Most patients probably don’t want to talk about halitosis—especially those who suffer from it. If you have a patient who seems to have this challenge but hasn’t mentioned it, sometimes a direct approach is best. Simply asking, “Do you ever have a problem with bad breath?” can open up a conversation. Then, you can help them feel at ease by reassuring them that halitosis, often called “bad breath,” is common, affects about half of all Americans, and there are actionable steps your patient can take to address it.
The causes of halitosis are complex and derive from both intraoral and extraoral sources.¹ Periodontitis, tongue coating, and dental decay are examples of intraoral sources, while extraoral sources can involve gastrointestinal diseases and other metabolic disorders.
Multiple factors can lead to halitosis, and in many cases, it could be stemming from something beyond the oral cavity. The good news is that a multi-step program may help reduce or eliminate the patient’s condition.
The 5R Framework
Consisting of five steps, the 5R Framework² takes a holistic approach to addressing halitosis, from removing potential causes to rebalancing the patient’s lifestyle. Start by taking a lifestyle survey of your patients who are suffering from halitosis so you can provide them with a personalized plan of action.
- Step 1: Remove—Eliminate anything that could negatively affect the gastrointestinal system or oral cavity. These factors could include certain foods, pathogens, environmental and emotional stressors, specific medications, and nutritional supplements.
- Step 2: Replace—Support or restore digestive capabilities. The patient may need to consult a gastroenterologist about adding one or more of the following: digestive enzymes, bile salts, compounded antibiotic medicaments directed at oral pathogens, and betaine hydrochloride.
- Step 3: Re-inoculate—After removing pathogenic bacteria, beneficial bacteria must be restored or enhanced. An over-the-counter probiotic supplement with various ingredients—such as Lactobacillus and Bifidobacterium strains—may help patients if their halitosis is related to extraoral causes. Intraoral causes often stem from anaerobic bacteria that produce volatile sulfur compounds (VSCs). Stabilized sodium chlorite (0.1%) is an oxidant compound that harnesses the power of oxygen to create an oral environment where anaerobes can’t survive, preventing the production of VSCs. In a pilot study, TheraBreath™ Fresh Breath Mouthrinse, which contains stabilized sodium chlorite, was shown to maintain overall oral microbial diversity, suggesting it selectively targets halitosis-related bacteria while sparing beneficial flora.³ Its pH-balanced formula can also help prevent bad breath caused by acid reflux.
- Step 4: Repair—Support the patient’s intestinal lining, beneficial bacteria, and mucosa with antioxidants, including glutamine, vitamins A, C, D, and E, zinc, DHA, and phosphatidylcholine.
- Step 5: Rebalance—Evaluate tangential contributors to halitosis. Supporting the patient’s mental health through practices such as meditation, therapy, and stress management may enhance overall well-being. Adequate sleep, exercise, and nutritional support (possibly with the help of a dietitian) are also important.
Patients who feel anxious about their bad breath may experience significant relief when they find an easy, daily-use solution like TheraBreath™ Fresh Breath Mouthrinse. It’s non-burning and has a pleasant minty flavor.
Fulfilling Patients’ Needs and Preferences
Today’s patients expect tailored solutions not only for their oral hygiene challenges but also products that align with their lifestyle and dietary values. TheraBreath™ offers dentist-formulated mouthrinses for every patient need—from caries prevention and gum health to dry mouth and whitening. Each formula includes intentionally selected, effective ingredients and excludes alcohol, parabens, dyes, and sulfates.
TheraBreath™ also considers dietary preferences: all formulas are certified vegan, kosher, and halal.
Register your office to receive a free case of TheraBreath™ Fresh Breath Mouthrinse at orders.hygienesquad.com.
REFERENCES
- Sujata Tungare; Nowera Zafar; Arati G. Paranjpe. Halitosis. National Library of Medicine, National Institutes of Health. August 14, 2023.
- The 5R Framework for Gut Restoration, The Institute for Functional Medicine
- Dinis MB, Agnello M, He X, Shi W, Tran NC. Pilot study on selective antimicrobial effect of a halitosis mouthrinse: monospecies and saliva-derived microbiome in an in vitro model system. J Oral Microbiol. 2021;13:1–9.
