Drugs for Bad Breath

These days, it seems there’s a prescription for everything - no wonder oral malodor sufferers look to their doctors for drugs for bad breath. What could be simpler than just popping a pill? No more mouth washes that taste like chemicals, no more breath mints, no more costly trips to the dentist to see if dental or gum care is needed. No more having people wince and pull away when they get a whiff of your breath. Unfortunately, it’s not that easy.

Most cases of bad breath are caused by the overgrowth of certain species of bacteria that live in the mouth. Many of them are anaerobes, bacteria that live in places where oxygen is scanty or absent. These bacteria hide in pockets in the gums, between the teeth, and in the tiny grooves at the back of the tongue. Drugs for bad breath would have to be delivered to these locations in order to work, and that’s not easy. Taken in pill form, such a drug would go straight past the mouth and into the stomach, and then return via the bloodstream to oxygenated tissues. An ideal halitosis medication, meanwhile, should stay in the mouth in places where oxygen is absent.

That’s why most products marketed as over-the-counter drugs for bad breath are liquids – mouth rinses and washes, or gum, lozenges etc. It’s also why some of these products have been designed to actually deliver oxygen to the mouth, exposing anaerobes to oxygen and killing them off. Unfortunately, we walk a fine line between killing off all the anaerobes, and also killing all the healthy bacteria that also live in the mouth and protect us from infection. This explains why halitosis medication typically needs to be used long term – you never get rid of the anaerobes completely and must prevent them from gaining in numbers again.

Ironically, while drugs for bad breath are in short supply, drugs that actually cause the problem are easier to find. A long list of drugs including stomach remedies, antihistamines and antidepressants list oral malodor as a side effect. When these drugs are needed long term for chronic health problems, the patient may be stuck with bad breath as an added problem. In these cases, a novel approach to halitosis medication is needed – it might mean switching to an alternate medicine, or it might mean trying the available over-the-counter remedies until one is found that works. Sometimes the problem is difficult, if not impossible, to fix.