By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

TREATMENT OF CO-WORKER’S BAD BREATH WOULD DEPEND ON CAUSE

Question: Here is a problem that a lot of people have, but they often don’t know they have it or what to do about it. I’m talking about Halitosis! I work with a person who has it so bad you have to get across the room to avoid it. What can be done to help this problem, and how can we let people know without embarrassing them or ourselves?

Answer: I really can’t answer your last question -- that would best be handled by a personal advice or manners columnist, but I can tell you some things that might be going on with your co-worker. For convenience sake, I’ll address this question as though you are the one with the problem. You can take it from there.

Bad breath, or halitosis, is very common, but usually it’s only an occasional and temporary problem. A typical scenario is going out to lunch and eating a meal with a lot of onions, garlic or other pungent foods. In these situations using a mouthwash or brushing your teeth might help some, but the smell will probably keep coming back until enough time has passed. This is because oils from these foods get into your blood and the “smelly air” comes from your lungs -- not your mouth.

On the other hand, chronic bad breath can be caused by a number of things. The primary cause is bacterial overgrowth in the mouth due dental problems and/or poor dental hygiene. It is easy for this overgrowth to occur because the warm, dark, and moist environment in your mouth provides an ideal environment for bacteria to flourish. The bad breath is cause by foul-smelling chemicals these bacteria produce.

The remedy for this kind of halitosis can start with a visit to your dentist. He or she can inspect your mouth for gum disease, teeth problems and denture issues that might be causing your problem. You’ll also be instructed in good dental hygiene techniques. These will include brushing your teeth every morning, after every meal, and each night before you go to bed. Daily flossing is also advisable, and perhaps the use of a water pic. You may also be told to brush your tongue daily. Tongue brushing does not need to be vigorous but just enough to clean your tongue. If you wear dentures, you might ask your dentist for additional instruction on how to clean them.

Sometimes bad breath is caused by a dry mouth. This can be from medications, dentures or smoking. Drinking more water can help this problem. Sucking on sugar-free hard candy can also increase saliva production.

Medical conditions such as lung disease, kidney disorders and liver failure can also cause bad breath. Chronic acid reflux and uncontrolled diabetes are also illnesses that can cause halitosis. These problems should be diagnosed and treated to get rid of the bad breath.

An often overlooked cause of bad breath is fad dieting. Severely restricting carbohydrates, for instance, causes your body to produce ketones. When these move through the blood stream to the lungs they can be exhaled and produce what’s been described as “rotten apple breath.”

Treatment for halitosis is aimed at the underlying cause. Go to the dentist, improve your brushing and flossing and drink more water. These things alone can improve your breath. Avoid offending foods, and discuss your medications with your physician to see if they are the cause of your problem. Get any medical conditions you have under control.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.