 |
 |
|
|
|
|
|
DESCRIPTION
Halitosis, also known as "bad breath or oral malodor", is a common disorder with more than 90 million Americans suffering from it. It can be embarrassing for those people who are experiencing it. Most adults probably suffer from bad breath occasionally, with perhaps about 25 percent suffering on a regular basis.
Bad breath could be a sign of a health problem and is typically caused by poor dental hygiene and the activity of bacteria in the mouth. However, other factors may be involved, including gum disease, tooth decay, heavy metal buildup, infection of the respiratory tract such as sinus infection, nose or throat infection, infection of the windpipe, improper diet, gastric problems, constipation, smoking, fever, diabetes, foreign bacteria in the mouth, indigestion, inadequate protein digestion, liver or kidney malfunction, postnasal drip, stress, and too much unfriendly bacteria in the colon. Halitosis can also be caused by a buildup of toxins in the gastrointestinal tract, salivary gland disorders, chronic bronchitis, sinusitis, or diabetes. Dieting, alcohol abuse, or fasting can cause bad breath as well. "Morning breath" results from dehydration and a reduction in the amount of saliva, which is needed to wash away bacteria in the mouth. Dieters and people who are fasting may experience bad breath because the lack of food causes the body to break down stored fat and protein for fuel; metabolic wastes resulting from that process have an unpleasant odor as the are exhaled from the lungs.
In the past, bad breath was often considered to be an incurable affliction. However, in recent years it has become increasingly evident that bad breath is usually treatable once a proper diagnosis is made.
The main problem is knowing whether we have it or not, because we are poor judges of our own breath odor. Some people suffer from bad breath without knowing it, while others build up exaggerated fears about breath odor even though they do not have it. The best way to find out whether we have bad breath is to ask for someone else's opinion. If we don't ask, other people are unlikely to tell us. And since bad breath can sometimes - fortunately rarely - be a sign of a significant general health problem, we should not be reluctant to tell people dear to us that they have a bad breath problem.
FREQUENT SIGNS & SYMPTOMS
Some people who come to dental and medical clinics claim that they can smell their own breath. They do this in a variety of ways some ingenious. The most common thing to do is just to cover your mouth and nose with your hands and take a deep whiff. Some people are able to detect odor in this manner. An easier thing to do is to lick your wrist. Some people smell their odor on the telephone receiver after a conversation. Others rub their gums with their finger and smell it. One woman claimed to be able to smell her own bad breath by covering her head with a blanket.
The problem with all these techniques is getting an objective viewpoint of the odor coming out. In a recent study, 52 people were asked to smell their own bad breath and score it on a scale. In general, the results showed that people were unable to score their own bad breath in an objective fashion. This is probably because we all have a certain preconception of how bad our breath smells, and when we come to score what we smell, we are heavily influenced by our mindset, regardless of how bad the smell actually is.
Several years ago, a Japanese company came out with a little bad breath detector that looks like a small powder box, mirror and all. But when you open it, there are little buttons and lights that go on and off. You blow over a small grid, and within several seconds it gives you a score. However, there is a serious question as to whether these small instruments are at all accurate.
Most people have bad breath at one time or another. The best way to find out if your have it on a regular basis, is to ask someone close to you. Provided that they love you, and that they have a sense of smell, family members will find a way of telling you the truth. You can also ask a very close friend.
CAUSES
Though there may never be an easy way to tell someone they've got bad breath, there are better ways to diagnose and treat the condition today than ever before. Today, dentists are much more capable when it comes to treating bad breath since about 75% of bad breath stems from the mouth. It is caused when decay and debris produce sulfur compounds that cause foul odor and gum disease.
This is a summary of different odor-related problems and their possible causes:
PROBLEM
POSSIBLE CAUSE OR SOURCE OF MALADOR
Odor after fasting, dieting, sleeping, taking medications, prolonged speaking, exercise.
Dryness in the mouth, insufficient saliva flow.
Gums bleed and/or smell.
Gum problems, poor cleaning between teeth.
Odor upon talking.
Postnasal drip on back of tongue.
Odor at onset of menstrual cycle.
Swelling of gums.
Small whitish stones with foul odor appear on tongue.
Tonsilloliths from crypts in tonsils.
Odor appears suddenly from mouth of young children.
Onset of throat infection.
Odor appears suddenly from nose of young children.
Foreign body placed in nose.
Odor appears suddenly from entire body of young children.
Foreign body placed in nose.
Taste or smell of rotten fish.
Trimethylaminuria (rare).
Odor in denture wearers.
Dentures kept in mouth at night or not cleaned properly.
Odor from nose.
Sinusitis, polyps, dryness, foreign body, hindered air or mucus flow.
Bad taste all day long.
Poor oral hygiene, gum disease, excessive bacterial activity on tongue.
Halitosis also known as oral malodor or bad breath can be caused by many localized and systemic disorders. Halitosis caused by normal physiological processes and behaviors is usually transitory.
Non-pathologic halitosis may due to hunger, low levels of salivation during sleep, food debris, prescription drugs, and smoking.
Chronic or pathological halitosis stems from oral or non-oral sources. In addition there appear to be several other metabolic conditions involving enzymatic and transport anomalies (such as Trimethylaminuria) which lead to systemic production of volatile malodors that manifest themselves as halitosis and/or altered chemoreception. Some of the oral causes are:
- Periodontal disease, gingivitis, and plaque coating on the dorsum of the tongue.
- Halitosis may be aggravated by a reduction in salivary flow.
- Radiation therapy, Sjorgen's Syndrome, some lung conditions, including cancer, peritonsillar abscess, cancer of the pharynx and cryptic tonsils can also contribute to oral malodor.
- Nasal problems such as postnasal drip that falls at the posterior dorsum of the tongue may exacerbate the oral malodor condition. Odor generated in this manner can be easily distinguished from mouth odor by comparing the odor exiting the mouth or nose.
The non-oral causes of halitosis include diabetic ketosis, uremia, gastrointestinal conditions, and irregular bowel movement, hepatic and renal failure and certain types of carcinomas such as leukemia.
The accurate clinical labeling and interpretation of different oral malodors both contribute to the diagnosis and treatment of underlying disease.
7 COMMON SOURCES OF HALITOSIS
1. Mouth & Tongue Sources 2. Nasal, Nasopharyngeal, Sinus, & Oropharyngeal Sources 3. Xerostomia-Induced Oral Malodor 4. Primary Lower Respiratory Tract & Lung sources 5. Systemic Disease-Induced Malodor 6. Gastrointestinal Diseases & Disorders-Induced Malodor 7. Odiferous Ingested Foods, Fluids, & Medications
Taste and smell can be altered due to facial injuries, cosmetic surgery radiation and olfactory epithelium located on the dorsal aspect of the nose.
A relationship between gastrointestinal diseases such as gastritis and oral malodor has not been established. However, oral malodor has been reported in some patients with a history of gastritis, or duodenal and gastric ulcers.
