History of Bad Breath

Not surprisingly, the history of bad breath – or halitosis – goes back a long way. People have been suffering from this problem for thousands of years and trying, of course, to find a solution. Medical scrolls from 1500BC mention the condition and ancient cultures had traditional ways of treating it, many of which parallel the remedies we use today. People in the Far East devised an early tongue cleaner, and people all over the world turned to aromatic herbs and spices to freshen the breath and mask breath odor. Mint, anise, cloves, cinnamon, parsley, guava, and lots of others have been used.

Halitosis in the past was generally regarded as a personal hygiene problem rather than a health problem and sufferers were often stigmatized, ostracized, and blamed for their condition. In some cultures divorce was sanctioned when one of a couple had the problem. During the twentieth century, help came in the form of commercial mouthwashes and breath mints, but the history of bad breath did not take a significant turn until we figured out the source of the odor. That information gave us a recognizable target.

University of British Columbia researcher Dr. J. Tonzetich figures prominently in the history of bad breath. In 1964, he proved that the typical foul smell of oral malodor came from volatile sulfur compounds (VSC). These compounds proved to come from anaerobic bacteria that are a normal part of the bacterial life in human mouths – they aren’t a problem unless they multiply to numbers large enough to be detectable. Most cases of halitosis in the past, like today, were caused by an overgrowth of anaerobes.

Since 1964, we’ve learned that VSC-producing anaerobes live in large numbers on the surface of the back of the tongue, and also in pockets and folds in the gums, and between the teeth. A suspicion that halitosis in the past was caused by gum disease and tooth decay has been proven, but we also know that lots of people with healthy mouths suffer from the problem as well. The most recent developments in the history of bad breath have been products that specifically attack anaerobic bacteria in the mouth, and objective methods of measuring and diagnosing oral malodor. In all likelihood, the first really effective treatments for this problem are just around the corner.

Diagnosis of Bad Breath

Once, a diagnosis of bad breath relied solely upon another person informing us that our breath was offensive – a family member, friend, doctor, dentist, or even a complete stranger. In some cases, people came to the conclusion on their own (still true today) and were not always right. It is only in recent years that medical specialists have taken the problem seriously enough to even try to develop an objective means of measuring oral malodor.

Tests for halitosis today have greatly improved, and though some of the old methods are still used, specialists have at least three measurement techniques to choose from. Patients who are serious about having their breath tested and getting some help with the problem can visit clinics that are equipped to do the testing and get a proper diagnosis of bad breath.

The most familiar method for assessing oral malodor, which attempts to achieve an objective result, is known as organoleptic measurement. The most subjective of current tests for halitosis, organoleptic measurement involves having the patient blow through a straw while an experienced examiner sits at a specified distance and rates the level of malodor on an established scale. The difficulty with this diagnosis of bad breath is that human smell sensitivity naturally varies from time to time and the results are therefore not always repeatable.

An instrument called a halimeter is gaining in popularity. With the halimeter, the diagnosis of bad breath is made by placing a straw or tube connected to the instrument in the open mouth and measuring the volatile sulfur compounds that travel down the tube to the halimeter with exhaled air. Volatile sulfur compounds are produced by anaerobic bacteria in the mouth, and are indicative of halitosis, but other compounds in room air and exhaled breath that are not related to bad breath can be measured by the halimeter and affect results. In addition, like most tests for halitosis, this method does not differentiate between odor produced in the mouth and odor that originates elsewhere in the body.

A third method, and the most recent of the practical tests for halitosis, is called gas chromatography. This procedure also detects sulfur, but it can tell whether the sulfur is coming from the mouth or from another source. Once an expensive, difficult laboratory test requiring specialized equipment and training, people involved in diagnosis of bad breath are moving toward portable user-friendly equipment for gas chromatography that may revolutionize the diagnosis of bad breath.