Bad Breath - Are you having one?

Bad breath - halitosis, can be quite embarrassing and may also cause anxiety, is something that you would want to treat it as soon as possible. It may be a sign of health problems or can result from poor oral health habits. It's no wonder that pharmacies are overflowing with gum, mints, mouthwashes and other products engineered to combat bad breath. However, do take note that many of these products are only temporary measures because they don't address the root cause of the problem. 

Certain foods, health conditions and habits are among the main causes of bad breath. In many cases, you can reduce the effects of bad breath with consistent proper dental hygiene. If simple self-care techniques don't resolve the problem, you should consider paying a visit your dentist or physician to ensure the condition of your bad breath is not worsening.

"To expect to be kissed having bad breath is the secret of a fool." 

Dejan Stojanovic

How can I tell if I have bad breath?

Good To Know: Finding out or evaluating your own breath can be challenging

Due to the fact that our bodies are built and structured in a way that makes it difficult for anyone, by themselves, smell and judge if they are having Halitosis, it is hence 

 1. Simple Smell Self-Test - Wrist

Cotton Ball

There are various signs that you may observe if you suspect that you are having a bad breath. Try to observe on people who talks to you and step away when you start to speak may help in finding out. Perhaps being turned away when you try to give a goodbye kiss? Or if you prefer to be direct, you can always check with your closest friends or relatives if they detect bad breath or smell from your mouth when talking to you.

If you do, however, suspect you might have bad breath, there are some simple tests that you can do. Let's start with the first and simplest method that requires no other equipment, which is through a simple smell test of your saliva. 

Quick Tip: Just lick the inside of your wrist and sniff - if the smell is bad, you can be fairly certain that your breath is too.

Some of the easier ways you can try checking bad breath for yourself at home:

• Lick around the area at the back of your hand, let the saliva dry off and then have a smell at the saliva.
• Floss your back teeth and smell the floss.
• Try using a clean cotton ball to wipe the coating on your tongue and then smell it. 
• Scraping the back of your tongue with a clean spoon and smelling the saliva and/or coating it removes can help you detect odorous breath too.

When you decide to seek help for your bad breath, your first point of call should be a dentist who treats bad breath.

2. Simple Self-test with Spoon
 

​The 2nd simple self test will also involve saliva, but from another part of the tongue and requires the help of a spoon. For method 1 above, you lick your wrist with the Anterior tongue. For this method, it will be using the saliva for odor checking from the Posterior tongue.

Usually this part of the tongue is not as self-cleansing and also the region of the mouth where the breath odors are coming from.

• Get a silver spoon. Clean and rinse with clear water for this test.
• Turn it upside down.
• Position it at the very back of your tongue and start drawing it forward to scrap some of the saliva gently.
• Collect these samples of saliva for visual and smell check

Visual - Color Checking

• ​Observe the gunk/saliva scraped off from the posterior part of the tongue 
• The darker the color and the thicker these sticky substances, more likely you are having or to discover breath odor

Smell

​Finally, go ahead and smell it to see if it really makes a bad breath?

Most of the common causes of halitosis is the build-up and accumulation of debris near the posterior tongue area.

3. Other types of simple tests 

Aside from the above, you can also make use of Gauze and Plastic Bags (airbag concept) to have a quick check on bad breath.

a) The Gauze Test

• ​Prepare a 2 by 2 medical non-stick gauze which is easily available from pharmacy. 
• Open your mouth wide and stick your tongue out. 
• Using the gauze and starting from the back/rear region of the tongue, scrap the saliva/substances on the tongue from back moving forward. 
• Once this is done, proceed again for the visual and smell test of the gunk you have wiped off.
• If the color is dark and smell is unpleasant, that's where you know most likely you are having a bad breath.

• ​Another simpler method is to get an odorless plastic bag and exhale your breath into it.
• You would hope to collect the breath from your mouth and do a smell test on it. 
• However, in practice, one difficulty involved in this is to find a truly odorless bag.

c) Dental Floss

• Prepare a new dental floss
• ​Use the floss and floss subgingivally, which is to let the floss slide below the gum line as you clean.
• Try to reach out to floss more of the teeth at the back of your mouth
• Do a quick smell test on the floss for quick checking

Are there other scientific ways to approach this? 

The following methods are more technical and require more advanced devices that are targeted to identify specific compounds, types of bacteria which are usually related to the cause of bad breath or halitosis cases.

Not everyone will require these methods and usually the 3 self-testing methods are enough to judge. However, it is always wise to obtain the dentist's advice to proceed if there are any other serious conditions to be tackled.

4.  Organoleptic Testing

This is a technique whereby it is a smelling test conducted by professional testers. 

Wait, isnt there supposed to be a more "scientific" way for this section? Yes, it is. We do think that it is worth mentioning it here as it is one of the oldest method to detect bad breath in the industry. 

The nose can pick up on 10,000 various smells, but there can be some problems with this form of testing. This method is not always completely objective, and other factors besides odors can impact the testing, such as menstrual cycle, hunger, head position, consumption of coffee, tea, alcohol, or juice, etc.

Do note that as there is no machine-level precision involved in this testing method, considerations such as bias from the tester may occur. On the other hand, the subject of the test may incur factors that ultimately affect the end results of the test, for e.g. consumption of garlic, onions and spicy food, scented oil and cosmetics, drinks or tobacco and other

5.  Sulfide Monitoring - Halimeter

​Among the common causes for bad breath is Volatile Sulfur Compounds (VSCs) which carries smell like rotten eggs or dead fishes. Halimeter (first introduced in 1991) is an instrument engineered to calculate the level of VSCs in your breath, which will then assist in determining the condition of bad breath. 

(Sulfides, such as hydrogen sulfide and methyl mercaptan (collectively referred to as volatile sulfur compounds or "VSC's"), are known to be causative agents of halitosis.)

Cons

• These machines test for sulfides as a class and not individual compounds which compared to gas chromatograph providing a breakdown of both the compounds present and their concentration levels.
• Ethanol or rather drinking alcohol, essential oils which are often found in mouthwash can interfere with the results of this machine

Pros

• No special training required for the use of this machine.
• Portable and relatively light.
• Quick results and machine is relatively inexpensive. This is useful for dentist to add to their equipment list in dental clinics.​

6. Gas Chromatography

This is a scientific apparatus which is able to identify and measure compounds in test samples gathered from your tongue and saliva samples. This method is acknowledged to be reliable as the results are rather objective, reproducible and reliable. However,  as it is relatively expensive, non-portable, require special training to operate and takes a significant amount of time to take each measurement, it is seldom for any dentist to pursue with this method. 

7. Chemical Sensors 

Simple and inexpensive sensors have now been developed to assist in improving sensitivity and provide greater convenience for Dentists to test on Halitosis.

It acts as a probe that take readings from both the surface of the tongue and below the gum line (these are the 2 areas which are most associated with halitosis)

Newer types of sensors can measure multiple types of sulfur-containing compounds separately (an improvement over Halimeter technology).

8. The BANA Test 

The BANA test (referring to the enzymaticbreakdown of [N-benzoyl-dL-arginine-2-napthylamide]), is a way dentist can check for the presence of these type of bacteria through the samples extracted from patient's saliva, plaque or a tongue swab.

The type of bacteria will produce an enzyme that degrades the compound benzoyl-D, L-arginine-naphthylamide (abbreviated BANA) whereby when this occurs, it will create a color change in the BANA test strip.