Halitosis From Dry Mouth
The patient (a 45 year old female) attended our Edgecliff Clinic complaining of constant bad breath and sour taste. They said the halitosis was sporadic and was therefore causing them stress as they could not identify the reason. The patient said they cleaned their teeth diligently. However they do not tongue clean as they tend to "gag" and found tongue cleaning uncomfortable. They were not concerned about particular toothpastes and tended to buy whatever was on sale when they went shopping.
Breath Consultation
We took a sample of mouth air and placed it into our Oral Chroma diagnostic device. This is a gas chromagraph machine calibrated to specifically detect the gases of Halitosis (lower than what can be detected by the human nose). Within 4 minutes we received the graphical readout below. On the graph the readings cannot be above the yellow line of 112, 26, 20 (we call this the "Smell Threshold Line"). As you can see the first reading is actually 119, so slightly above the acceptable limit of 112. This reading is not offensive and would only be smelt by someone who was very close to them (in their personal space). So it could become offensive if a loved one was next to them or was kissing them.
The first reading measures Hydrogen Sulphide (rotten egg gas). This occurs when you have a biofilm (sludge of dead cells, mucous and saliva) remaining on the tongue surface and always shows in people who do not tongue clean.
We then ask the patient to think of something stressful. The purpose of this exercise is to dry their saliva up. Saliva is nature's means of protecting us from Halitosis. We then took a second reading as per the image below.
As you can see the first and second gases quadrupled in volume. Making this now a case of embarrassing bad breath. With these numbers the person would definitely offend any person they would be near.
Why Did The Readings Change So Quickly
Biofilm on the tongue (dead cells, mucous, saliva, food particles, plaque) build up and mature over a time period of 12 hours. Normal healthy bacteria that live in our mouth and throat, then break down the proteins in this mature biofilm for body energy. The waste products from this energy conversion smell of different sulphur compounds. (Hydrogen sulphide = rotten eggs, Methyl mercaptan = faeces, Dimethyl sulphide = rotten garbage).
The waste products are volatile and quickly will absorb into your saliva. At this stage they are not a gas and cannot smell. However you can taste them. And often we see patients complaining of bad taste and not necessarily bad breath.
If your saliva dries up (as it does under stress), then the gases will instantly evaporate into the mouth and be pushed out with lung air as we speak. This is the bad breath model.
What Causes Dry Mouth
Obviously stress is the number one cause. And because bad breath can be so dynamic (as you see from the readings above) people who suspect they have an issue often create the issue by the added stress. Other causes are medications, age, health issues, autoimmune diseases, and recreational drugs.
What Treatment Did We Recommend
We recommended the KForce Starter Kit with the added Bad Taste Kit This kit lasts approximately one month. Long enough to resolve the issues and get everything under control. The kit also teaches you how to properly clean all parts of your mouth and throat so you do not get this biofilm collection happening again. We also recommend that patients continue on with the refill kits to keep everything under control. These refill kits are usually posted every few months by our subscription service. Cost wise it is about the same as a daily cup of coffee. So well worth it for fresh breath, mouth health and confidence people can see.
Conclusion
If you have any questions about your particular case, we would be happy to talk to you. Please book in for a Free Phone consultation and we can discuss your personal needs.
Dr Geoffrey Speiser