11. Which chewing gums and mouthwashes should I use to get rid of halitosis?

The vast majority of chewing gums produce two effects (at the most): they increase saliva production (which is what happens naturally when we chew) and they can mask malodour (as they release a more intense smell (mint, cinnamon, etc.)).

Patients know that the masking effect only lasts a short while, so it would therefore be a gross exaggeration to say that these two effects “eliminate bad breath”. The production of extra saliva can be of some benefit to those suffering with dry mouth, although a few minutes after the patient stops chewing, the bad breath, dry mouth etc. return. As a result, chewing gums are not recommended for treating bad breath or dry mouth problems.

Continued use of chewing gum can lead to joint problems related to the opening and closing of the mouth (temporomandibular articulation, which is characterised by noise, wearing down of the joint surfaces, pain, swelling, etc.) and creates excess acid in the stomach (which is a neuronal reflex of chewing) which can cause gastritis, ulcers, etc. There are other ways to increase saliva production with are not harmful and, of course, many other ways to treat bad breath. Now there are chewing gums on the market that contain antimicrobials and probiotics. Although they have been proven to show some degree of effectiveness, they only have a short-term impact (and only yield therapeutic benefit when the cause of the bad breath is intra-oral).

“Chewing gum is not recommended for treating bad breath or dry mouth problems”.

As for mouthwashes, I think I have made my opinion clear. A good mouthwash should be alcohol-free (which eliminates the “burning” sensation during use) and contain scientifically tried and tested antimicrobials, such as el cetylpyridinium chloride or chlorhexidine digluconate, or substances which neutralise bad odours, such as zinc lactate or sodium chloride. When the cause of the bad breath is in the mouth (oral bacteria), these mouthwashes have their use and can work well. The problem is that the ingredients of many of the mouthwashes on the market do not contain substances whose effectiveness has been scientifically proven. For any other causes of halitosis (causes not related to oral bacteria) mouthwashes are not effective therapeutic agents. For this reason, nearly all manufacturers of mouthwashes containing antimicrobials include mint flavouring in their products, in an attempt to disguise their lack of effectiveness in dealing with halitosis that is not caused by oral bacteria).

Therefore, if a person uses a scientifically tried and tested mouthwash twice a day and continues to have bad breath, the cause will not be oral bacteria but something else. It is not realistic to rely on the odour-masking substances found in the ingredients of mouthwashes (which in most cases tare only included for marketing purposes) such as mint, as their effects only last for around 15 minutes, at the most. The various types of halitosis need to be vigorously treated at their source, not masked by mint or cinnamon-flavour chewing gum, mint-flavoured mouthwash or similar products. The benefits of certain pleasant-smelling foods (parsley, etc.) or even capsules sold in some stores do not always work for everyone, and even when they do, they rarely last for more than one hour.