure called “root planing” that goes deeper than a typical dental cleaning. This treatment effectively eliminates calculus that has penetrated deeply, not only in the tooth but also in the root, and helps prevent halitosis.

7. Halitosis due to the use of poorly cleaned dental prostheses

Acrylic dental prostheses can develop pores on their surface due to wear and tear, causing a foul odor and fungal growth. It is important to avoid using them beyond their recommended lifespan. To address this issue, regular maintenance and polishing of the prosthesis is required, and it should be replaced at least every five years. At-home cleaning can be done using a strong brush specifically designed for prostheses, and special effervescent cleaning products can be used every 15 days. Consult with your dentist to find suitable brands available in your area.

8. Halitosis from leaving acrylic crowns in the mouth for a long time (temporary)

Temporary acrylic crowns are intended to be a short-term solution while waiting for the final crowns. However, some people keep them for a long time due to financial or time constraints, which can result in a foul odor in the mouth due to their porous surface. To resolve this issue, it is recommended to replace them with permanent crowns and have regular dental cleanings at least twice a year.

Halitosis due to general illness

There are several diseases that must be treated first in order to solve the halitosis that these would be generating, these diseases are:

  • Infectious conditions such as tonsillitis, pharyngitis, and laryngitis can result in bad breath.
  • Sinusitis, a type of paranasal sinus disease, is also an infection that can cause halitosis as it is in close proximity to the mouth.
  • Carcinomas of the respiratory tract usually require treatment either with medication or surgery.
  • Gastroesophageal reflux is a condition where the helicobacter pylori bacteria produces compounds that contribute to bad breath. Research has demonstrated that managing helicobacter can also alleviate halitosis.
  • When diabetes is not properly controlled, it can result in the presence of certain substances in the blood that can cause a particular smell resembling that of fish.
  • Medications that induce dryness in the mouth (xerostomia): The lack of moisture in the mouth can lead to halitosis, and hence, one can consult with the prescribing doctor if the dosage of the medication can be modified or if artificial saliva can be used to alleviate the condition.

Pseudohalitosis

La pseudohalitosis se da cuando el paciente piensa que presenta halitosis pero objetivamente no hay presencia la misma, y las pruebas diagnosticas dan resultado negativo. En estos casos algunas veces se recomienda el apoyo de un psiquiatra


Sara Pelaez Monsalve

Aesthetic dentistry with more than 14 years of experience in the field. Founder of Clinica Viena and Viena Kids (clinic focused on pediatric dentistry). Professional focused on patient care, on the application of best practices and high-quality world-class treatments.

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