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By Kasmiah Mustapha
IMAGINE these parting words from your ex-boyfriend: "And by the way, your breath smells." If the break-up was not depressing enough, realising you have bad breath will certainly have you down in the dumps.
Surprisingly, many who suffer from bad breath or halitosis are unaware that they have this condition. And those who do, however, do not know how to treat it.
According to Dr Geoffrey Speiser, a dentist and halitosis expert, professional help should be sought as cleaning the mouth by simply using mouthwash or brushing your teeth will not work in treating the condition.
"Even professionals who suffer from this condition do not realise that they have bad breath. The woman who was told that she has bad breath by the ex-boyfriend is actually a dentist. But she never realised it as no one had told her."
Speiser says that bad breath is caused by bacteria in the mouth, as well as lifestyle and personal hygiene issues. Each factor has to be addressed differently, including changing one's lifestyle and type of bacteria inhabiting the mouth.
"Since people are not sure how to treat the condition, they simply resort to using mouthwash or changing their toothpaste. Actually, there is no one particular product that can fix bad breath. If you do not suffer from chronic bad breath, mouthwash is fine, but it will not work for those with a more serious problem.
"They need professional help. We have to reduce the amount of protein in the mouth, discourage a high acid diet or prevent a dry mouth."
Dr Speiser, who runs a breath clinic in Sydney, Australia, says there is a machine that is able to detect the different smells. With it, the doctor will be able to gauge the strength of the smell, determine its causes and find out where in the mouth the bacteria is existing.
"Then we can target the treatment. If we clean the protein from the tongue and the gum, teeth and back of the throat, then obviously we remove a lot of food source and bacteria that cause the smell.
There are two types of bacteria that live in the mouth. One thrives on oxygen while the other can live without it. The latter can flourish if you do not clean your teeth, or if you have a high acid or dry mouth condition.
Studies have found that one in four will have chronic bad breath and as you get older, the condition will worsen if left untreated.
"As you get older, your saliva flow starts to slow. Saliva is the mouth's natural defence mechanism against bacteria and if you continue to have a dry mouth, you will have chronic bad breath."
To determine if the person has chronic bad breath, they will be tested using the "smell line". If their breath is above the three main smell categories, they have it. The three smells are methyl mercaptan, hydrogen sulphide and dimethyl sulphide.
Methyl mercaptan smells like faeces, hydrogen sulphide smells like rotten eggs and dimethyl sulphide is the smell of cabbage, sulphur and gasoline put together. If your breath is above these three, then it does not matter if you clean your teeth, tongue or use mouthwash as the smell will never go away, said Dr Speiser.
Treatments include an intense cleaning programme for five days to remove the bacteria and protein directly from the mouth, tongue and back of the throat.
The patient also needs to change his or her lifestyle and lower protein intake and ensure he or she does not have a high acid or dry mouth condition.
"Halitosis sufferers need to change their lifestyles and start taking probiotics. They also need to avoid dairy products, egg yolks, soft drinks, coffee, snacking and smoking. People do not realise that every time they eat, they create an acidic condition in the mouth. And acid stimulates bacterial growth.
"So does snacking. My advice is that you never skip breakfast, lunch and dinner. After each meal, wash your mouth with a glass of water and chew sugarless gum for five minutes to increase saliva."
Meanwhile, Dr Roland Chia, who has set up a breath centre in Kota Kinabalu, believes that many Malaysians are unaware of the causes of and treatments for bad breath.
"People know about bad breath but they just do not know where to seek treatment.
"There is a way to measure bad breath, and treat and manage it. One cause for bad breath is gum disease and in Malaysia, this is on the rise."
Those who are on long-term medication can also suffer from bad breath, especially those taking medication for blood pressure, allergies and sinuses, indigestion and heartburn. Antidepressants, sedatives and relaxants can also contribute towards halitosis.
This story was first published in the New Straits Times on Feb 9, 2009.
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