Saliva plays a central role in the formation of oral malodor. Such formation has its basis due to bacterial putrefaction, the degradation of proteins, and the resulting amino acids produced by microorganisms.
Many patients with a chief complaint of oral malodor have some level of gingival and or periodontal pathology sufficient to be the etiology, but clearly periodontal pathology is not a prerequisite for production of oral malodor.
Medications such as antimicrobial agents, anti-rheumatic, anti-hypertensive, antidepressants and analgesics may cause altered taste and xerostomia.
Halitosis in healthy people arises from the oral cavity and generally originates on the tongue dorsum. The sulfur producing anaerobic bacteria appears to be the primary source of this odors. The large surface area of the tongue and its papillary structure allow it to retain food and debris. This is an excellent putrefactive habitat for gram negative anaerobes that metabolize proteins as an energy source. The bacteria hydrolyze the proteins to amino acids, three of which contain sulfur functional groups and are the precursors to volatile sulfur compounds (VSC's). These gaseous substances, responsible for malodor, consist primarily of hydrogen sulfide (H2S), dimethyl sulfide [(CH3)2S], methyl mercaptan (CH3SH) and sulfur dioxide (SO2). Cadaverine levels have been reported to be associated with oral malodor and this association may be independent of VSC. Subjects challenged with cysteine rinses produced high oral concentrations of VSC, which thus seems to be a major substrate for VSC production. The other sulfur-containing substrates had much less effect. It was found that the tongue was the major site for VSC production.
- Tongue Plaque Coating: Research suggests that the tongue is the primary site in the production of oral malodors. The dorsoposterior surface of the tongue has been identified as the principal location for the intraoral generation of volatile sulfur compounds (VSC's). The tongue is a haven for the growth of microorganisms since the papillary nature of the tongue dorsum creates a unique ecological site that provides an extremely large surface area, favoring the accumulation of oral bacteria. The proteolytic, anaerobic bacteria that reside on the tongue play an essential part in the development of oral malodor. The presence of tongue coating has been shown to have a correlation with the density or total number of bacteria in the tongue plaque coating. The weight of the tongue coating in periodontal patients was elevated to 90 mg, while the VSC was increased by a factor of four. The CH3SH/H2S fraction was increased 30-fold when compared with individuals with healthy periodontium. This high ratio of amino acids can be due to free amino acids in the cervicular fluid when compared with those of L-cysteine. The BANA (Benzoyl-DL-arginine-2 napthylamide) test has been used to detect T.denticola and P.gingivalis. The two organisms that may contribute to oral malodor can be easily detected by their capacity to hydrolyze BANA a trypsin-like substrate. BANA scores are associated with a component of oral malodor, which is independent of volatile sulfide measurements, and suggest its use as an adjunct test to volatile sulfide measurement. Higher mouth odor organoleptic scores are associated with heavy tongue coating and correlate with the bacterial density on the tongue and it also correlates to BANA-hydrolyzing bacteria-T. denticola, P.gingivalis, and Bacteroides forsythus.
- Microbiota Associated With Oral Malodor: The actual bacterial species that cause oral malodor have yet to be identified from among the 300 plus bacterial species in the mouth. Putrefaction is thought to occur under anaerobic conditions, involving a range of gram-negative bacteria such as Fusobacterium, Veillonella, T.denticola, P. gingivalis, Bacteroides and Peptostreptococcus. Studies have shown that essentially all odor production is a result of gram-negative bacterial metabolism and that the gram-positive bacteria contribute very little odor. Fusobacterium nucleatum is one of the predominant organisms associated with gingivitis and periodontitis and this organism produces high levels of VSC's. The nutrients for the bacteria are provided by oral fluids, tissue and food debris. Methionine is reduced to methyl mercaptan and cysteine. Cysteine is reduced to cystine, which is further reduced to hydrogen sulfide in the presence of sulfhydrase-positive microbes. This activity is favored at a pH of 7.2 and inhibited at a pH of 6.5. Isolates of Klebsiella and Enterobacter emitted foul odors in vitro which resembled bad breath with concomitant production of volatile sulfides and Cadaverine both compounds related to bad breath in denture wearers. The amounts of volatile sulfur compounds (VSC) and methyl mercaptan/hydrogen sulfide ratio in mouth air from people with periodontal involvement were reported to be eight times greater than those of control subjects.
PREVENTION
FLOSSING
Researchers, for the most part, suggest flossing as a very important addition to tooth brushing. In research, subjects who said that they floss had much less bad breath (as well as gum disease) as compared with those that said they did not. It is important to use floss properly, following professional instruction. Remember to floss around the ends of the teeth at the ends of each row.
Children would probably have problems flossing, since it requires a delicate control of the fingers they don't have yet.
One of the great advantages of using floss, is that you can smell the floss directly following each passage between the teeth, and clean the smelly areas more diligently.
Consult your dentist or hygienist for instructions for proper flossing techniques.
MOUTH RINSES/MOUTHWASHES
The best time to use any mouth rinse appears to be right before bedtime. Since in many instances, bad breath involves the back of the tongue, it is probably helpful to gargle the mouth rinse. Some clinicians recommend extending the tongue while gargling, in order to allow the mouth rinse to reach farther back.
Mouthwashes have been used as chemical approach to combat oral malodor. Mouth rinsing is a common oral hygiene dating back to ancient times. Antibacterial components such as cetylpyridinium chloride, Chlorhexidine, Triclosan, essential oils, quaternary ammonium compounds, benzalkonium chloride hydrogen peroxide, sodium bicarbonate41, zinc salts and combinations have been considered along with mechanical approaches to reduce oral malodor. Any successful mouth rinse formulation must balance the elimination of the responsible microbes while maintaining the normal flora and preventing an overgrowth of opportunistic pathogens.
Most commercial mouth rinses/mouthwashes only mask odors, providing little antiseptic function and should not be used. Most of these products contain nothing more than flavoring, dye, and alcohol. Even when these mouth rinses do contain antiseptic substances, the effects are usually not long-lasting. The microbes survive antiseptic attacks by being protected under thick layers of plaque and mucus. While they may kill bacteria that cause bad breath, the bacteria soon return in greater force. These type of mouth rinses/mouthwashes can also irritate the gums, tongue, and mucous membranes in the mouth.
Many commercially available rinses contain alcohol as an antiseptic and a flavor enhancer. The most prevalent problem with ethanol is that it can dry the oral tissues. This condition in itself can actually induce oral malodor. In addition, there is some controversy as to whether or not the use of alcohol rinses are associated with oral cancer. The FDA states that there is no evidence to support the removal of alcohol from over-the-counter products but alcohol-free mouth rinses are becoming increasingly popular.
People having present or past alcohol-dependency (alcoholism) problems should avoid mouth rinses that contain alcohol.
