Defeating halitosis – the sweetest taboo?

Bad breath or halitosis, remains quite a taboo subject in modern society, and the majority of us would be quite embarrassed to be told we have the symptoms.

It is, however, a condition that affects millions of people, and it is important that sufferers have access to non-judgmental advice and support.

As a dental professional, not only are you ideally placed to offer said advice on managing bad breath, you are also in the immediate firing line when sufferers present for treatment.

Some degree of halitosis is present at any one time in about half of the population, with one person in four believed to be experiencing regular periods of mal odorous breath, intense enough to be highly anti-social.

While treating patients with bad breath in the confines of the surgery is not a pleasant experience for you or your team, the condition can have a far more damaging effect on the patients’ behaviours and quality of life.

Constant awareness of bad breath can often lead sufferers to avoid all manner of social activities, affecting their interactions and relationships in both their personal and professional lives.


The psychological effects can be equally if not more severe. Depending on the character of the individual, halitosis sufferers are likely to lack self-confidence or belief in their self-worth which, in time, can cause depression, severe social isolation and possibly even the need for psychiatric support.

There are several different causes of bad breath, and these can be anything from spicy foods or smoking to medical issues such as periodontal disease, kidney or liver failure and respiratory infections.

However, almost 90% of cases of chronic halitosis are believed to originate from within the oral cavity.

As oral bacteria break down food particles, they release ‘volatile sulphur compounds’, or VSCs, which cause the mal odour in the mouth, detected upon exhalation. Usually located in the crypts at the back of the tongue or in periodontal pockets, these bacteria can be difficult to remove without the help of a dental professional.

While every oral cavity hosts a range of bacteria, it is the concentration of the bacteria that affects the odour of the breath.

The three VSCs responsible for halitosis are hydrogen sulphide (H2S), methyl mercaptan (CH3SH) and dimethyl sulphide ((CH3)2SH). Although all three must be neutralised for fresh breath, methyl mercaptan produces a strong odour even when present in only very small quantities, and so is the prime target for elimination.

There is also some evidence that VSCs are able to penetrate periodontal tissue and may be a factor in the aetiology of periodontal disease.

As a dental professional, you are best placed to help your patients identify and manage this condition.

Short-term solutions such as chewing gum, mints or certain mouth rinses can provide fast relief from symptoms, but they often rely on antibacterial ingredients and masking agents to merely disguise the malodour, and so do not serve as successful resolutions.

The combination of zinc acetate and chlorhexidine diacetate however, has now been shown to effectively convert the noxious sulphur content of the VSCs to odourless, insoluble sulphides in an action with significantly increased longevity.







Product news

One product available on the market that uses this combination of ingredients is CB12, a clinically proven mouth rinse supplied by Meda Pharmaceuticals Ltd.

The synergistic action of even the low concentration of the zinc and chlorhexidine, allied to a characteristic ability of CB12 to adhere to the teeth and gingiva, enables the neutralising of VSCs to continue for up to 12 hours following a single 30 to 60 second rinse with 10ml of CB12.

With clinical trials showing CB12 performs this action better than 18 leading oral hygiene brands, there is little doubt that the product represents something of a breakthrough in the management of halitosis, allowing a single dose to deliver all-day fresh breath confidence for all suffers over the age of 12. CB12 also contains 0.05% sodium fluoride to help prevent tooth decay and promote all round better oral health.

So, whether a patient comes to you with concerns about bad breath, or it is left to you to approach the sensitive subject, it is essential you can recommend an effective solution to suit any lifestyle.

Clinically proven mouth rinses are a convenient and affordable method of tackling halitosis at the source, and can be the simplest way of relieving sufferers of their anxieties.

By encouraging the regular use of such products and educating your patients on the full importance of an effective oral health regime, you can help your patients enjoy a life free from halitosis.

• References available on request

For more information on CB12, visit

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