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Would you know if you had halitosis?

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South Africans are not tremendously confident about the freshness of their breath, according to the Fresh Breath Survey. Around 400 people between the ages of 18 and 60 across all race groups in the greater Cape Town, Durban and Gauteng areas completed questionnaires.

Up to 89% said they suffered from bad breath, while up to 42% said they had bad breath daily. Men are more confident about fresh breath than women are; 13% of men said they never had bad breath, while only 10% of women claimed this.

"Approximately 50% of the adult population emit socially unacceptable breath. The most common cause of bad breath is the accumulation of bacteria at the back of the tongue where they settle on the sloughed-off cells from the oral tissues. Mucus, which comes from the nose, breaks down the protein, and that causes the release of sulphur which is what smells," says Dr Leslie Lang, a Cape Town-based dentist and lecturer.

While all the respondents agreed that it is 'extremely' important to have fresh breath themselves, raising the topic with their partners and colleagues remains taboo.

The stats bear this out: 83% said they would not tell a colleague that their breath smelled, 67% would not tell a friend, and 32% would not even tell their spouse or partner.

If you're wondering why your partner or the last person you went on a date with hasn't called, test your breath. Around three quarters of people polled said bad breath was the worst thing a date or partner could have, much worse than dirty nails, stained teeth or bad skin.

"Generally individuals are not aware of their halitosis," says Dr Lang.

If you've been contemplating telling a friend, partner or colleague that their breath smells, Dr Lang advises that you suggest they see their dentist, commenting that there is a malodour at times and perhaps something might be wrong.

"Generally speaking bad breath is an indicator of the health of a person. Some conditions can of themselves cause bad breath, such as post-nasal drip, stomach ulcers, diabetes, hiatus hernia, cirrhosis, leukaemia and uremia. We also know that the plaque which is formed in the arteries due to cholesterol intake is the same as the plaque in the mouth. The same bacteria are implicated in its formation, therefore a person with a high plaque count in the mouth is more at risk of heart disease than someone who maintains a diligent plaque-control programme," Dr Lang explains.

Fresh breath

To keep their breath fresh 95% of respondents said they brushed their teeth. Two in five used breath mints, while fewer people use mouthwash to freshen their breath.

"Breath mints and chewing gum work in two ways – firstly they disguise the odour and, secondly, they stimulate saliva, which helps wash away the debris that has built up on the back of the tongue. Mouthwashes work by breaking up the plaque and mucus build-up on the tongue. Recent Australian studies warn about the alcohol content of some mouthwashes. They found that people who used them over a long period were at greater risk of developing oral cancer," says Dr Lang.

All respondents said they brush their teeth at least once a day while more than a third never floss. A third only visit the dentist when they have a dental problem, or less frequently than once a year.

Women lead the way in oral care: 35% of women are more likely to visit the dentist twice a year or more compared to 25% of men. And 20% of men said they never go to the dentist, or only when they have dental problems.

When it comes to flossing, 31% of women said they never flossed their teeth, compared to 40% of men. Furthermore, 37% of male respondents who said they don’t floss daily said they didn't think it was necessary, and 36% said they didn’t have the time.

One in ten men knew that oral hygiene was important to prevent heart disease, compared to 16% of women.

The respondents who participated in this survey spent less on oral care than on hair care, vitamins and minerals.

"Generally people will take their mouths for granted until something forces the issue. Proper home care is initially time-consuming until one's hands are able to find their way around the mouth quickly and easily. Hence people will start off enthusiastically, but then start to skip one night, then two, until they are back to their quick-scrub routine. The dentist has to spend a lot of time motivating the change in behaviour," says Dr Lang.

Test your freshness

"Scientifically we can use an apparatus which measures the amount of sulphur in a person's breath. On a personal level one can do several tests at home. Extend the tongue and use the area which is the most further back, put some saliva on your wrist, allow it to dry and smell it. Alternatively take a teaspoon, gently scrape the back of the tongue and smell the debris which is lifted off. Finally, take some dental floss, pass it between two molar teeth and smell the debris which comes out," advises Dr Lang.

Don't despair if there's a bad smell as bad breath can be treated by diligently removing all plaque build-up on the teeth through brushing and flossing. Remember to brush the back of the tongue or use a specially designed tongue cleaner. The use of a non-alcohol-containing mouthwash also helps.

(Leandra Engelbrecht, Health2)

Sources:
-Dr Leslie Lang
-Dentyl ph National Fresh Breath Survey Key Findings
-Ivodent press release, Get your tongue around fresh breath. Paula Wilson Media Consulting

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