TYPES OF RINSES
Zinc Rinses: Clinical trials conclude that zinc mouth rinses are effective for reducing oral malodor in people with good oral health. Zinc rinses (in chloride, citrate or acetate form) have been found to reduce oral volatile sulfur compound (VSC) concentrations for greater than three hours. The zinc ion may counteract the toxicity of the VSC's and it functions as an odor inhibitor by preventing disulfide group reduction to thiols and by reaction with the thiols groups in VSC's. It has been reported a zinc-based rinse was more effective as compared to chlorinedioxide based rinse when both rinses were used twice a day for 60 seconds over a 6-week period. Zinc containing chewing gum has been shown to reduce oral malodor.
Chlorhexidine Rinses: Chlorhexidine digluconate is useful in decreasing gingivitis and plaque buildup. It is one of two active ingredients in mouth rinses that has been shown to reduce gingivitis in long-term clinical trials and appears to be the most effective anti-plaque and anti-gingivitis agent known today.
The efficacy of chlorhexidine as a mouthrinse to control oral malodor has not been studied extensively. The primary side effect of chlorhexidine is the discoloration of the teeth and tongue. In addition, an important consideration for long-term use is its potential to disrupt the oral microbial balance, causing some resistant strains to flourish, such as Streptococcus viridans.
The effect of 1-stage full mouth disinfection in periodontitis patients (Scaling and root planing of all pockets within 24 hrs together with the application of Chlorhexidine to all intra-oral niches followed by chlorhexidine rinsing for 2 months) resulted in a significant improvement in oral malodor when compared to a fractional periodontal therapy (consecutive root planings per quadrant, at a 1 to 2 week interval).
While Chlorhexidine appears to be clinically effective from these open-design clinical studies, it is not an agent that should be used routinely, or for long periods of time, in the control of oral malodor, because of its side effects. Mouth rinse containing Chlorhexidine, Cetylpyridium chloride and Zinc lactate was evaluated in a clinical study for two weeks. Eight subjects participated in this pilot study and this formulation showed improvement in organoleptic scores and a trend to reduce tongue and saliva microflora.
Antimalodor properties of chlorhexidine spray 0.2% chlorhexidine mouth rinse 0.2% and sanguarine-zinc mouth rinse were evaluated on morning breath. Oral malodor parameters were assessed before breakfast and four hours later after lunch. Results indicated that a sanguarine-zinc solution had a short effect as compared to chlorhexidine that lasted longer.
Chlorine Dioxide Rinses: Chlorine Dioxide (ClO2) is a strong oxidizing agent that has a high redox capacity with compounds containing sulfur. Chlorine dioxide is also used in water disinfection and in food processing equipment sanitation and functions best at a neutral pH. Commercially available mouth rinses are a solution of sodium chlorite since chlorine dioxide readily loses its activity. Further independent clinical investigations are needed to substantiate the effectiveness of sodium chlorite containing rinses for the control of oral malodor. In fact, chlorine dioxide, the agent most widely touted on the Internet, has no published clinical studies (as of December, 1999) to substantiate the claims to reduce oral malodor. Benzalkonium chloride in conjunction with sodium chlorate has been shown to be effective in reducing oral malodor. In this pilot study subjects with mild to severe periodontitis were instructed to use the mouthwash twice a day for a period of six weeks and periodontal and oral malodor parameters were assessed.
Triclosan Rinses: Triclosan (2,4,4'-trichloro-2'-hydroxydiphenylether) is a broad spectrum non ionic antimicrobial agent. This lipid soluble substance has been found to be effective against most types of oral cavity bacteria. A combined zinc and triclosan mouth rinse system has been shown to have a cumulative effect, with the reduction of malodor increasing with the duration of the product use.
Two-Phase Rinses: Two-phase oil-water mouth rinses have been tested for their ability to control halitosis. A clinical trial reported significant long-term reductions in oral malodor from the whole mouth and the tongue dorsum posterior. The rinse is thought to reduce odor-producing microbes on the tongue because there is a polar attraction between the oil droplets and the bacterial cells. The two-phase rinse has been shown to significantly decrease the level of volatile sulfur compounds eight to ten hours after use, although not as effectively as a 0.2 percent chlorhexidine rinse. Positive controls such as Chlorhexidine and Listerine® that had previously shown to reduce organoleptic scores were used in these clinical studies.
Hydrogen Peroxide: The potential of hydrogen peroxide to reduce levels of salivary thiol precursors of oral malodor has been investigated. Using analytical procedures, percent reduction in salivary thiols levels post treatment compared to baseline was found to be 59 percent.
Topical Antimicrobial Agents: Azulene ointment with a small dose of Clindamycin was used topically in eight patients with maxillary cancer to inhibit oral malodor that originates from a gauze tamponade applied to the postoperative maxillary bone defect. The malodor was markedly decreased or eliminated in all cases. Anaerobic bacteria such as Porphyromonas and Peptostreptococcus involved in generation of malodor also became undetectable.
Breathnol is a proprietary mixture of edible flavors, which was evaluated in a clinical study, and this formulation reduced oral malodor for at least 3 hours. Certain lozenges, chewing gums, and mints have been reported to reduce tongue dorsum malodor.
Alternative Remedies: Some of the natural controls for oral malodor include gum containing tea extract. Also recommended are natural deodorants such as copper chlorophyll and sodium chlorophyllin. Alternative dental health services suggest the use of chlorophyll oral rinses in addition to spirulina and algae products.
Conclusions About Mouth rinses/Mouthwashes: Many of the mouth rinses available today are being used for the prevention and or treatment of oral malodor. Much more research is required to develop an efficacious mouth rinse for the alleviation of oral malodor. The treatment of oral malodor is relatively a new field in dentistry and many of the treatments thus far have involved a trial and error approach, but the knowledge and experience gained so far will hopefully facilitate clinical investigations in this field and eventually lead to improved diagnostic techniques and treatment products.
SMOKING & TOBACCO USE
For at least a century, people have smoked in order to cover up other oral odors. In my mind, this is not advisable. First, smoking itself is a health hazard, not only to you, but to those around you. Smoking can exacerbate gum (periodontal) disease and post-nasal drip, two important bad breath risks. Furthermore, in many people, the smoke odor lingers in the mouth itself and mixes with the other smells, resulting in a particularly noxious aroma.
Smoke odor comes out of two places: the mouth and the lungs. Interestingly, in some people the smell from the lungs is much weaker than that coming out of the mouth. This observation indicates that smoke components are retained in the mouth itself. On one hand, it is true that this may have an effect in reducing the activity of bacteria in the mouth. However, the toxic components in smoke have a similar effect in injuring our own cells. All in all, smoking is not a good idea as far as breath freshening is concerned.
Tobacco smoke may occasionally be detected on the breath of people who don't smoke at all. These individuals have been continually exposed to the smoke of others, and end up having telltale odor as a result.
BAD BREATH (HALITOSIS) IS USUALLY WORSE...
- Upon awakening.
- When your mouth is dry (lots of things cause dry mouth - not drinking enough fluids, having just given a long speech, being under stress, hundreds of medications...).
