Ooh, That Smell: What to Do if It's Coming From You

From the WebMD Archives

Aug. 9, 2001 -- Though there may never be an easy way to tell someone they've got bad breath, there are better ways to diagnose and treat the condition today than ever before.

Call it what you like -- malodor, halitosis, or just plain bad breath -- it stinks and no one wants it. Yes, more than 90 million Americans suffer from it, and it could be a sign of a health problem.

"Bad breath can be embarrassing and it can be masking gastric problems, sinus infections, or ... severe gum disease," says Mark Wolff, DDS, PhD, director of operative dentistry at State University of New York at Stony Brook, who discussed advances in treating bad breath at the recent annual meeting of the American Academy of General Dentistry in New York City.

Today, he says, dentists are much more capable when it comes to treating bad breath.

About 75% of bad breath stems from the mouth, he tells WebMD, and is caused when decay and debris produce sulfur compounds that cause foul odor.

Better treatment begins with improved detection. And that starts with new devices, such as the Halimeter, that can detect the amount of sulfur-producing bacteria in the mouth.

"Licking the back of your hand, letting it dry, and smelling it is still a powerful tool to see if you have bad breath, but now we can quantify it," says Wolff.

Along with good oral hygiene, some of the most promising treatments are mouthwashes, toothpastes, and other oral products that contain both chlorine dioxide and zinc.

"Zinc stops an enzyme from breaking down an amino acid that makes the sulfur -- and by doing this stops the process for a longer period of time -- while the chlorine dioxide kills the already formed bacteria," Wolff tells WebMD. "These products pack a one-two punch."

His advice to people with bad breath?

"Look for a product containing zinc and chorine dioxide," he says. Often such products can eliminate bad breath for up to eight hours.

Another breeding ground for odiferous bacteria is a dry mouth, he says.

An as-yet-unpublished study from SUNY Stony Brook found that when mouths are dried out, there's a sixfold increase in such sulfur compounds.

The dryer the mouth, the less saliva, and the worse the breath, Wolff explains. Alcohol as well as some medications -- including antidepressants, asthma drugs, antihistamines, and some blood pressure medications -- may dry the mouth out, he says.

"You have to get to the bacterial source and turn it off," he says. Try tongue rakes that gently scrape bacteria off the tongue, he says, and clean between the teeth with floss.

Daniel Lippiner, DDS, a periodontist and halitosis specialist in Manhattan, agrees that the first step toward treating bad breath is to isolate the cause.

"Treatment is dependent on what's found and what the reasons are," he says, "If the cause is gum disease then we treat the gum disease -- if it's caused by calcium deposits on the tonsils that are bad smelling, we can remove them from the folds of the tonsils."