For most, bad breath isn’t something that particularly worries or concerns us. We may notice that our mouths occasionally feel a little stale in the morning and we might be aware that our breath isn’t quite at its best after eating a spicy meal. For the majority of the population, these occasions are transient and are easily dealt with by our normal oral hygiene routines. For some people though, bad breath is more than merely a passing concern, it is an on-going problem and one which causes much anguish and plays havoc with their everyday lives.
The smelling experience is intimate, emotionally charged and connects us with the world. Just think of the pleasure we derive from the smell of freshly baked bread. A particular perfume can evoke intense memories. The flip side is also true. We all know how it feels to stand in close proximity to a person with body odour on a crowded bus or train. Given such negative reactions it is easy to understand why the odour of bad breath might disconnect a person from their social environment and intimate relationships.
How one experiences one’s own body is very personal and private, but also very public. Breath odour is both public, as it occurs within a social and cultural context, and also personal as it affects one’s body image and self‐confidence. Body image, self‐image and social relations mesh, interact and impact upon each other. Having worked with patients concerned about bad breath for over twenty years I know that more than 75% of them report decreased self‐confidence and insecurity in social and intimate situations.
The Good news
The good news is that for the vast majority of sufferers treatment is both straightforward and inexpensive. The key is correct diagnosis, the first step being to determine if the patient does indeed have bad breath. The simple fact of the matter is that as individuals, it is extremely difficult to know whether we have it or not. I’m sure most of us have, at some point licked our wrists or breathed into cupped hands in the hope can work out the state of our breath. This rarely works though and it takes a second person to establish the truth, a visit to your dentist is the best course of action.
The upshot of all of this is that most patients present with at best a notion that they may have bad breath, at worst they simply don’t know and may have spent many years living an unfulfilled life. So, when I meet a concerned patient for the first time I ask how does he/she know they have bad breath? The second question I ask is the impact their bad breath (albeit real or perceived) has on their daily lives. The answers can be quite saddening and include a lack of confidence, inability to form relationships, crippled social lives and career choices based on an unwillingness to come into contact with others.
I always smell a patient’s breath, there is no need to feel embarrassed but patients often feel a little uncomfortable with this so I also have my secret weapon, a machine called a Halimeter which draws air from the patient’s mouth through a straw and provides a readout of the volatile sulphur compounds in the mouth that lead to bad breath. These two approaches provide both a subjective and an objective measure of the patient’s breath. They are combined with a full oral examination and a treatment plan drawn up to tackle the problem. In the vast majority of patients the problem arises within the mouth and unlike popular opinion, does not come from the stomach or other systemic causes. This is not to say that there are no systemic cause of bad breath, merely that the mouth is the source of most bad breath by a very long way.
Treatment will usually comprise a tailored oral hygiene programme (including the use of specialist mouthwashes) with particular attention to susceptible areas such as the tongue and in between the teeth.
I am happy to write that in all the years I have been working in this field I have enjoyed a very high success rate. The most rewarding aspect is seeing patients liberated from the social tyranny of bad breath. So if you are worried about your breath, then don’t let embarrassment prevent you from speaking to your dentist. That conversation could literally transform your life.
Dr Philip Newsome graduated with Honours from Leeds University Dental School in 1976. After five years in general practice, he returned to Leeds as a Lecturer in Conservative Dentistry. In 1986, he left the UK to take up a position at the Faculty of Dentistry at The University of Hong Kong remaining there for more than twenty years becoming Professor in the process. Dr Newsome holds the Fellowship in Dental Surgery and Membership in Restorative Dentistry from the Royal College of Surgeons of Edinburgh as well as an MBA from the University of Warwick Business School, and a PhD from The University of Bradford Management Centre. He is also on the Specialist Prosthodontist Registers of both Hong Kong and UK. His clinical speciality is the use of modern techniques and materials to restore damaged or unsightly teeth and has lectured and published widely on this subject.