- After indulging in products with high levels of proteins, such as milk products and meat. If a little piece of meat remains between you teeth for a time, it is rapidly putrefied. Coffee may increase malodor, although no scientific evidence is available. Foods containing onions, garlic, (cabbage?) and various spices may cause bad breath. Some of this odor may be due to the odorants being released into the lungs from the blood stream, sometimes for days following ingestion.
- Directly prior to or during the menstrual period, perhaps because the gums tend to get swollen and trap bacteria and/or debris.
TIPS FOR TONGUE BRUSHING
Brush your tongue whenever you brush your teeth. Choose a brush (make sure that the bristles are not hard) that minimizes gagging reflex. Stroke from near the throat (as far in as you can get) in an outwards motion. Take care not to press to hard, as you don't want to do damage your tongue. For even better results, try wetting the brush with an effective mouthwash.
Another way of cleaning your tongue is to use a tongue scraper. Several kinds are currently available. You can also try using a piece of gauze, washcloth or other material, which you can wet with mouthwash or water.
People with hairy tongues (you can ask your dentist whether yours is hairy) may have more likelihood of having bad breath from their tongue. So do people with periodontal disease. Smokers may similarly suffer from foul tongue odor. In such instances, back-of-the-tongue cleaning becomes even more important.
Animated-Teeth: Getting Rid of Halitosis By Cleaning Your Tongue
TREATMENT
Oral malodor has been recognized in the literature since ancient times, but in the last five to six years it has increasingly come to the forefront of public and dental professional awareness. Approximately 40-50 percent of dentists see 6-7 self-proclaimed oral malodor patients per week. Standard diagnosis and treatment for oral malodor in the routine care of each patient has not been established in the dental or the medical field. However the transfer of knowledge is increasing because of pioneering researchers and clinicians that have developed reputable clinics dealing with this condition. Dental and medical schools must incorporate diagnosis and treatment of oral malodor into their curriculum, so that the future generations of clinicians can effectively treat this condition.
To date, there have been four international conferences where the experts in the field have gathered and published their observations and research findings. The fourth international conference was held at the School of Dentistry, University of California (UCLA) and it was a big success and demonstrated a continued enthusiasm towards further meetings and scientific research in the area of oral malodor. Although this area of research has been ridiculed, at least 50 percent of the population suffers from a chronic oral malodor condition by which individuals experience personal discomfort and social embarrassment leading to emotional distress. The consequences of oral malodor may be more than social; it may reflect serious local or systemic conditions. Oral Malodor research has gained momentum with increasing suspicions being directed at the sulfur-producing bacteria as the primary source of this condition.
DIAGNOSIS
HALITOSIS ASSESSMENT:
Organoleptic Measurements: One major research problem that must be tackled is the lack of an established gold standard for rapidly measuring oral malodor condition. The objective assessment of oral malodor is still best performed by the human sense of smell (direct sniffing-organoleptic method) but more quantifiable measures are being developed. At present, confidant feedback and expert odor (organoleptic) judges are the most commonly used approaches. Both assessments use a 0-5 scale in order to consistently quantify the odor (0= No odor present, 1= Barely noticeable odor, 2= Slight but clearly noticeable odor, 3= Moderate odor, 4= Strong offensive odor, 5= Extremely foul odor). Individuals are instructed to refrain from using any dental products, eating or using deodorants of fragrances four hours prior to the visit to the clinic Individuals are also advised to bring their confidante or friends to assess their oral malodor.
ORAL & NON-ORAL DETECTION METHODS
1. Self-monitoring oral malodor tests. 2. Spousal and friend/confidante feedback. 3. Spoon Test. 4. Home microbial testing. 5. Wrist-lick test. 6. In-office oral malodor testing 7. Odor Judges. 8. Microbial and fungal testing. 9. Salivary incubation test. 10. Artificial noses including the Halimeter®
In order to create a reproducible assessment, subjects are instructed to close their mouth for two minutes and not to swallow during that period. After two minutes the subject breathes out gently, at a distance of 10 cm from the nose of the their counterpart and the organoleptic odors are assessed. In order to reduce inter-examiner variations, a panel consisting of several experienced judges is often employed. A study on the inter-examiner reproducibility indicates that there is some co-relation, albeit poor. Gender and age influence the performance of an organoleptic judge. Females have a better olfactory sense and it decreases with age. Dentists and periodontists may not be ideal judges if they do not use masks on a daily basis.
Oral malodor can be analyzed using gas chromatography (GC) coupled with flame photometric detection. This allows separation and quantitative measurements of the individual gasses. However the equipment necessary is expensive and requires skilled personnel to operate it. This equipment is also cumbersome and the analysis is time consuming. As a result, GC cannot be used in the dental office and is not always used in oral malodor clinical trials. Recently a closed-loop trapping system followed by off-line high resolution gas chromatography ion trap detection was used for detection of compounds from saliva and tongue coating samples. Numerous volatile components were detected ranging from ketones to many unknowns. Adding casein (to provide cysteine and methionine) during incubation led to the appearance of nine new sulfur-containing compounds.
Better treatment begins with improved detection. And that starts with new devices, such as the Halimeter, that can detect the amount of sulfur-producing bacteria in the mouth.
Portable Sulfide Meter: The portable sulfide meter (Halimeter® - Interscan Corporation, Chatsworth, CA.) has been widely used over the last few years in oral malodor testing. The portable sulfide meter uses an electrochemical, voltametric sensor which generates a signal when it is exposed to sulfide and mercaptan gases and measures the concentration of hydrogen sulfide gas in parts per billion. The halimeter is portable and does not require skilled personnel for operation. The main disadvantages of using this instrument are the necessity of periodic re-calibration and the measurements cannot be made in the presence of ethanol or essential oils. In other words, the measurements may be affected if the subject is wearing perfume, hair spray, deodorant, etc. In addition, this limitation does not allow the assessment of mouthwash efficacy until after these components have been thoroughly rinsed out or dissipated.
The Electronic Nose: The "Electronic Nose" is a hand held device, being developed to rapidly classify the chemicals in unidentified vapor. Its application by scientists and personnel in the medical and dental field as well as it is hoped that this technology will be inexpensive, miniaturizable and adaptable to practically any odor detecting task. If the Electronic Nose can learn to "smell" in a quantifiable and reproducible manner, this tool will be a revolutionary assessment technique in the field of oral malodor. This device is based on sensor technology that can smell and produce unique fingerprints for distinct odors. Preliminary data indicates that this device has a potential to be used as a diagnostic tool to detect odors.
CONVENTIONAL MEDICAL TREATMENT
MEDICAL MANAGEMENT OF ORAL MALODOR
A large number of so called "Fresh Breath Clinics" are offering diagnostic and treatment services for patient complaints of oral malodor. There are no accepted standards of care for these services, and the clinical protocols vary widely.
