Taming the Sulfur-Breathing Dragon

(HealthNewsDigest.com).. Several of my recent columns have discussed toxic substances in our environment, with the goal of cutting through the hype, and seeing what good science really has to say. Let's turn today to some toxics that are present in nearly everyone's internal environment.

I'm talking about the so-called volatile sulfur compounds—hydrogen sulfide, methyl mercaptan, and dimethyl sulfide—that are responsible for most cases of chronic halitosis. These VSC's, as they are fondly referred to, are produced during the putrefaction of food particles, by oral bacteria. Note that this chronic condition is different from the temporary bad breath that we get from simply eating odoriferous foods, such as onions and garlic.

Chronic halitosis affects millions of people, who seem to have a genetic predisposition to growing these microorganisms to a greater extent than is normal. Unfortunately, the chronic and temporary conditions have been lumped together in the minds of the public, resulting in brisk sales for all sorts of supposedly remedial products, some of which may exacerbate the condition.

For example, alcohol-based mouthwashes can provide short-term germicidal action, but will dry out the mouth, creating ideal conditions for even more prolific growth of the offending bacteria. Minty cover-ups do nothing to attack the source of the problem, of course, and will enhance bacterial growth, owing to their high sugar content.

So, what's the answer for chronic halitosis? In three words: See your dentist.

It turns out that 90 percent of chronic oral malodor originates in the mouth, and is nearly always the result of some sort of gum condition. It is well known that one symptom of advanced periodontitis is constant bad breath and a bad taste, although this is probably the least of the patient's problems, at that point. Less publicized is that even "mild" gum disease can produce oral malodor. In fact, a significant number of dental patients present with bad breath as their primary complaint, only to find out that they have some sort of developing periodontal issue.

Conventional dental treatment of chronic oral malodor usually includes management of the underlying perio, and often instructing the patient to use a tongue scraper a few times during the day. An antimicrobial rinse may be prescribed. Many dentists also utilize a special clinical instrument, called the Halimeter® to diagnose the condition, and monitor the progress of treatment.

The Halimeter® analyzes breath samples for the VSC's mentioned above, but does more than just put a number on the odor. The instrument will also pinpoint the source of the odor. Malodor not originating in the mouth can be due to nasal polyps, chronic respiratory infections, or more serious kidney and lung problems. Cases with non-oral etiology are referred out to the appropriate specialist.

As you might expect, based on the extensive marketing of breath improvement products, and the resulting stigma associated with halitosis, certain overly self-conscious individuals actually believe they have bad breath, when, in reality, they don't. The Halimeter®, an objective clinical instrument, is sometimes the only way to convince these patients that they are just fine.