Is there any subject as mundane as bad breath? And yet this is a very common problem for everyone. Singers may find it of particular concern, since they’re often in close proximity to others. A love duet with halitosis may be more than uncomfortable–it might hurt your career.
Bad breath is most often caused by the action of bacteria in the upper aerodigestive tract. The mouth usually harbors a variety of bugs. Many of these flourish in microenvironments with little or no oxygen (called anaerobic or microaerophilic), such as the crevasses between the teeth and gums, or in pockets within the tonsils. The breakdown products of bacterial metabolism, such as dental plaque, dental caries, debris in the tonsils, and gases, are a prime cause of bad breath. Since these bacteria need little oxygen, they continue to work when your mouth is closed, such as during sleep. Even in people not normally prone to halitosis, this can lead to “morning breath” the next day.
Other sources of bad breath include the nasal passages and the nasopharynx. Infection in the nose or sinuses may produce pus, which has an unpleasant smell. Mucus is normally carried back through the nose into the upper part of the throat–the nasopharynx. It then progresses down to the lower throat (hypopharynx), and is eventually swallowed. When mucus becomes too thick, or when its progress is impeded by obstruction, it thickens and becomes infected. A postnasal drip with yellow or green discoloration, along with bad breath, can result.
Less commonly, conditions in the lower throat or upper esophagus can cause a stasis or reflux of partially digested food. Rarely, a chronic lung infection can give breath a pus-like smell.
When you are dieting excessively (i.e., in a catabolic state), the breath can have an acetone-like odor. This is caused by ketones–byproducts of fat breakdown. Certain foods, such as garlic or onions, produce volatile byproducts which are exhaled (and sometimes even excreted through the skin).
In most cases, however, the problem is in the upper portion of the aerodigestive tract. What should you do (and what should you not do) to minimize halitosis?
First, have a complete examination of your head and neck area (both ENT and dental) to determine any potential source of chronic infection. These need to be eradicated to remove collections of bacteria and infected tissues.
If no obvious source is found, you should embark on a daily regime of dental flossing to remove smelly plaque. Clean especially carefully around dental work, such as bridges and crowns, which can trap bacterial debris. An ultrasonic toothbrush may be useful, since it can dislodge smaller particles than ordinary scrubbing. If you wear dentures, they should be impeccably cleaned daily.
Daily nasal irrigation with salt water will reduce post-nasal drip. Steaming can loosen this mucus, or you can wash it away with a saline spray or an irrigation device. Drink a lot of water to make the mucus less viscous and easier to clear. If postnasal drip persists, find out if you have any nasal obstruction or sinus disease that causes mucus to be excessive, or excessively thick.
Brushing your tongue with a soft toothbrush can also reduce bacteria which are harbored in its crevasses. If your tonsils are chronically infected, they can also be cleaned with a Water Pik. Little pockets, called crypts, often accumulate whitish debris that smells bad. If the problem continues, the tonsils can even be removed.
Eating small, frequent meals will reduce the fluctuations in blood sugar and ketone breath that may occur when you eat infrequent larger meals or starve yourself. Not to belabor the obvious, but avoid foods that are known to cause heartburn or bad breath.
If you smoke, try to get rid of this harmful habit. Not only does the tobacco cause bad breath, but the nicotine actually paralyzes
the cilia (little hairs) lining the trachea and bronchi, making it more difficult to clear mucus from the lungs. This mucus can harbor bacteria and lead to chronic infection.
What should you not do? Do not wash your mouth, or gargle with commercial mouthwash. Although they transiently reduce the bacterial count in the mouth, commercial mouthwashes can also damage the cells lining the oral cavity. The remaining bacteria reproduce rapidly, and may be back within an hour, but the mucous membrane remains damaged and more vulnerable to their action. Furthermore, by killing off “good” bacteria, you leave yourself open to invasion by pathogenic bacteria or yeast. A vicious cycle ensues–the irritation and secondary bacterial overgrowth after mouthwash use can produce a feeling of sore throat, leading to further mouthwash usage.
Avoid breath mints and throat candies that contain sugar. Sugar is the primary food for bacteria in the oral cavity, and will lead to increased tooth decay, plaque formation, and bad breath. In the long term, you pay for the momentary improvement. Breath sprays are similar. Chewing on a clove is a traditional and sugar-free alternative to reducing bad breath.
In most cases, these measures will eliminate bad breath. Remember, the body has evolved to rid itself of bacteria. You can help this process by the measures described above. Then you, too, will be able to sing confidently “on the breath!”
