Part of my job involves socialising with clients, and I am anxious about and embarrassed by my bad breath. I smoke about 10 cigarettes a day but am an otherwise healthy 55-year-old man. What is likely to be causing my problem and what treatments are available?
Conventional remedy
Bad breath or, to give it its proper name, halitosis, is commonly caused by dental problems such as tooth decay or food trapped between the teeth. Likewise, food can become trapped under dentures, causing an unpleasant smell.
Other dental problems, such as gingivitis - inflammation of the gums - can contribute to the problem. Plaque build-up on the teeth can also cause halitosis.
Your first port of call should be your dentist, for a check-up; he will be able to advise you on a course of treatment if he finds that dental problems are the cause.
There are other medical conditions that can cause halitosis. These include tonsillitis, sinus infections, lung disease, diabetes and liver or kidney disease. Some medications can give rise to bad breath, and smoking does not help. Anxiety and stress also seem to exacerbate the problem.
Although halitosis is rarely a serious problem, it can affect your personal and social life. If a visit to your dentist does not reveal the cause of the problem, you should visit your family doctor, to rule out any treatable or potentially serious medical cause.
At a practical level, you can help the problem by cleaning your teeth and mouth regularly with a toothbrush and dental floss, to remove tiny particles of food and plaque. Rinsing your mouth after meals, gargling with an antiseptic mouthwash and gently brushing the back of the tongue with a soft toothbrush will help.
In general, eat a healthy diet and avoid strong-smelling foods such as onions, peppers, garlic and spicy foods. Do not eat strong cheeses and cut back on alcohol consumption. Your GP will help you give up smoking - it is not helping the problem. Cut back on coffee consumption and avoid fasting for long periods during the day. The problem should improve with these measures.
Dr Muiris Houston
Alternative remedy
Halitosis, or bad breath, is a fairly common problem. It is not a condition in itself, however, but a symptom of other possible problems. To try to find its source, you need first to check your oral health and hygiene. A visit to the dentist will identify any build-up of plaque, cavities and food lodged between teeth.
Remember to clean the tongue when brushing teeth. You can also buy a proprietary tongue cleaner from health-food shops or pharmacies.
These can then be eliminated as sources, but if the problem persists you may need to investigate further, by looking at the diet and the overall digestive and eliminatory systems.
Tea, coffee, cigarettes, alcohol and strong food may contribute to bad breath. These need to be identified and eliminated as possible problems. Aside from the immediate effect they have on the breath, they may also cause other problems, a symptom of which may be bad breath.
If throat or mouth infections have also been eliminated, then the most likely cause is poor digestion, particularly of animal proteins and fats, or poor elimination.
Low stomach acids may also be a problem. If so, you need to reduce animal fats and proteins as much as possible. Have fish, chicken, turkey and pulses instead. Eat lots of fresh fruit and vegetables and ensure you are well hydrated. A fruit and vegetable fast for three to five days may help speed up the eliminatory system and improve digestion.
Only undertake fasting when healthy or under the supervision of a qualified nutritional therapist.
Chewing raw foods such as carrots, celery sticks or parsley may help. You may also consider foods that encourage a healthy intestinal environment, such as acidophilus, sauerkraut and fibre, and avoid sweet foods and refined carbohydrates.
The CoQ10, vitamin C and B complex supplements may also be of benefit. CoQ10 is good for gum conditions and vitamin C may help repair damaged tissue; B complex may help with digestive problems.
Rinsing the mouth with peppermint tea, eucalyptus, sage or fennel can provide temporary relief. Nettle tea or juice may help with kidney elimination; dandelion tea or juice may help with a sluggish liver.
Using tissue salts could also help - Nat Phos, for example, if the breath is overly sour and acidic; Nat Sulph if there is a bitter taste in the mouth and the tongue is coated yellow. Kali Phos may help if the mouth is dry, especially due to nervous tension or anxiety.
Maria Costello
Maria Costello is a Limerick-based nutritional therapist and a member of the British Association of Nutritional Therapists (00-44-870-6061284)
The advice in this column is not intended as a substitute for advice received directly from a medical doctor or alternative practitioner. Individuals should receive a thorough diagnosis of complaints before embarking on a course of treatment