Bad breath third most common dental complaint

BAD breath or halitosis was the third most common dental complain after dental decay and gum disease.

According to Dr Ronald Chia Ming Shen bad breath could be "a cause of social embarrassment". It was not an issue to be taken lightly.

Dr Ronald was a guest speaker at the 4th FDI/MOH Brunei Dental Convention where he lectured on "Clinical Management of Halitosis".

During an interview with The Brunei Times, Dr Ronald highlighted that most dentists were not trained in the proper methods of diagnosis or treatment.

It was of concern because, it was felt that through better understanding of "how to treat bad breath in an objective and scientific manner" patients would get better results.

Dr Ronald told The Brunei Times that as a halitosis dentist it was his duty to "educate (other) dentists and the public that bad breath can be cured and managed, not subjectively but objectively and scientifically".

Dr Ronald explained that bad breath was caused by coatings or biofilm that build up on the tongue surface, around the teeth, between the gums and at the back of the throat.

This biofilm contained protein that could support bacterial life . Bacteria in the mouth would bury themselves into the biofilm and break down proteins to amino acids and a waste compound called Volatile Sulphur Compounds (VLC).

"It was this waste compound that gave bad breath its smell," Dr Ronald said and not indigestion, constipation nor worms in the stomach as assumed.

The amount of saliva present in the mouth affected bacterial growth, Dr Ronald said. The less saliva there was in the mouth, the more bacteria will develop.

Eating habits, medication and smoking changes how much saliva there is in the mouth.

For example, people taking medication such as anti-depressants would have bad breath because anti-depressants cause the mouth to dry and this causes bacterial build up, Dr Ronald said.

Dr Ronald explained that 90 per cent of bad breath contained the same gases that can given out by rotten eggs, faeces and gasoline. The name of these gases are methyl mercaptan, hydrogen sulphide and dimethyl sulphide.

The amounts of these gases present in the mouth can be analysed and that is by "Halicheck".

Dr Ronald explained that "Halicheck" uses a specialised gas chromatography machine. The machine would break down and individually measure the gases of bad breath.

He added that from the results, the different amounts of the different gases would reveal the problem areas causing bad breathe that were either in the mouth, nose or throat.

If the results showed high amounts of high amount of hydrogen sulphide, the gas that smelled like rotten eggs, this meant that a lot of bacteria was growing on the tongue surface.

If readings are of methyl mercaptan, the gas that smells like faeces, then it would mean a lot of bacteria was growing in the gums.

Should there be a high reading of dimethyl sulphide, the gas that smelled like gasoline, this would mean that a lot of bacteria in the nose and throat. Dr Ronald recommended after getting the results of the "Halicheck", the patient should see the proper doctor to treat their problem areas.

Dr Ronald was trained as a certified halitosis dentist under Dr Geoffrey Speiser, the founder of the Australian Breath Clinic. Dr Ronald's clinic, based in Rafflesia Medical Centre, is the first halitosis clinic in Malaysia.The Brunei Times