Bad breath (halitosis) and the oral microbiome

February 4, 2021

Halitosis, also known as ‘bad breath’ or oral malodor is a common problem affecting around 25-45% of the general population. Bad breath is the third most common reason, after cavities and gum issues, patients seek dental help. In about 85-90% of all cases, the origin is found in the oral cavity and you can often manage it yourself.

In general, underlying dental causes, like bad oral hygiene, gum disease (periodontal disease) or tongue coating are considered to be the most an important cause for halitosis.

There are other frequent factors such as tobacco or alcohol consumption, active, deep cavities, oral infection, ulceration, uncleaned dentures, food packing in between the teeth, and others. Sometimes problems with the tonsils (tonsil stones), nose or sinuses, stomach, and other systemic conditions can be responsible for bad breath, too. These factors need to be excluded when persisting bad breath is a problem.

Dry mouth (xerostomia) often causes a higher plaque volume around the teeth, increasing the risk of developing tooth decay and gum disease, as well as halitosis. Saliva has a natural cleaning and antimicrobial property that keeps the oral microbiome in a natural balance. Xerostomia is associated with aging, but also a symptom of certain diseases, or a common side effect of several therapeutic and illegal drugs or dehydration.

In most cases microbial degradation in the mouth is the responsible mechanisms, when volatile sulfur compounds (VSCs) are formed. Several bacteria species are capable of these type of protein degradation, many of them play important roles in other oral conditions, such as gum disease.

In a healthy microbiota, these bacteria are not present, or only in a very low ratio and cannot cause problems. The good bacteria in a high proportion make sure that a healthy balance is maintained.

You can easily self-diagnose by asking a trusted friend or relative. An older, but popular method was to lick the back of the wrist, let it dry for a minute, and smell the result. This often results in overestimation, hence should be avoided. Professional help is the best approach if the bad breath doesn’t go away after a few weeks of self-treatments.

The management first of all involves the treatment of any underlying issues. Since the most common cause is bad oral hygiene or plaque build-up around the teeth and on the tongue, proper mechanical cleaning is essential.

Brushing however is not sufficient to clean all teeth surfaces, flossing and mouthwash use is also beneficial.

Antiseptic mouth rinses may provide temporary help. However, the long term use of these chemicals may lead to further imbalance - dysbioses of the oral microbiota, which then may lead to other issues.

Certain probiotics (good bacteria) are proven to quickly decrease the number of bad microbes, so VSCs as major causative factors are not produced, and a more diverse balance is maintained.

Natorally's Dental Probiotic Mouthwash helps to restore the oral microbiota. Probiotics and other ingredients work to decrease the number of potential pathogen microbes while supporting balance.

This solution keeps the natural ecosystem in a healthy and diverse state, rather than constant disruption, so bad bacteria cannot overgrow.

Bad breath (halitosis) and the oral microbiome

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