What do you tell your patients and their parents who are worried about 'BB' (Halitosis)?
You’ve undoubtedly heard the question, “Doctor, what can we do about her bad breath?”
Jenny’s mom asked me that question a worried look on her face. “I’ve talked to the pediatrician, and nothing is wrong. But, she is being teased about it, and we notice it at home too. Can you help us?”
And you’ve undoubtedly run through the conventional wisdom of telling them to check with their pediatrician or doctor about any upper airway infections, congestion, allergies, and about any GI tract illness, including GERD -- and be sure they brush and floss well every day.
Past that, you have suggested mouthwash. Maybe.
Mouthwash? Not. A. Good. Idea... because many-to-most mouthwashes have alcohol which dries the oral cavity and may worsen the situation. Of course there are products created for just this situation, the 'BB' (Bad Breath) that embarrasses the patient and/or parents. Those may work, though are often expensive and do not get to the etiology of the problem.
About 25% of the population has chronic BB, apparently not related to the above etiologies. A study of Army recruits found that only 17% did NOT have halitosis.
What could be the reason for BB?
Once you have ruled out the respiratory tract and GI tract (including gingivitis/perio disease) as sources, and the patient’s medical reports do not show other systemic diseases or challenges, the etiology is… GET READY…FOR…IT…
PROBABLY… an unhealthy and highly pathogenic MICROBIOME.
Bad bugs in the gut.
BB (Bad Breath) is caused by BB (bad bugs).
The trillions of microbes we call the microbiome is the community of coexisting microorganisms found in and on the human body. According to studies, the number of microbes is actually from three to ten times the number of cells in the human body. This includes the red blood cells, which are about 25 trillion, or 84% of the total cells of the body.
These microbes include bacteria, fungi and viruses (as well as other simple organisms called archaea and protists (algae and amoebae), that coexist with body cells. They are crucial for the immune system, and for hormonal and metabolic balance. Many are necessary “good bugs” that work with the body for health.
Some are not good. These are the BB (bad bugs), and have been implicated in cardiovascular diseases, cancer, infections, diabetes, Alzheimer’s, even obesity and other serious illnesses.
Everyone routinely carries some pathogens or “bad bugs.” In healthy people, they co-exist with the body (their host) and its total microbiome. However, these pathogens are etiologic in disease states such as infections, heart disease and cancers.
It hasn’t helped that we have become so “germ-conscious” that we’ve overdone it to the point of killing the “good bugs”, and letting the “bad bugs” overgrow. We use anti-bacterial soaps, and disinfecting wipes and lotions. Often more quickly able to "bounce back" from such an attack, the bad bugs have a heyday.
Additionally, nutrition and diet are critical parts of the body’s interaction with its environment, as frequent snacking and high carbohydrates and sugars help the pathogens overtake the friendly microbes.
When out of balance, one of the possible results in a human body is BB - halitosis.
Balancing and restoring the microbiome has the potential to make us much more healthy.
Start with probiotics, the supplemental “good bugs” that are packaged in liquid, capsule and chewable forms. In fact, for the patient with BB, the chewable can be fantastic.
Encourage the patient to reduce the intake of sugars and carbohydrates, on which the “bad bugs” feed, and to chew up three or four probiotic tablets a day. One brand is American Health Chewable tablets, and available on Amazon as well as at many health food stores.
It works! Amazing when we get to the etiology of the problem!
Jenny’s mom reports that she no longer has any problem with BB, now that she is limiting sugar and carbs and using Probiotics. She’s a happy girl! Likewise, no BB for my daughter, one of my assistants and a colleague, all of whom have successfully addressed their microbiome.
Got BB? Get Probiotics!
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Dr Chris Baker
America's most-trusted teacher of orthodontic continuing education, Dr. Chris Baker has practiced and taught for more than 30 years, and is a current or former faculty member of three U.S. dental schools. She is a pediatric dentist, author, blogger, dental practice consultant, and mentor. Dr. Chris is also Past President and Senior Instructor of the American Orthodontic Society. She is based in Texas, USA, but lectures around the world.
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© 2023 Dr Chris Baker