Source 13

So I looked at another dental article today dealing with bad breathe. The article addressed quite a bit about oral malodor which I thought was interesting because it is something that we all deal with wherever we are.

Oral malodor is a common problem among general population and evidences reveal that it forms about 85% of all bad breath. Bad breath can have a distressing effect that may become a social handicap and the affected person may avoid socializing. Volatile sulphur compounds (VSC), namely hydrogen sulphide (H2S) and methyl mercaptan (CH3SH) are the main cause of oral malodor. These substances are by-products of the action of bacteria on proteins. Treatments corresponding to the causes of oral malodor include mechanical or chemical tongue cleaning, periodontal disease treatment, oral hygiene instruction and mouth rinses or mouthwashes.

Bad breath is usually caused by bacteria that live in person's mouth. Bacteria, just like humans, go through their lives consuming food and excreting waste. The waste products produced by some oral bacteria are sulfur compounds. These odoriferous waste products usually lie at the root of person's bad breath problem. Most of the odoriferous compounds that cause bad breath are waste products created by anaerobic bacteria, as they digest proteins. High protein foods include meat, fish, sea food and eggs; dairy foods such as milk, cheese, yoghurt; cereal grains and products; desserts especially cakes and pies.
The stench associated with rotten eggs is caused by hydrogen sulfide. The stinky smell emanating from feed lots and barnyards is one produced by methyl mercaptan and odor associated with ocean is that of dimethyl sulfide. Each of this is excreted as a waste product by bacteria that live in our mouths. Together dentist refer to them as Volatile Sulfur Compounds (VSC'S). Term volatile simply describes the fact that these compounds evaporate readily even at normal temperatures. The extreme volatility of these compounds explains how they have the ability to offend around us instantly.

Breath smells only when certain aromatic compounds are found dissolved in it. These include methyl mercaptan, hydrogen sulphide, cadaverine, putrescine, skatole and isovaleric acid.
Some of these may be absorbed from the bowel in the bloodstream and then circulated around the body until they are excreted via the lungs in the breath. In the same way garlic rubbed into the soles of feet can later be detected in trace amounts in the breath.
Temporary halitosis: It results from hot/spicy food, certain drinks, alcoholic beverages, coffee and most common from garlic, onion, salty foods, spices, curries, cured foods like salamis and cooked food such as kippers. Tobacco consumption causes mouldy odor and Hyposalivation/ Xerostomia (dry mouth) also leads to bad breath.
Morning breath: Everybody has a degree of halitosis, first thing in the morning. There is a physiological reason for this. During sleep, the flow of saliva is reduced drastically and tongue and cheek move very little. This allows food residues to stagnate in the mouth and dead cells that are normally shed from the surface of tongue and gums and from the inside of cheek to accumulate. As bacteria starts to work on them and digest them, an unpleasant smell is generated. This process is biologically known as putrefaction/rotting.
Although normal, anyone suffering from nasal congestion whose mouth breathes is more likely to suffer from these actions to a greater extent. Luckily, this morning breath generally disappears after breakfast and after brushing the teeth because saliva starts to flow again and any left over residues are washed away and swallowed.
Smoking (cigarettes/cigars): Breath smells like ash tray. Smoking also reduces the flow of saliva and therefore further exacerbates the problem.
Crash dieting/fasting: When the body is no longer supplied with energy giving carbohydrates it first breaks down glucose stored in the muscles and liver in the form of glycogen. But this does not last long. After a few hours, the body begins to breakdown its fat stores and the waste product of their metabolism, ketones, endows the breath with a distinctive sweet and sickly smell. This can be seen in those who has vigorously worked out and exercised and not taken sufficient carbohydrates before or after. People on a strict caveman or high protein diet experience the same effect for similar reasons.

Other Waste Products:
Cadaverine: Smell associated with corpses
Putrescine: Produced by decaying meat;
Skatole: Human faecal matter;
Isovaleric acid: Sweaty feet.

The above wonderful mixture of compounds emanates from mouth of human and no one is exception. Everyone has some level of these unpleasant compounds in their breath. Fortunately however, low levels of these compounds cannot be detected by human nose. It is only when the levels become elevated, others nose can detect them.
Bad breath is caused by waste products of anaerobic oral bacteria (more specifically gram negative anaerobic bacteria e.g.: prevotella intermedia, porphyromonas gingivalis etc.). Term anaerobic describes that they best grow in environments devoid of oxygen. Person's mouth is a home for hundreds of different species of bacteria and on going in our mouth is a constant battle for living space between type of bacteria which do create waste products that causes bad breath and those that don't and it's the precise balance between the relative number of these type of bacteria that determine the quality of person's breath.
Plaque accumulation (the whitish film that is formed above and below gum line and also on tongue) can tip the scales in favor of odor causing bacteria. A layer of plaque as thin as 0.1-0.2 mm becomes depleted to oxygen, precisely in which anaerobic bacteria flourish. So, as more and more plaque builds up, bacteria causing bad breath gain available living space and proliferate, thus increasing the level of odor.
A correlation has been found between VSC concentration in mouth air and increased pocket depth in periodontitis patients. The uptake of volatile sulphurs by epithelial cells may play an important role in the pathogenesis of periodontal disease: it has been proposed that volatile sulphurs may alter the permeability of affected cells and facilitate the access of toxic metabolites into the underlying connective tissue thereby contributing to collagen degradation. There is also general agreement that the VSC content of exhaled mouth air and the concentration of VSC precursors increases with the severity of periodontal disease.

The most important step a person can take towards improving the quality of breath is to clean their mouth in a manner which helps to minimize the amount of food available for anaerobic bacteria, minimize the total number of these bacteria that exist, minimize the availability of type of environment in which these bacteria prefer to live, make any environment in which these bacteria do live less hospitable. On a second front, a person can use products that neutralize the odor causing volatile sulfur compounds.

Minimizing the food supply for bacteria that causes bad breath

When anaerobic bacteria digest proteins, volatile sulfur compounds are created as waste products that cause bad breath. The person who maintains a vegetarian diet mostly of fruits and vegetable has fewer chronic breath problems than those who consume protein rich food such as meat.It is important for a person to clean one's mouth thoroughly especially after eating protein rich food. This is because even after we have finished a meal minute particles of food still remain in our mouth. Much of this food debris ends up lodged between our teeth and incorporated into the coating found on the posterior part of our tongue. Since these are precisely the same locations in which the anaerobic bacteria that cause bad breath live, if a person does not clean their mouth thoroughly a food supply is provided for these bacteria over an extended period of time.

Can breath mints, lozenges, drops, sprays, and chewing gum help to cure bad breath?
These products when used alone are not as effective as when used in conjunction with tongue cleanser, toothbrushes and flossing, especially when they contain agents that have the ability to neutralize VSC's. As an added benefit, the use of mints, lozenges and chewing gums will stimulate the flow of saliva in person's mouth and saliva has cleansing and diluting effect on the bacteria and bacterial waste products that are found in person's mouth and therefore, helps to minimize person's problems.

This article was interesting because it gave a lot of information for how bad breath occurs and what can cure it. It was interesting because it talked about how hot and spicy foods and curries cause temporary bad breath. I know these two things are prevalent in India. I am curious if people over there consider bad breathe to be a big problem or if they don't even mind. If these foods are known for causing bad breathe, it would seem that many people over there would have bad breathe, especially since they don't practice the same hygiene habits. If they clean their teeth through alternative methods, I am curious if they also have a way to clean their tongue since much of the bad breathe smell comes from the posterior part of it.