The Morning-after Bouquet: Bad Breath

My boyfriend has corpse breath. It smells like someone curled up and died inside him. It is at its worst in the mornings, but even after he cleans his teeth I can still detect it under the minty toothpaste. Would you recommend some sort of supplement or a change in his diet? Or, could it just be that my nose is too sensitive?
- Chris from Vancouver

Like you, I come from a long line of excellent smellers. Members of my family can detect a Cinnabon across a crowded mall, in spite of an assault by Crabtree and Evelyn along the route. We’ve even won competitions for determining cottage cheese expiration dates to within fifteen minutes. Impressive, yes, but it’s not all fame and glory: I’m as easily offended in movie theaters by whiffs of patchouli as others are affronted by ringing cell phones. And once, I blurted out my ATM PIN-code over a threat with the fragrance Curious by Britney Spears. It’s a curse, really, and I long for the days of retirement when I become hard-of-smelling – especially important if I’m to survive in a nursing home.

Your boyfriend’s halitosis is quite common, and if you haven’t noticed it in previous boyfriends, they were likely noticing yours. More than eighty percent of cases of bad breath are caused by breakdown of food particles by normal mouth bacteria. Obvious explanations, like smoking, account for only a minority of cases. Though fairly rare, serious conditions of the liver or kidney may also result in off-putting changes in breath. And for some, severe low carbohydrate diets cause potent halitosis, leaving them wondering why their dramatic loss of girth has paradoxically increased their co-workers’ “personal space.”

In the absence of a health problem, that fetid smell is a mixture of what are called volatile sulfur compounds (VSC). Bacteria, living primarily in the craters of the tongue’s back one-third, break down protein from food debris into component amino acids. Further breakdown of certain sulfur-containing amino acids can release foul gases, including hydrogen sulfide (known to giggling lab partners everywhere as “the rotten egg smell”). Additionally, decreased saliva flow during sleep creates a smell-amplifying dry mouth. As a result, your first waking sentence frequently has all the earmarks of an effective morning-after abstinence program.

Countless societies have attempted find methods to battle mouth odor, being less concerned about identifying the cause. From chewing fennel seeds, to sucking on cloves and eating coriander, many natural remedies have eventually been translated into mass-marketed products. Perhaps the first, Clorets gum, contains chlorophyll to theoretically absorb odors. Similarly, Listerine is an alcoholic four-herb blend of menthol, eucalyptol, thymol and wintergreen – each an essential oil of a common plant. A few years back this inebriated herbal foursome ganged-up on, and chased off, a pretender to the breath-freshening throne: a little peasant named parsley.

In the late 1990’s, Breath Asure had become hugely successful marketing a capsule containing parsley-seed oil as cure for bad breath. Sold as an “internal breath freshener,” the company promoted a theory that halitosis originates in the digestive tract, not the mouth. These claims were based on data about as weighty as a parsley garnish itself. Warner-Lambert, then owner of Listerine, Certs and Dentyne easily challenged their statements in court and eventually forced Breath Asure into bankruptcy. What emerged was a new product, MintAsure (old formula, with mint!), which now competes poorly with the reigning breath-masking monarch, Altoids.

Masking odor, however, is not a substitute for eliminating it. Removing both bacteria and food particles goes much further than any curiously-strong breath mint. A 2006 study, for example, demonstrated that scraping the gunk off your tongue works significantly better than simply brushing it off with a toothbrush, as many people routinely do. Tongue scrapers are widely available at drugstores, take only moments to use, and are easy to adjust to – even if you have a strong gag reflex. That, plus good dental hygiene (you remember floss, right?), will remove a significant amount of bacteria and nearly all the food bits they need to reproduce.

As for changing your boyfriend’s diet or feeding him supplements, there is little to recommend. Certainly, eliminating garlic and onions might reduce the likelihood of his breath wilting the centerpiece, but at what price? A life without “everything bagels” and lasagna is a high price to pay to avoid offending sensitive noses like ours. Let him have his Bloomin’ Onion and just put a tongue scraper in his Christmas stocking. People with extra-sensory olfaction, like us, must beware of picking the wrong battles this time of year. We could too easily end up on the receiving end of a horrific, buttercream-scented Yankee Candle.

Dr. Ed Rabin is a chiropractor practicing at Life Chiropractic Center in Boise. Don’t send tongue scrapings, but do send health-related questions to theantidote@edrabin.com (on the Web at www.edrabin.com).