A thorough medical, dental and halitosis history is necessary to determine whether the patient's complaint of bad breath is due to oral causes or not. It is important to determine the source of oral malodor; complaints about bad taste should be noted. In most cases patients that complain of bad taste may not have bad breath. The taste disorders may be due to other causes. It has been reported that in approximately 8% of the individuals the odor was caused by tonsillitis, sinusitis, or a foreign body in the nose. This percentage of individuals may be higher, additional research is needed in this area. Approximately 80-90% of the oral malodor originates from the dorsum of the tongue. Therefore the treatments targeted towards reduction of the oral malodor will require antimicrobial components directed against the tongue microbiota.
Treatment of oral malodor is important not only because it helps patients to achieve self-confidence but also because the evidence indicates that volatile sulfur compounds can be toxic to periodontal tissues even when present at extremely low concentrations. The best way to treat oral malodor is to ensure that patients practice good oral hygiene and that their dentition is properly maintained.
MANAGEMENT OF ORAL & NON-ORAL MALADOR
1. Local chemical/antibacterial methods. 2. Systemic antibacterial methods. 3. Mechanical debridement of the tongue. 4. Salivary stimulation and/or substitutes. 5. Nasal mucous control methods. 6. Avoidance of foods, fluids and medications. 7. Correction of anatomic abnormalities. 8. Medical management of systemic diseases.
Traditional procedures of scaling and root planing can be effective for patients with OM caused by periodontitis. All patients should be instructed in proper tooth brushing and flossing and tongue cleaning. Mouth rinses should be recommended based on scientific evidence. Caution should be exercised and professional advice should be sought as to administration and type of mouth rinse to be used. Tongue scraping should be demonstrated and patients should be asked to demonstrate to the dental hygienist the appropriate use of tongue scrapers. The tongue has a tendency to curl up while tongue scraping therefore a combination of flexible tongue scrapers and tongue scrapers with handles should be recommended to the patients.
The saliva functions as an antibacterial, antiviral, antifungal, buffering and cleaning agent and so any treatment that increases saliva flow and tongue action, including the chewing of fibrous vegetables and sugarless gum, will help decrease oral malodor. Finally, oral rinses can be used as supplement good oral hygiene practices.
For most people, a healthy diet, good oral hygiene on a daily basis and visiting the dentist twice per year for cleanings and exams are adequate to prevent bad breath. If you follow this advice, your days should be filled with hugs and kisses. For more information on fighting halitosis and to obtain a dental referral call 1-800-DENTIST to find dentists in your area.
HOME TREATMENT
One method often used, but is not totally reliable is "Licking the back of your hand, letting it dry, and smelling it". It is considered to still be a powerful tool for self diagnosis to see if you have bad breath.
Along with good oral hygiene, some of the most promising treatments are mouthwashes, toothpastes, and other oral products that contain both chlorine dioxide and zinc. Zinc stops an enzyme from breaking down an amino acid that makes the sulfur and by doing this stops the process for a longer period of time. The chlorine dioxide kills the already formed bacteria. As a rule, do not use commercial mouthwashes. Most contain nothing more than flavoring, dye, and alcohol. While these may kill the bacteria that cause bad breath, the bacteria soon return in greater force. Mouthwashes can also irritate the gums, tongue, and mucous membranes. Look for a product containing zinc and chorine dioxide. Often such products can eliminate bad breath for up to eight hours. Use liquid chlorophyll, 1 tablespoon per 1/2 glass water for a gargle/mouthwash or a chlorophyll based mouth rinse. Use helpful mouth rinse daily as needed.
Another breeding ground for odiferous bacteria is a dry mouth. When mouths are dried out, there's a sixfold increase in such sulfur compounds. The dryer the mouth, the less saliva, and the worse the breath. Alcohol as well as some medications, including antidepressants, asthma drugs, antihistamines, and some blood pressure medications, may dry the mouth out. Be sure to drink plenty of quality water and other healthy liquids daily to help alleviate "dry mouth" issues.
Brush your teeth and tongue after every meal may help to remove food and bacterial deposits that sour the breath. You have to get to the bacterial source and remove it. Try tongue rakes or tongue scrapers that gently scrape bacteria off the tongue and clean between the teeth with dental floss. Use Stim-U-Dent wooden toothpicks, available in most drug stores, after every meal to massage between the teeth. This is important for the prevention of gum disease.
Brush your teeth with circular motions, and apply only gentle pressure to avoid injuring the gums.
Replace your toothbrush every month (4 weeks), as well as after any infectious illness, to prevent bacteria buildup and fungi. Keep your toothbrush clean. Between uses, store it in hydrogen peroxide or grapefruit seed extract to kill germs. If using hydrogen peroxide, rinse it well before brushing. There are bacteria-destroying toothbrush sanitizers available that turn on automatically at intervals throughout the day.
If you practice good oral hygiene and still have bad breath and bleeding gums, consult your dentist to see if you have developed a peridontal disease.
Bad breath may be a sign of an underlying health problem. Treatment is dependent on what's found and what the reasons are for your halitosis. The first step toward treating bad breath is to isolate the cause. For instance, if the cause is gum disease then your health care provider or dentist will treat the gum disease. If it is caused by calcium deposits on the tonsils that are bad smelling, your health care provider can remove them from the folds of the tonsils. Consult your health care provider for a thorough checkup if the suggestions given in this web page do not improve the condition.
CONSIDERATIONS
Care for you teeth regularly and thoroughly. Floss and brush them after every meal, if possible. Chew your food well to help break down the food particles so the stomach and intestines are less burdened. Aid digestion further by eating plenty of fresh fruits and vegetables. Avoid foods whose odors linger. Also, avoid alcohol, which leaves residues on the teeth and affects digestion. If you smoke, stop.
See Peridontal Disease, Sinusitis, and/or Sore Throat for more information.
HERBAL & HOLISTIC RECOMMENDATIONS
Bad breath can be a source of embarrassment, even a source of shame. We tend to shun people whose breath offends us, wondering if we, too, are afflicted. However, bad breath is a condition you can usually correct easily, not by masking it with sprays or rinses, but by getting at the source of the problem. The most obvious causes of bad breath are gum disease, poor dental hygiene, dry mouth, smoking and chronic throat and nasal infections. The less obvious source is often the most common. Foul odors travel up from the stomach as a result of poor digestion that leaves food putrefying in the digestive tract. Recurrent digestive ills and respiratory infections may themselves be caused by underlying disease or impaired immunity. In this case, unpleasant mouth odor that doesn't respond to better dental care and diet can be a warning sign you and your health care provider should attend to. You can often, however, turn to effective herbal remedies to aid digestion, improve gum health and freshen breath.
MYRRH FOR HEALTHY GUMS
Myrrh, both astringent and antimicrobial, is well known for its ability to defeat mouth and gum inflammations and infections and strengthen the gums at the same time. Made of dried resin from Myrrh Tree Bark, Myrrh tinctures work well in both gargles and direct applications. Gargle with 1 teaspoon of Myrrh Tincture, available at health food stores or online, diluted in water; or massage your gums several times daily with a cotton ball soaked in the tincture.
