Getting rid of bad breath

According to World Health Organsiation, oral health is a key indicator of overall wellbeing and quality of life. Brenda Mugisha who owns a salon almost lost customers because some of her workers’ bad breath.
Mugisha says her regular clients started complaining saying they could not tolerate the bad breath from the workers any more.
“A client told me that the workers talk too much and yet their breath is horrible. She said I had to do something or lose her as a customer,” Mugisha recounts.

Dr Maria Gorretti Nakyonyi a dental surgeon at Jubilee Dental says many people with bad breathe are usually oblivious of their condition. It is those with whom they interact who usually notice.
“Bad breath from a patient can even be smelt through the face mask that dentists wear,” she says.
Dr Ayub Twaha, the president of Uganda Dental Association, reveals that bad breath is normally a indicator of an underlyingproblem. Dr Nakyonyi agrees adding that most cases of bad breath are due to poor oral hygiene and gum disease.

Poor teeth brushing habits
Poor teeth brushing habits such as not brushing the tongue is one of the most common causes of bad breath.
Improper brushing causes food debris to stay in the mouth making it a nidus (a place in which bacteria have multiplied or may multiply) of bacteria.
It is that rotting food and bacterial waste that cause bad breath. It is important to learn the right and proper way of brushing teeth. It’s equally important that the tongue is never forgotten when cleaning.
“Poor brushing damages your gums and leads to gum disease which is also associated with bad breath as these gum defects create areas of food retention.
This is why it is important to brush atleast twice a day; in the morning, after breakfast and in the evening after dinner,” Dr Nakyonyi advises.

When brushing teeth, it is important to ensure that all food particles are removed. This can be done by flossing.
Dental floss is a cord of thin filaments used to remove food and dental plaque from between teeth in areas a toothbrush is unable to reach.
Dental cavities

These are small holes in teeth that can retain food. The food rots as the bacteria that feed on it also produces foul smelling compounds, hence the bad breathe.
Dental cavities can be filled or treated according to how deep they are. Badly broken teeth/ roots of teeth can equally be removed from your mouth to avoid food retention, according to Dr Nakyonyi.
Paying your dentist a visit for routine check up to rule out any intraoral cause of bad breath is key.

Food
According to Dr Twaha the breakdown of food particles in and around your teeth can increase bacteria and cause a foul odour.
“All foods whose breakdown produces sulphur and ammonium compounds can cause bad breathe for example eggs, meat, onions, spices, dairy products such as milk etc,” says Dr Nakyonyi.

Dry mouth
This is a medical condition known as xerostomia. This too can cause bad breath. Dr Nakyonyi articulates that a dry mouth which is caused by reduced saliva production sees the mouth not receiving its ‘bathe’ as the saliva is comprised of its innate ability to ‘bathe’ the mouth.
Lack of saliva could be as a result of medication and frequent use of mouth wash that contains alcohol but as well as people who undergo radiotherapy and also having chemotherapy among others.

Foods that stimulate saliva
According to Dr Nakyonyi, people who have an issue of reduced saliva production/ dry mouth should take plenty of water as this performs an artificial role of saliva bathing and lubricating the mouth but could also use Sugar-free gum to stimulate saliva production.
If the cause of dry mouth is medication one is taking, the physician can always weigh risk versus benefit and may opt to change the drug or maintain it and the patient manages side effects such as dry mouth.

Kidney failure Dr Nakyonyi points out that kidney failure could cause bad breathe.
“The Kidney clears waste and toxins from blood. In case of chronic kidney failure, the kidneys role is compromised. So waste builds up in the blood. The ammonia substances in the waste causes bad breathe because eventually, all these gases are emitted through the lungs,” she adds.
Diabetes
When it comes to diabetes, a group of metabolic disorders characterised by high blood sugar levels over a prolonged period has a peculiar smell from high ketone levels (smells like nail polish remover). Sometimes some patients describe it as an alcoholic breathe. This scent usually points to a condition called “diabetic ketoacidosis”

Lungs
Lungs are used for respiratory and exchange of gases, blood goes to the lungs for gaseous exchange. The lungs connect to both the mouth and nose through the oropharynx that is the part of the throat at the back of the mouth behind the oral cavity and nasopharynx, the upper part of the pharynx, connecting with the nasal cavity above the soft palate respectively.
The former connects to the mouth so through breathing and any other respiratory activity, if anything going wrong in the lungs, it will definitely be smelt in the mouth.

Medication
Some medications directly cause bad breath while others cause the mouth to dry up which leads to bad breath.

Remedies
Issues coming from the gum can be addressed through dental cleaning (scaling and polishing) done at the dental clinic. Baking soda has also been proven to be good for the gums. Alcohol free antiseptic mouth rinses can also be used to control disease-causing bacteria but only with a dentist’s prescription. Flavours have been added in some toothpastes to help with the odor like mint flavors. This does not mean that the cause has been solved. Dr Twaha advises that mouth washes can musk or educe bad breathe but understanding and treating the root cause is important.

Brushing the right way
Bad breathe can be aided by poor teeth brushing techniques. Dr Ayub says the right way to brush is by holding the toothbrush like a pen, make small circular rubbing motions and avoid moving the tooth brush from left to right or vice versa, what is termed as horizontal brushing. After brushing the teeth, Dr Twaha says one should use the tongue to check if the teeth are clean. Clean teeth are smooth and the tongue easily glides over them whereas uncleaned teeth feel rough and sticky.
Choosing tooth paste
Dr Twaha says, “Any toothpaste is good but we prefer fluoridated pastes. Be ware of counterfeit. If in doubt as your dentist.”

Does charcoal whiten teeth?
Dr Twaha shares that charcoal can clean teeth and some toothpaste companies add it in toothpaste. Dr Nakyonyi adds that activated charcoal (heated or treated) can clean teeth as well as unactivated charcoal it is known to make teeth whiter however warns that its abrasive effect wears down the outer layer of the teeth (enamel) during progressive use and hence weakens the tooth.

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