“Hi friend, do you have bad breath?”
When many people hear this question, their first reaction is:
(Source: doutula.com)
Don’t rush to a conclusion, in fact, there are quite a few friends with bad breath!
According to statistics, about 10% to 65% of people in the world have suffered from bad breath[1]. In China, the prevalence of halitosis is 27.5% [2].
And recently, because of wearing more masks, many friends realize that they really have bad breath:
(Source: Sina Weibo)
My dad, who wants to save face, finally bowed his head in front of bad breath….
In the past, “bad breath” always slandered others, so many people don’t know that they have been “mouthing others”.
Since wearing a mask, for more than a month, many people have understood what the virus is like and what bad breath is like!
(Source: Internet)
Weird! Why does bad breath always smell others
Can’t smell it?
There are two main reasons for this. First, from the perspective of human body structure, the soft palate at the back of the mouth is connected to the nasal cavity, and the nose cannot smell the odors produced at the back of the mouth.
Second, our olfactory nerve cells stay with our own “smell” for a long time, and they have long been used to it and cannot smell it.
After wearing a mask, the mouth and nose are in a closed space, and the odor in the mouth is easy to gather. The moisture exhaled in the mouth and the droplets during conversation will form a local humid and warm environment around the mouth, which is easy to cause the growth of bacteria in the oral cavity. Under the decomposition of microorganisms, it is more likely to produce oral odor.
Therefore, it is always easy to roll over when bad breath encounters a mask!
How can you quietly find out if you have breath problems without wearing a mask?
There is a popular “30-second self-test” on the Internet:
“Put your wrist out, lick your wrist with the middle of your tongue, wait 30 seconds for the saliva to air dry, and then smell the licked spot.”
However, other studies have found that the test is inaccurate and may lead to overestimated results[8]. In other words, people who didn’t have bad breath at first also detected bad breath themselves, scaring themselves…
It’s more reliable to find a single-use plastic spoon (often found in takeout lunch boxes) and gently scrape the back of your tongue to smell the dry residue.
Image source: Zhanku Hailuo
Friends with courage can also sigh at the people around them and observe their reactions…
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Brush your teeth every day and still have bad breath!
Where does this smell come from?
Halitosis does have a lot to do with brushing, but it’s not all about brushing.
For example, after eating garlic, the smell of garlic fills our entire mouth.
What’s even scarier is that even brushing your teeth and rinsing your mouth can’t get rid of the garlic smell right away!
Because the odor molecules in garlic will enter the blood from the stomach, and then reach the lungs through the blood, and exhale from the lungs through the respiratory tract.
Therefore, even the lungs of people who have just eaten garlic are “garlic lungs”…
(Source: Internet)
Halitosis caused by drinking, smoking, eating onions, etc. is usually a temporary odor directly emitted from the digestive tract or respiratory tract. It is physiological and will be eliminated by itself [3].
As for bad breath in the morning, it is actually related to dry mouth. When the oral cavity lacks “saliva”, the flushing effect of self-cleaning is weakened, and bacteria are more likely to breed, thereby producing odorous gas. Generally, brush your teeth carefully for 3 minutes, and it will be gone.
However, some bad breath can’t be shaken off or covered up, so it must be noticed.
This type of bad breath is usually pathological, caused by oral or other systemic diseases. According to statistics, 80%-90% of halitosis is related to factors in the oral cavity [3], which is medically called “oral” halitosis: bacteria in the oral cavity (mainly Gram-negative anaerobic bacteria) ) metabolites of the decomposition of sulfur-containing amino acids, mainly volatile sulfides (VSCs), which are the main source of odor in the oral cavity.
These bacteria are mainly found in the periodontal pockets and tongue coating.
People with poor oral hygiene, periodontal disease, dental caries, and oral mucosal diseases (such as recurrent oral ulcers) are more likely to suffer from oral halitosis[4] .
Image source: Zhanku Hailuo
Another study found [9] that the tongue coating is the hardest hit area for bad breath! 60% of the volatile sulfides in the breath are produced by bacteria on the surface of the tongue! (Friends, brushing the tongue coating is very important!)
After the oral hygiene environment has improved and these diseases have been cured, the bad breath can basically be eliminated.
The other 10% or so of bad breath is caused by causes outside the mouth, which is called “non-oral halitosis”. For example, the pharynx, larynx, lungs and stomach, these organs adjacent to the mouth may be the source of odor. Studies in recent years have shown that Helicobacter pylori (HP) in the stomach, one of the pathogens with the highest infection rate in the world, may also be the source of bad breath[5]. Therefore, people with bad breath must check whether Helicobacter pylori exceeds the standard after excluding oral diseases.
In general, the oral environment and bad breath are inextricably linked. The most reliable way to avoid bad breath is to start with oral hygiene.
How to stay away from “bad breath”?