HERBS
Alfalfa is a good source of minerals and other nutrients for the body. It supplies chlorophyll, which cleanses the blood stream and colon, where bad breath often begins. Take 500 to 1,000 mg in tablet form or 1 teaspoon of liquid form in juice or water three times daily.
Herbal Remedies: Chlorophyll With Alfalfa Powder, NOW Foods, 100 mg, 90 Caps
Chlorophyll is a unique substance found in all green plants and is sometimes called the blood of plant life. Identified as sodium-copper chlorophyllin, this water soluble extract is derived exclusively from alfalfa through a natural process.
Herbal Remedies: Alfa max, Alfalfa Extract, Nature's Way, 525 mg, 100 Caps
Nature's Way Alfa Max Alfalfa Extract capsules is a 10X extract of fresh green alfalfa leaves.
Herbal Remedies: Alfalfa, NOW Foods, 650 mg, (10 Grain), 500 Tabs
NOW Foods Alfalfa tablets deliver excellent health benefits. Alfalfa is a rich natural source of chlorophyll, vitamins, minerals and protein which supports a healthy colon.
Herbal Remedies: Alfalfa Tincture, 100% Organic, 2 fl. oz.
Alfalfa (Medicago Sativa) is useful to generate energy and endurance; a tonic for the whole body, due to its highly nutritive value.
Herbal Remedies: Alfalfa Leaf Root (Medicago Sativa) Powder, Kosher, 4 oz. Bulk
Alfalfa's deep root system pulls valuable minerals from the soil. With the aid of sunlight, nutrients including beta carotene and chlorophyll are made available to the body in a usable form.
Herbal Remedies: Alfalco (Alfalfa Tonic), Homeopathic Boericke & Tafel (B&T), 8 fl. oz.
Alfalco, Alfalfa Tonic, relieves fatigue, stress & sleeplessness and is a natural homeopathic.
Herbal Remedies: Alfalfa Leaves, Nature's Way, 405 mg, 100 Capsules
Nature's Way Alfalfa Leaves are organically grown by Trout Lake Farm, Washington, and Certified Organically Processed in accordance with Oregon Tilth standards and the California Organic Foods Act of 1990.
Herbal Remedies: Alfalfa Powder, Whole Food Supplement, NOW Foods, 1 lb.
Alfalfa Powder is a supplement which can be blended into vegetable juices or used in baking or in vegetarian dishes. It is 20% protein and 15% fiber; plus it contains 16 amino acids, 13 trace minerals and 13 vitamins. Alfalfa Powder is a whole food supplement highly valued for its nutrition.
Herbal Remedies: Alfalfa Supplements & Products
Gum disease is a major factor in bad breath. If infection is present, place alcohol-free Goldenseal Extract on a small piece of cotton and place the cotton over infected gums or mouth sores. Do this for two hours per day for three days. It should quickly heal the infected parts.
DOUBLE-ACTING PEPPERMINT
Peppermint improves digestion, specifically aiding digestion of fats, also acts as an oral antiseptic. It helps to freshen breath in these two basic ways. Add a couple of drops of Peppermint Essential Oil to a glass of water, and gargle with the mixture regularly. You can use Myrrh Essential Oil or Dill Essential Oil in the same way. Suck Peppermint Lozenges to fight dry mouth, which encourages bacterial growth and bad breath, and to mask lingering odors of strong-smelling and spicy foods. Or, try enteric-coated Peppermint Oil Capsules, which act both as a digestive aid and a breath freshener.
Use Myrrh (to brush your teeth and rinse your mouth), Peppermint, Rosemary, and Sage. Caution: Do not use Sage if you suffer from epilepsy or other seizure disorders.
Garlic & Breath: Although Garlic has a reputation for causing "bad breath", it may actually help halitosis sufferers by supporting the immune system and promoting digestion. Garlic also deters bacteria in the mouth and bowels. Eat plenty of this potent food, or take Garlic Capsules 2-3 times daily.
Chewing a sprig of Parsley after a meal is an excellent treatment for bad breath. Parsley is rich in chlorophyll, the active ingredient in many popular breath mints.
Other herbs that may be helpful for bad breath include Anise, Cloves, Fennel, and Parsley.
DAILY RITUAL
To sweeten your breath, chew seeds such as Cardamom, Dill, Fennel, or Anise several times a day. The volatile oils in these seeds are disinfectant, mask unpleasant odors and help eliminate gas and bloating in the intestines. Chewing on a sprig of Parsley can improve bad breath, as well. Parsley is rich in chlorophyll, long believed to be a breath freshener.
MEDICINAL TEAS
Sage Tea For Inflamed Gums: The tannins in Sage reduce gum, mouth and throat inflammations, all of which can cause bad breath. Pour 1 cup of hot water over 1 teaspoon of sage. Steep for 10 minutes, and then strain. Rinse your mouth with the tea several times daily.
Tea Blend To Improve Digestion: When poor digestion is suspected as a cause of breath odor, a bitter herb tea can promote digestive juice flow to improve matters. Combine 1 teaspoon each of Chicory, Dandelion, Oregon Grape and Chamomile. Pour 1 cup of hot water over 1 teaspoon of the blend; steep for 10 minutes. Strain. Drink 1 cup before meals.
HERBAL RINSES & GARLICS
Chamomile, Sage, Myrrh and Oregon Grape, all antimicrobial and astringent, make effective oral disinfectants. Steep 1 tablespoon of one of these herbs in 1 cup of hot water, strain and use as a gargle three or more times a day. You can also add tinctures of these herbs to water.
STRENGTHEN YOUR IMMUNITY
Frequent mouth and throat infections not only can cause bad breath but signal a poor state of health and low resistance. To rebuild your resistance, take immune-stimulating herbs, such as Echinacea, Astragalus and Panax Ginseng. These are good choices. Take 1/2 teaspoon of a tincture (one or a combination of these herbs), 5 or 6 times a day for several weeks.
NUTRITIONAL RECOMMENDATIONS
Go on a five-day raw foods diet. After the fast, eat at least 50 percent of your food raw every day. This a good routine diet to adhere to on an ongoing basis.
Drink generous amounts of quality water.
Avoid spicy foods, whose odors can linger for hours. Foods like anchovies, blue cheese, Camembert, garlic, onions, pastrami, pepperoni, Roquefort cheese, salami, and tuna leave oils in the mouth that can release odor for up to 24 hours, no matter how much you brush or gargle. Beer, coffee, whiskey, and wine leave residues that stick to the soft, sticky plaque on teeth and get into the digestive system. Each exhalation releases their odor back into the air.
Avoid foods that get stuck between the teeth easily or that cause tooth decay, such as meat, stringy vegetables, and sweets, especially sticky sweets.
Go on a cleansing fast with fresh lemon juice and water to detoxify the system. See Fasting for more information.
Brush your teeth and tongue after every meal.
Use a tongue scraper to help remove bacterial plaque and shed dead cells and food debris from the surface of the tongue.
Replace your toothbrush every month, as well as after any infectious illness, to prevent bacteria buildup.
Use dental floss and a chlorophyll mouthwash daily.
