Sunday 25 February 2018

Dealing with bad breath and shaving tips to avoid inflammation

Smoking is bad for your breath, as is alcohol and coffee
Smoking is bad for your breath, as is alcohol and coffee

Nina Byrnes

Advice from our GP on how to tackle bad breath and how to avoid irritation during shaving.

Question: My mouth feels constantly dry and my family tells me I have bad breath. This is very embarrassing and makes me quite paranoid when talking to others. I think I have decent dental health. What could be causing this?

Dr Nina replies: Bad breath, or halitosis as it is medically known, will likely affect most people at some stage in their lives. In most cases there is a short-term cause and the condition resolves but occasionally it can be more prolonged. This can be embarrassing and lead to reduced confidence and anxiety.

Coffee and cigarettes are two of the most common causes of halitosis and this combination can be particularly unpleasant. Foods such as garlic, onions or certain spices are another common cause of bad breath at some stage.

Alcohol is another culprit (beer breath anyone?). This is often most pronounced the next morning.

Morning halitosis is almost universal. We produce less saliva at night. Our mouths become drier, thus food debris and dead skin cells that are normally washed away accumulate. Bacteria work on these, producing a very unpleasant smell.

Any disease of the mouth or poor dental hygiene will increase the chance of halitosis. Bacteria colonising the tongue can produce sulphur compounds and may cause bad breath. Fixed dentures can be harder to clean properly and may result in an increased risk of halitosis.

Disease of the nasal cavity and throat may also result in halitosis. Those who suffer with chronic sinus problems and congestion tend to have bad breath. They may have increased levels of bacteria present, which can affect breath. This leads to a chronic dried mouth, which is a common cause of halitosis. Other diseases of the chest and lungs can also contribute.

A less obvious cause of halitosis is acid reflux or stomach problems. Helicobacter pylorus is a bacterium that can live in the stomach and lead to conditions such as heartburn or gastritis. Treating digestive problems can improve breath in some people.

Those with pseudo halitosis are convinced they have bad breath, even when there is no evidence to confirm it. This is a psychological condition but those affected may spend time and money trying to get a diagnosis. Psychological therapies may help here.

It is hard to smell your own breath and those closest to you may notice or confirm it.

A visit to the dentist is a good starting point to check your gum and dental health and to have any active dental disease treated. Drink plenty of water as a dry mouth can emit unpleasant odours amd avoid smoking and drinking too much coffee. Make sure to brush your teeth and tongue regularly, and after consuming smelly and spicy foods. Use a daily antibacterial mouth wash (chlorhexidine) and floss your teeth daily.

Visit your doctor to be assessed for any sinus, throat or gastrointestinal problems. You can be referred for a breath test to rule out helicobacter pylori and sometimes trying a course of medicine to eradicate stomach acid can help.

Question: I started shaving my face a few months ago. My skin was fine before, but now I seem to have acne across my lower face. Am I allergic to shaving or what is causing this?

Dr Nina replies: It is unlikely you are allergic to shaving, but running a razor across the skin can irritate it. It is important to use appropriate skin products and take care of your skin. It is unlikely that shaving has brought on acne, and more likely an infection related to inflammation in your hair follicles. This is either folliculitis or pseudofolliculitis barbae.

Folliculitis is commonly caused by a bacterial infection or, though rarely, a fungus may be the cause. Superficial skin infections are most common. Bacteria that live on the skin most commonly cause these. This causes red inflamed and at times itchy lumps. These may fill with pus and appear as yellow pustules resembling acne. If infection lies deeper, large thick red lumps, which may be painful, may appear.

Pseudofolliculitis barbae may appear similar but this is due to ingrown hairs growing back into the skin after shaving, leading to inflammation and redness.

Folliculitis may improve using antibiotic ointments or creams. More pronounced infection might require antibiotic tablets. It is important to treat this as, if untreated, scarring can occur. In chronic infection, steroid creams may reduce inflammation.

Growing a beard for up to 30 days may allow the inflammation to resolve. Or consider using an electric or single blade razor that leaves you with a five o'clock shadow. Keeping the hair above the skin line may reduce inflammation in the hair follicle. For close shaves, using new, clean blades each time is essential. Apply a warm cloth to the face to heat the skin and soften the hair. Apply a decent amount of shaving cream. Shave in the direction of hair growth, not against it. Rinse the skin and pat the face dry after shaving.

Avoid using a cream or lotion that contains alcohol as it may irritate the skin. Applying a cream that contains glycolic acid unclogs pores and may help reduce infection.

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