Pay attention to these 5 details in life, and say goodbye to bad breath:
1. Brush your teeth in the morning and evening and rinse your mouth after meals.
Enough time: at least 2 minutes each time.
The method should be right: The currently recommended scientific method of brushing teeth is the modified Pasteur brushing method (horizontal flutter brushing method).
How does it work? Check out this animation:
(Specific operation: place the toothbrush near the gingival margin, with the tips of the bristles facing the gum, at a 45-degree angle to the long axis of the tooth;
Gently press the bristles against the gum edge, slightly into the gap between the teeth and the gum, vibrate horizontally for a short distance, and then brush up and down along the gap between the teeth. )
Brushing the inside of the upper and lower front teeth:
2. Brush your teeth and your tongue! A study found that brushing off the tongue coating removed 75% of volatile sulfur compounds [6]. Although the bacteria may come back, it can help maintain oral health. You can use a soft-bristled toothbrush to gently brush the “tongue coating” from the inside out.
3. Carefully floss food debris and plaque.
4. Drink enough water to keep your mouth moist. Drinking water helps the salivary glands secrete more saliva, and drinking water has a flushing effect on the mouth.
Many people say that it is inconvenient to drink water while wearing a mask, so they are too lazy to drink water. In fact, you can drink it with a straw.
5. Diet control. It is best to avoid irritating, strong-smelling (such as garlic, chives, stinky tofu, etc.), indigestible, greasy food and bacon products.
If you want to breathe fresh air while wearing a mask, the following 3 things are very helpful:
Image source: Zhanku Hailuo
Change masks promptly. Pay attention to the hygiene of masks. General surgical masks are recommended to be replaced every 4 hours; medical protective masks are recommended to be replaced every 6-8 hours; N95 masks are more stuffy to wear, and it is recommended that they be used for no more than 4 hours at a time.
According to the recommendations of the US Centers for Disease Control and Prevention, masks can be reused according to usage (in non-infected areas and when the use time is not long, masks can be reused no more than 5 times) , and dry it in a ventilated, non-polluting place when not in use [7], so as to protect your oral health on the premise of effectively preventing viruses.
Chew xylitol gum before wearing a mask to cover up some odors.
Rinse your mouth after meals. Rinse your mouth with warm water immediately after eating to remove debris and reduce the number of bacteria. Some people like to use mouthwash, but remember that mouthwash is only a temporary relief for bad breath, not a substitute for brushing and flossing, let alone long-term use, because the antibacterial ingredients in it have the risk of destroying the flora in the oral cavity.
Finally, Tencent Medical Code wishes you a fresh breath and a sweet breath with a mask on!
Reviewer: Xu Tongkai| Attending Physician of the Second Department of General Surgery, Peking University Stomatological Hospital
References
[1] Quirynen, M., Dadamio, J., Van den Velde, S., De Smit, M., Dekeyser, C., Van Tornout, M., & Vandekerckhove, B. (2009). Characteristics of 2000 patients who visited a halitosis clinic. Journal of clinical periodontology, 36(11), 970-975.
[2]Liu, X. N., Shinada, K., Chen, X. C., Zhang, B. X., Yaegaki, K., & Kawaguchi, Y. (2006). Oral malodorrelated parameters in the Chinese general population. Journal of clinical periodontology, 33(1), 31-36.
[3]Scully C,Greenman J.Halitology (breath odour: aetiopathogenesis and management)[J]. Oral Dis,2012,18(4):333-345.
[4] Xu Fanxing, Li Xiaoyu, Liu He, Jin Liji, Xu Yongping. Research progress on the etiology and treatment of oral halitosis [J]. Advances in Modern Biomedicine, 2011,11(04 ):791-794.
[5] Zhang Yu, Chen Xi, Feng Xiping. The relationship between halitosis and Helicobacter pylori infection: a case-control study [J]. Stomatology, 2016,36(07):607-611 .
[6] Cicek Y, O rbak R, Tezel A etal. Effect of tongue brushing on oral malodor in adolescents. Pediatr Int [J]. 2003; 45 (6): 719-23 .
[7] Questions and Answers Regarding Respiratory Protection for Preventing 2009 H1N1 Influenza Among Healthcare Personnel
https:https://www.cdc.gov/h1n1flu/guidelines_infection_control_qa.htm
[8] Rosenberg M. The science of bad breath[J]. Scientific American, 2002, 286(4): 72-79.
[9] Yaegaki K, Coil J M, Kamemizu T, et al. Tongue brushing and mouth rinsing as basic treatment measures for halitosis[J]. International dental journal, 2002, 52(S5P1) : 192-196.
*The content of this article is for the popularization of health knowledge. It cannot be used as a specific diagnosis and treatment recommendation, nor can it replace the face-to-face consultation of a licensed physician. It is for reference only.
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