Getting Rid of Bad Breath

Just ate some garlicy hummus? Great, but you may want to listen in on our first story.

Approximately one in three people suffer from halitosis—bad breath. What can we do about it? I’ve got videos on tongue cleaning, gum chewing, and the best mouthwash. Population studies suggest that those who eat fewer fruits and vegetables may be at higher risk, but there are a lot of things associated with worse diets that are also linked to halitosis, though the fruit and vegetable link seemed to remain even after controlling for these other factors.

It works in dogs. Vegetable chew toys seem to help, but what about people? There is a compound found in cruciferous vegetables that can effectively eliminate the volatile sulfur compounds like the rotten egg gas hydrogen sulfide. These are the foul gases that cause bad breath produced mainly from the breakdown of sulfur-containing amino acids concentrated in animal protein—cysteine and methionine. The cruciferous compound gloms onto the sulfur compound and prevents it from going gaseous, whereas peppermint, spearmint, wintergreen, and many of the flavors in breath mints and chewing gum didn’t actually treat the cause, and just have kind of have a masking effect, whereas something like broccoli chewing gum might help at least temporarily, but why not just eat broccoli instead?

Researchers have tried using a compound that clears cysteine from the tongue for those who don’t just want to try to cut down on casein and other animal proteins that are concentrated in it. The compound they used is derived from kiwi fruit; so, can you just eat kiwis instead? No word on halitosis, but twice-daily kiwi fruit consumption for two months showed significant improvements in gingivitis, plague, and gum disease.

Of course, not all fruits are going to be beneficial. Durian fruit may give rise to the most profound bad breath because the fruit itself stinks to high heaven, as many of you will remember from my harrowing experience with it in medical school that I sheepishly related in my book How Not to Die. And the vegetable that comes to mind when you think bad breath is garlic. Is there anything you can do to deodorize garlic breath using different kinds of foods? You don’t know, until you put it to the test. After giving people some garlic, they tried whey protein, lemon juice, green tea, chlorophyll, 7UP soda, a raw pink lady apple, a cooked apple, parsley, spinach, and mint leaves. Anyone want to take a guess as to which worked best?

Parsley, spinach, and mint treatments were effective in the deodorization of garlic breath stinky compounds. They’re all green, so they wondered if it was the chlorophyll, and it turned out nope, chlorophyll alone didn’t help. There are four stinky garlic compounds. If you don’t do anything after the garlic, the stench kind of goes away on its own. And taking chlorophyll didn’t seem to change that at all, but parsley, spinach, and mint did, starting almost immediately. What do we think was going on?

Raw apples worked better than cooked apples, which are basically the same food except for the enzymes being destroyed by heating; so, maybe there was some enzymatic deodorization. And yes, raw worked better than cooked, but cooked still worked better than nothing, and so did the lemon juice and green tea, even though they didn’t have active enzymes since they were both pasteurized.

Here are the beverages data. The whey protein in water didn’t seem to work at all, even compared with the soda, though green tea and lemon appeared to do better. Maybe the acidic pH was involved in the deodorization from the lemon juice and soft drink breath experiments, since they used a sour lemon-lime soft drink.

Garlic breath volatiles (allyl methyl disulfide, diallyl disulfide, allyl mercaptan) were significantly reduced by parsley, spinach, mint, raw and microwaved apple, soft drink, green tea, and lemon juice treatments in comparison to water (the control). But they were not reduced by chlorophyll and whey protein treatments. And perhaps the polyphenol phytonutrients were the active ingredient in green tea. With consumption of full-flavor garlic, it is not yet possible to completely avoid malodorous breath associated with garlic consumption, but there are some chasers that may help you bring it down a notch.

Finally today, we explore the wondrous properties of green tea, for controlling halitosis.

Tea is the second most widely consumed beverage in the world, after water, to the tune of billions of pounds every year. I showed how drinking green tea after eating garlic helps deodorize your breath. But what about drinking green tea to deodorize regular bad breath without the garlic?

There have been a lot of studies on the effect of green tea on other aspects of oral health. For example, green tea appears to work as well as chlorhexidine for reducing plaque, and chlorhexidine is like the gold standard. Green tea is safer too. Chlorhexidine has so many side effects that you’re not supposed to use if for more than a short time period––side effects like discoloration of the teeth, increased formation of tartar, impairment of taste sensation, and occasionally damage to the inner lining of your mouth, whereas, if anything, drinking green tea appears to have good side effects.

Tea consumption is associated with living a longer life thanks to links to less cardiac death, heart disease, stroke, and type 2 diabetes—and not just by a little. A three-cup (720 ml) a day increase in tea consumption per day is associated with a 24 percent decreased risk of premature death from all causes put together––the equivalent of adding about two years onto your lifespan. The longevity link extends to both green tea and black, though the per cup effect appears greater with green.

If you compare the anti-microbial efficacy of green tea and chlorhexidine mouth rinses against the bacteria associated with tooth decay in children with severe early childhood cavities, this study found that a green tea mouth rinse was superior to chlorhexidine. But this study found the opposite. Chlorhexidine wiped out like 95 percent of the decay bacteria, versus more like 70 percent for green tea. But just rinsing with water alone can cut levels in half. So, in terms of protecting teeth, the effectiveness of green tea as a mouth rinse agent has not been proven. But what about for bad breath?

The effect of green tea on halitosis has evidently been well known from early times, perhaps due to the deodorizing activity of certain antioxidant polyphenols. But you don’t really know until you put it to the test.

This study found that sucking on green tea tablets reduced stinky breath compounds. But who sucks on tea tablets? Here, green tea was compared to breath mints, chewing gum, and parsley oil, and green tea seemed to help, but it did not reach statistical significance. But again, this wasn’t drinking or swishing with green tea, but rather some green tea power sprinkled on people’s tongues. This study used actual tea and found that one minute later, swishing with green tea was no better than swishing with water.

Okay, but what about chronic use over time? This is the study I had been looking for. A randomized, double-blind, placebo-controlled trial in which people rinsed their mouths twice a day for a month with a green tea mouthwash, or a similar looking and tasting placebo mouthwash. And at the end of the month, the stinky bad breath compounds were reduced nearly 40 percent in the green tea group, versus closer to only 10 percent in the placebo group.

Bottom line: a systematic review on the effect of the tea plant on decreasing the level of halitosis concluded that green tea mouthwash can indeed reduce bad breath––though they don’t feel the evidence is sufficiently robust for dentists to start recommending it on its own, due to lack of enough randomized clinical studies. But green tea mouthwash can be a good treatment of choice beside other halitosis treatments, like tongue scraping, to achieve better clinical results.