Use Stim-U-Dent wooden toothpicks, available in most drugstores, after every meal to massage between the teeth. This is important for the prevention of gum disease.
Keep your toothbrush clean. Between uses, store it in hydrogen peroxide or Grapefruit Seed Extract to kill germs (if using hydrogen peroxide, rinse it well before brushing). There are bacteria-destroying toothbrush sanitizers available that turn on automatically at intervals throughout the day.
Do not use commercial mouthwashes. Most contain nothing more than flavoring, dye, and alcohol. While they may kill the bacteria that cause bad breath, the bacteria soon return in greater force. Mouthwashes can also irritate the gums, tongue, and mucous membranes in the mouth.
Bad breath may be a sign of an underlying health problem. Consult with your health care provider for a thorough checkup if the suggestions on this page do not improve the condition.
NUTRITIONAL SUPPLEMENT RECOMMENDATIONS
The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.
BAD BREATH / HALITOSIS SUPPLEMENTS & PRODUCTS
Information, supplements and products for bad breath, a condition that occurs when an offensive odor is detected in the mouth.
AloeDyne Organic Toothpaste, Triple Action, Kiss My Face, 3.4 Oz.
Kiss My Face Certified Aloe Vera Organic Toothpaste offers cool mint freshness. While using ingredients formulated to keep teeth white and gums healthy. Triple Action ~ Total Confidence!AloeDyne Organic Whitening Toothpaste, Kiss My Face, 3.4 Oz.
Kiss My Face Whitening Toothpaste uses soothing Certified Organic Aloe Vera combined with a powerful blend of carefully selected natural whiteners to create a truly exceptional toothpaste that still leaves your mouth feeling tingly fresh.Breath, Teeth & Gums Formula Tincture, 100% Organic
Hardens teeth, protects gums and melts plaque on contact.Breath Gel Concentrated Natural Mouthwash, All Natural, Mint Flavor, 1.25 oz.
This versatile all natural mouthwash breath gel contains an impressive blend of selected botanicals and pure natural mint oils recognized for their effectiveness in promoting long lasting fresh breath, and a clean, healthy mouth and gums.chlorofresh, Chlorophyll Supplement, Nature's Way, 50 mg, 90 Softgels
Chlorofresh, Chlorophyll Supplement, is used chiefly as an aid to reduce odor from a colostomy or ileostomy and to reduce fecal odor due to incontinence.Chlorofresh Liquid, Chorophyll, Mint Flavor, Nature's Way, 16 fl. oz.
Chlorofresh is a special liquid chlorophyll complex, derived from premium alfalfa leaves.Eucalyptus Essential Oil, 100% Pure, 4 fl. oz.
Eucalyptus Essential Oil is a potent decongestion with strong antiseptic properties. Eucalyptus Oil is used as an inhalant for asthma, diphtheria, sore throats, sinus and respiratory problems.Fennel Seed Supplement, Nature's Way, 480 mg, 100 Caps
Fennel Seed has been historically used to aid digestion and sweeten the breath.Gum Rejuv Oral Treatment, 1 fl. oz.
Gum Rejuv is a time-tested ancient formulation of 24 plants and herbs used for healing and strengthening the gums.Ionic Toothbrush, Dr. Tung's, 1 Each
Dr. Tung's Ionic Toothbrush may be the most advanced toothbrush in the world.Ionic Toothbrush Replacement Heads, 2 Heads
Two replacement heads for Ionic Toothbrush.Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian Medium, Lactose Free, Apple Strawberry Flavor, Dynamic Health, 16 fl. oz.
Beneficial bacteria, such as Lactobaciillus acidophilus and Bifidobacterium bifidum, are called probiotics, available in a liquid Lactobacillus Acidophilus from Dynamic Health.Liquid Flavored Sweetleaf Stevia, 4 Flavored Stevia Bottles, 6 ml, 60 Servings
Flavored Sweetleaf Stevia has Four exciting All Natural, Zero Cal, Zero Carb, Zero Glycemic index - Flavored Stevia bottles at an exciting value of only one penny per drop.MouthFresh Natural Mouthwash & Gargle, 12 fl. oz.
Refreshes breath, promotes healthy gums, soothes sore throats, sweetened naturally with Stevia.MSM Toothpaste (Methylsulfonylmethane), 5%, 3 oz.
MSM Toothpaste promotes dental hygiene, improves gum and tooth health, freshens breath, improves tooth brightness, and reduces tartar and plaque buildup.Nature's Antiseptic Tea Tree Oil & Grapefruit Seed Extract, CJ Puotinen, Paperback
Nature's Warfare, this book covers tea tree oil and grapefruit see extract use in safely destroying viruses, bacteria, molds, yeasts and parasites that want to live in us and on us.Nutribiotic Dental Gel, With Grapefruit Seed Extract, Natural Flavoring, 4.5 oz.
This Dental Gel uses natural ingredients, is only mildly abrasive, and contains ingredients known to support healthy teeth and gums. It is free of fluoride, which has stirred some controversy due to its toxicity.Oral Fresh Natural Toothgel With Propolis & Tea Tree, 3.5 oz.
Comvita OralFresh Natural Toothgel combines the natural active ingredients of bee propolis and tea tree oil, both of which are effective oral hygiene ingredients, keeping the teeth and gums healthy.Organic Whitening Toothpaste, Kiss My Face, 1 oz.
Kiss My Face Whitening Toothpaste uses soothing Certified Organic Aloe Vera combined with a powerful blend of carefully selected natural whiteners.Parsley Herb Tincture, 100% Organic, 2 fl. oz.
Parsley leaves are the traditional antidote for garlic's pungent smell. It is a good source for Vitamin C and is strengthening to the digestion.Parsley Leaf Herb, Nature's Way, 450 mg, 100 Caps
Parsley leaf herb is a chlorophyll-rich member of the carrot family. Most fine restaurants offer parsley as a garnish and breath freshener, a custom borrowed from the ancient Romans.Pasca-Dent Bentonite Tooth Powder, Super Fine, 6 oz.
This super fine pascalite Bentonite powder is a wonderful oral cleanser is a wonderful oral cleanser and teeth powder that also makes a good bath and body powder.Pepogest Peppermint Oil, Enteric Coated, Nature's Way, 60 Softgels
Pepogest peppermint oil is a targeted release peppermint oil supplement that provides natural gastrointestinal comfort. Pepogest peppermint oil is a targeted release peppermint oil supplement that provides natural gastrointestinal comfort.Peppermint Herb Tincture, Liquid, Organic, 2 fl. oz.
Alternative Health & Herbs Remedies Peppermint liquid peppermint herb tincture can be an effective herb for the digestive system as it has an antispasmodic effect on the smooth muscle of the digestive tract.Peppermint Tea, Caffeine Free, NOW Foods, 30 Tea Bags
Peppermint Tea can be a natural aid to the digestive process by soothing the stomach lining and supporting a healthy liver and gallbladder.Pro Breath Tongue Cleaner With Free Replacement Head
Dr. Tung's Tongue Cleaner is an impressive addition to your daily oral care regimen.ProGums Advanced Gum Brush, 1 Each
ProGums is the first gum brush designed for gentle gum massage.SilvaSolution Silvafresh Homeopathic Antibacterial Toothpaste, TriMedica, 3 oz.
