Bad breath (halitosis in doctorspeak) is not a topic for polite conversation. In fact, even your dentist or best friend may not bring up the subject of dragon breath.
Many people are painfully aware of their breath problem. They chew gum, suck on mints, gargle regularly and ask health professionals for help. They frequently feel frustrated.
Others may imagine that they have bad breath. Doctors have a term for this condition. It is called halitophobia, or delusional halitosis. No matter how much they are reassured that their breath smells fine, such people are convinced they could knock out a horse with each breath.
Determining the cause behind actual bad breath can be challenging. There are so many contributing factors that it can take Sherlock Holmes-type sleuthing to discover what is really going on.
Food is an obvious source of odor. It's not just garlic and onions that can cause bad breath. Readers of this column have shared some fascinating stories about milk and dairy products:
"I have a problem with terrible bad breath after eating anything with dairy in it, and also anything with sugar. I have had this problem since my early 20s and am now in my 60s. My husband says it is so bad that he can sometimes smell it from his side of our king-size bed. This is right after brushing, flossing and rinsing with mouthwash before bedtime.
"If I stay away from sugar and dairy, the smell goes away completely after four or five days. It starts again within 30 to 45 minutes of eating the offending foods."
Another reader shared this: "I suffer from severe lactose intolerance. Even after taking Lactaid enzyme pills, I would have body odor when I ate dairy products. Once I eliminated dairy from my diet, the odor went away."
Other causes of bad breath may include gum disease, tooth abscess, bacterial overgrowth on the tongue, tonsil troubles, sinusitis, bronchitis, diabetes or liver disease. A specialist should do a complete work-up to discover the source of the odor.
Here is an example: "My 11-year-old daughter had terrible breath. The dentist said that it wasn't coming from her teeth and referred us to an ear, nose and throat specialist. The ENT said that he suspected that the small sinus cavities on each side of her nose had fungal infections in them. He prescribed a special nose spray to get rid of the infection. Within two days, her bad breath was gone. Now whenever her breath starts to get bad, we just have her start using the nose-spray mixture and the odor disappears."
Sometimes bad breath originates in the stomach. Decades ago, we spoke with Nobel Prize laureate Dr. Barry Marshall. He discovered that the bacterium Helicobacter pylori could cause stomach ulcers. He told us that these germs are behind some cases of hard-to-treat bad breath.
Through the years, we have heard from readers who reported success after curing their infections: "When I read about a blood test for a germ in the stomach that causes bad breath and gastritis, I saw my doctor. He hadn't heard of this, but he gave me the blood test. It turned up positive. Now I am fine, after years of bad breath."
Diagnosing the cause of bad breath can be challenging. But once the origin is identified, halitosis frequently can be remedied.