Foul breath—also known as halitosis—is an unpleasant condition that affects almost everyone. Because it is so widespread, determining and subsequently diagnosing each individual patient can be difficult. And it gets even harder because patients really can’t smell their own bad breath. But strong-nosed scientists have been discerning the truth bit by bit: there is now hope for those hoping to remedy their morning dragon’s breath.
Originally many believed that malodors originated in the stomach and blamed things like acid reflux, indigestion and gut flora. But what people are beginning to see is that in most cases of halitosis, the mouth is to blame. Halitosis originates from bacteria on the tongue, a condition known as tongue coating. The byproducts are largely responsible for bad breath in patients. They produce what are known as volatile sulfur compounds (VSCs) such as hydrogen sulfide and methyl mercaptan. In order to then treat halitosis, efforts have focused on developing products that will either reduce these odiferous bacteria or neutralize the VSCs themselves.
The main form of treatment against halitosis is to simply brush the tongue to remove built-up bacteria. When halitosis persists, patients instead try to stop the creation of VSCs. By neutralizing the VSCs, the malodor does not volatilize, and the mouth does not stink. Some of the most successful neutralizing compounds have been zinc salts, chlorhexidine and hydrogen peroxide. Chlorhexidine can result in stained teeth, tongue numbness and burning; on the other hand, hydrogen peroxide can be highly oxidative and damaging to soft tissues. Zinc seems the best breath-fighting agent out there.
Zinc ions have a very high affinity for sulphur and can therefore inhibit the formation of stinky sulphur compounds by reacting with them before they leave the mouth. Zinc is also non-toxic and does not stain teeth, making it an ideal candidate to treat bad breath. While protocols to measure the efficacy of bad breath levels vary, the best measure of a persons’ breath is when the human nose smells it. And generally, these smell-tests result in accurate and reproducible results. When put to the schnoz studies show that mouthwashes, lozenges, and gums containing zinc in 0.2-0.5% are the most pleasant and effective in treating halitosis. It should not be used alone, however. A careful combination of good dental hygiene, eating plenty of fruits and vegetables, and drinking plenty of water will help minimize the smell.