TriMedica SilvaFresh Homeopathic Antibacterial Toothpaste is the only toothpaste ever to contain 100% pure homeopathic anti-bacterial silver that effectively helps wash away and eliminate bacteria and food debris that cause tooth decay, gum disease, tartar buildup and bad breath.Stabilized Oxygen OxyDrops, Liquid Electrolytes, Sodium Chloride Solution, 4 fl. oz.
WaterOz stabilized oxygen is the highest quality, strongest and most stable of all the liquid electrolytes of oxygen available on the market.Stomach Upset Formula Tincture, 100% Organic, 2 fl. oz.
Stomach Upset Formula is used as an all natural herbal remedy for an upset stomach and acidosis, digestive problems, halitosis, morning sickness,and motion sickness.Super Veggie Powder, Truman's Best, 3.5 oz.
Super Greens are great for survival storage or if you are on the go.Sweet Breath Herbal Tea, 20 Tea Bags
Herbal tea to remove breath odor, refresh the mouth and enhance mental alertness.Tea Tree Oil Antiseptic Solution (15% Water Soluble), 2 fl. oz.
Tea Tree Oil Antiseptic Solution can be used for mixing with water for douching, athlete's foot, facial problems and bathing.Tea Tree Toothpaste With Baking soda, 5 oz.
Tea tree oil toothpaste with baking soda combined with proper brushing and oral care will leave your teeth clean, your gums healthy and your breath refreshed!Thera Neem Toothpaste, Mint Herbal, Organix South, 4.23 oz.
Neem toothpaste is another herbal wonder from used in Ayurveda for oral health care, that many researchers believe have helped rural Indians avoid cavities despite limited access to modern dental care.Tongue Cleaner, Stainless Steel
Like good silverware Dr. Tung's Tongue Cleaner is made of Stainless Steel (not plastic), and this curved cleaning edge removes bacteria and soft plaque in seconds.Toothpaste Gel, XyliWhite Whitening Gel With Xylitol Natural Sweetener, NOW Foods, 6.4 oz.
XyliWhite is a remarkable new toothpaste gel from NOW Foods that uses Xylitol, a natural sugar alcohol that looks and tastes similar to conventional sugar with one major exception - it has 40% fewer calories!Tea Tree Mouthwash, 12 fl. oz.
Tea Tree Mouthwash has a natural fresh mint flavor with the antiseptic properties of tea tree oil.The Miracle of Fasting, By Paul C. Bragg, N.D., Ph.D., and Patricia Bragg, N.D., Ph.D.
Fasting is the best detoxifying method. It's also the most effective and safest way to increase elimination of waste buildups and enhance the body's miraculous self-healing and self-repairing process that keeps you healthy and youthful.Throat Spray GSE, 4 fl. oz.
This natural formulation is designed to promote healthy conditions in the mouth and throat. NutriBiotic Throat Spray provides protection from sore throat due to germs.Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Whitening Dental Gel Plus, With Dental Peroxide, 4.5 oz.
Nutribiotic Dental Gel Plus is a truly whitening gel formulated with dental peroxide, the superior whitening ingredient dentists use.Women's Aloe Vera Organic Toothpaste, Kiss My Face, 3.4 oz.
Kiss My Face Women's Toothpaste uses soothing Certified Organic Aloe Vera combined with a powerful blend of carefully selected natural whiteners to create a truly exceptional toothpaste that still leaves your mouth feeling tingly fresh.XyliWhite Cinnafresh Toothpaste Gel, NOW Foods, 6.4 oz.
XyliWhite Cinnafresh is a remarkable new toothpaste gel from NOW Foods that uses Xylitol, a natural sugar alcohol that looks and tastes similar to conventional sugar with one major exception - it has 40% fewer calories!PET CARE Acidophilus For Cats & Kittens, Cat Probiotic, Kosher & Dairy Free, Dynamic Health, 16 fl. oz.
Acidophilus For Cats, cat supplement, will help maintain a healthy digestive system, treat and prevent diarrhea, eliminate smelly stools and foul gas.Acidophilus For Dogs & Puppies, Dog Probiotic, Kosher & Lactose Free, Dynamic Health, 16 fl. oz.
Acidophilus for Dogs & Puppies helps maintain a healthy digestive system, helps eliminate smelly stools and foul gas and helps reduce bad breath.Doggie Breath Wellness Oil, Nature's Inventory, 2 fl. oz.
A few drops on the tongue will take the "doggie" right out of your dog's breath! Peppermint helps to settle any tummy troubles at the same time.
Herbal Remedies: Bad Breath / Halitosis Information
Herbal Remedies: Bad Breath / Halitosis Supplements, Information & Products
Herbal Remedies: Tooth Decay / Cavities Supplements, Information & Products
NOTIFY YOUR DENTIST OR HEALTH CARE PROVIDER IF...
You have symptoms halitosis, oral malodor, or bad breath. You need to be assessed as to the cause of the condition since treatment will be dependent upon the cause.
You have unusual symptoms or symptoms of infection. Infections need to be treated by your health care provider.
HELPFUL ORGANIZATIONS
American Dental Association (ADA)
ADHA - American Dental Hygienists' Association
HELPFUL RELATED LINKS
For a full list of available products from Mountain Rose Herbs, click on banner below:
HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
If you see a suggested Amazon product "not there" as indicated by an orange box with the Amazon logo, this only means the specific product link has been changed by Amazon.com. Use the "click here" icon on the orange box and it will bring you to Amazon.com and you can do a search for a specific product using keywords and a new list of available products and prices will show. Their product and resource links are constantly changing and being upgraded. Many times there are more than one link to a specific product. Prices will vary between product distributors so it pays to shop around and do price comparisons.
Educational materials and health products are available through Amazon.com. Use the search box provided below to search for a particular item.
HERBS, OILS, & SUPPLIES
Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
Click Here To Visit Herbal Remedies Product Page
A Source For Medicinal & Ritual Herbs & Supplies
Aphrodisiacs Aromatherapy Bath & Body Care Bulk Herbs By The Pound Capsules, Tablets & Extracts Chinese Herbals Electronics Extracts First Aid Products Food Products, Mixes, Seeds, Snacks & More! Hair Care Products & Supplies Herbs & Oils, Kilo & Ton Hydroponics & Gardening Kava Products Kitchen & Housewares Mushrooms Musical Instruments Oral Care & Dental Products PC & IT - Computer Supplies & Assessories Skin Care, Cosmetics, & Gift Sets Smokes, Seeds, Cacti Spices, Salts, Sweeteners, & Seasonings Sports, Toys & Games Sweets, Candy, Chips & Snacks Stimulants Sedatives Teas & Coffees
Shaman Shop Home Page
