Breath of strife

BAD breath is nothing new. It's been around at least since Raquel Welch made the wearing of animal skins glamorous back in One Million BC, and quite possibly longer than that. And it's a world-wide problem. Over the years, different cultures have developed their own folk remedies. In Thailand, sufferers chew the peels of oversize guavas. Iraqis keep cloves between their teeth, Italians chew parsley, Indians fennel seeds.

In Brazil, cinnamon is used, while the Chinese take crushed eggshells in rice wine. "At least one person I met swears by dates," adds Prof Mel Rosenberg, a leading expert in halitosis from the university of Tel Aviv.

And yet after all this time, and despite all these "remedies", we still don't like talking about it.

Which is a problem in itself. Millions of people in the UK have bad breath, Prof Rosenberg says - and everybody they meet knows it but themselves.

It can have a devastating effect on their lives - holding back their careers, making it difficult to make friends or form relationships. And all the time they may be totally unaware.

Which makes it all the more important that if there is someone you love - husband, wife, parents, children - who suffers from bad breath, you should pluck up courage to tell them. It could just change their life.

It's not always easy.

"Not everyone has the gumption to tell a friend that he or she has bad breath," Prof Rosenberg, who's in York to address the York Dental Society, says. "However, at the very least, we should be prepared to tell family members if they have bad breath, and hope that should the need arise, they will reciprocate in kind."

The extent of the social stigma attached to bad breath is revealed by a recent British Dental Association study.

"They found that many people will not date someone who has bad breath," says Prof Rosenberg. "Most people in the study believed that people with bad breath will not get advancement in their careers."

It is a stigma that has been around a long time. "According to Jewish Talmudic law, a man who marries a woman and subsequently discovers that she has bad breath can summarily divorce her," says the professor.

"In Roman times, the Roman entrepreneur Cosmos made a living pitching breath-freshening pastilles to his fellow friends and countrymen."

There is little secret why bad breath has always been such a sensitive topic. The mouth, says the professor, is an intimate organ. "And body odours, human odours, are extremely important in our self image and in our sexuality. The combination of having a very intimate organ, and an odour that we cannot control, or don't think we can, this is a very potent combination psychologically."

Some people are so appalled at the thought of having bad breath that they become obsessive about it. There are probably around a million people in Britain who are halitophobes, says the professor. "It becomes the main thing that worries them in their life. They have read most of the literature, scoured the Internet, they are constantly looking for a solution to a problem that probably doesn't even exist."

There are a number of things which can cause bad breath. Generally, Prof Rosenberg says, the odour originates in the mouth itself, rather than the stomach, as many people believe.

He believes that one important cause is 'postnasal drip' from the nose that accumulates and putrefies on the very back of the tongue.

Other sources include the cracks between teeth, abscesses and even faulty dental work, such as a leaking crown.

The good news is that in more than 90 per cent of cases, bad breath is treatable.

So if you think you might have bad breath, what should you do?

The first thing, says Prof Rosenberg, is to ask a member of your family for an honest assessment. The problem, after all, may just be all in your mind. You have to make sure you ask someone you can trust, however. "Not a kid," says the professor. "A kid will say everybody smells. Ask an adult."

If they confirm that... well, yes, not always of course, but just occasionally perhaps there is a problem, then probably it is time to see your dentist. Not your doctor, stresses Eddie Gergely, the peridontist (dentist who specialises in gum disease) at York Hospital who arranged the professor's visit. "Most people go to their doctor about bad breath. But they know less about it than a dentist. So go to your dentist!"

More and more dentists nowadays should be up to speed on bad breath, Prof Rosenberg says. But if you go to one who doesn't seem to know what to do, then the remedy is simple. "Find another!"

Before you go for your appointment, adds Eddie, try to resist brushing your teeth too fiercely or gargling to make your breath minty fresh. That would defeat the whole object of going.

It's also a good idea to take a confidante, says Prof Rosenberg - someone who will be able to monitor your progress and give you an objective assessment of whether your breath really is improving. Otherwise, because we're often not aware if our breath does smell bad, you'll have no way of knowing.

Finally, remember that if you do suffer from bad breath, you're in excellent company. "At the university where I work, four or five people in the dental faculty have bad breath!" says Prof Rosenberg. "I have only told one of them, who is close to me."

And? "He took it like a man!"

Prof Rosenberg's fresh breath tips:

- See your dentist regularly to keep teeth and gums in good condition.

- Clean your teeth regularly, and also floss or use a small brush to clean the inter-dental areas (cracks between your teeth).

- Clean the back of your tongue regularly with a tongue cleaner. This is a plastic implement you should be able to get from a good pharmacist or your dentist. Simply draw it forward from the back of your tongue gently, to remove build-up of bacteria.

But do not scrape too vigorously or you may damage your tongue.

- Eat a wholesome breakfast each day. Eating regularly reduces bad breath.

- Drink plenty of liquid to maintain a positive liquid balance, since a dry mouth contributes to bad breath. Water is best, coffee and beer are diuretics and can actually dry you out.

- Chew sugar-free gum for a couple of minutes a day. It has an important mechanical effect and also gets the saliva working.

- Gargle with an alcohol-free mouthwash before going to bed.

Updated: 09:30 Monday, February 17, 2003