DEAR DOC: How do I  deal with bad breath?

Dr Flo, I feel that my breath smells bad. I am afraid to talk when my colleagues are near me, and I try to cover my mouth so that they cannot notice the smell. I brush my teeth every day. What could be the cause? And is there a cure for this? Embarrassed Reader.

Dear Embarrassed Reader,

Bad breath, otherwise known as halitosis, can be caused by certain foods, habits or health conditions. When you don’t brush or floss your teeth thoroughly, food particles that remain in the mouth after we eat begin to rot, causing excessive growth of bacteria, which leads to bad breath. This can also lead to tooth decay and gum disease, which also contribute to bad breath.

To deal with bad breath, brush your teeth at least twice a day or after meals with a fluoride toothpaste, brush your tongue, floss regularly and replace your toothbrush after three months. 

Some foods have very strong smells, like onions and garlic, spices, fish, alcohol, and some cheeses, and although the smells can be masked temporarily by brushing teeth and using a mouth wash, they remain until these foods pass out of the body.

Also, eating very little starch — when fasting, or when on a diet — causes the body to break down fats, and this leads to making of ketones, which produce a fruit-like smell when you breath out. Smoking and chewing tobacco also lead to bad breath and gum disease. Another cause of bad breath is dry mouth due to reduced flow of saliva caused by a salivary gland problem, or mouth breathing, or by some medicines.

Some medical conditions can also contribute to bad breath, like throat infection, tonsillitis, gum disease, sinusitis, lung, kidney or liver disease, and problems in the gastrointestinal tract like reflux (heartburn).

Bad breath in the morning is caused by accumulation of bacteria in the mouth overnight. In addition, some people sleep with their mouths open, especially when they are snoring.

To deal with bad breath, brush your teeth at least twice a day or after meals with a fluoride toothpaste, brush your tongue, floss regularly and replace your toothbrush after three months.  You can also use a mouth wash, and it helps to take a lot of water, chew sugarless gum, chew on mint or parsley, avoid strong smelling foods, stop smoking or chewing tobacco, and reduce alcohol intake.

If there are any underlying medical conditions, they should be treated to prevent the bad breath. It is also important to get a dental check up twice a year even when there is no pain in the teeth or gums. Usually with the dental hygiene and treatment of any underlying problems, the problem should be resolved within a short time.

Dr Flo, I keep getting boils in different places in the body, especially in my armpits. Sometimes I take antibiotics and sometimes I just leave them alone. On two different occasions they had to be cut open for the pus to be removed. Is there something wrong with my blood? Is there an injection I can get so that I never get them again? Thanks, Wafula.

Dear Wafula,

A boil, or an abscess, is caused by infection getting into the layers of the skin through tiny cuts, or around a hair follicle, sweat glands or sebaceous gland (skin glands that produce “oil”). Because of the infection, pus forms and accumulates in that place, leading to a painful swelling which may turn red. Sometimes a part of it will turn yellow due to the pus underneath. The most common sites for these infections are in the armpits, the groin, around the anus, or around a tooth.

Getting recurrent abscesses is associated with poor hygiene, dirty environments, being near people with some kinds of skin infections and poor blood circulation. It could also be a sign of a weak immune system, for example due to diabetes, long-term use of steroids, cancer, blood disorders, alcoholism, HIV/Aids, and other diseases. In some people, though, there is no good reason for getting the recurrent infections.

Treatment involves opening the abscess so that the pus can drain out, and sometimes antibiotics are needed. If the swelling is small — less than 1cm diameter — you can press it with a cloth dipped in warm water several times a day for about 20 to 30 minutes. Unfortunately, there’s no treatment that can be given once to prevent future infections. Each new infection has to be treated when it occurs.

Send your health questions to [email protected] for absolutely free expert advice.

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In a nutshell...

To deal with bad breath, brush your teeth at least twice a day or after meals with a fluoride toothpaste, brush your tongue, floss regularly and replace your toothbrush after three months.  You can also use a mouth wash, and it helps to take a lot of water, chew sugarless gum, chew on mint or parsley, avoid strong smelling foods, stop smoking or chewing tobacco, and reduce alcohol intake.