HEALTHWISE

During Ramazan, Muslims around the world spend the daylight hours in a complete fast. However, hunger and thirst are not the only issues we are concerned about during this month; a common complaint, especially amongst fasting Muslims required to work with others is bad breath or halitosis. Bad breath can lead to a decrease in self-confidence and insecurity in social and intimate relations.

So what can we do to reduce bad breath whilst fasting? To be able to understand how to reduce bad breath, it is important to have some understanding of its origins.

Causes of bad breath

Bad breath is most often a result of certain bacterial activity in our oral cavity. Bacteria break down food remnants trapped in our mouth into foul-smelling gases. Large quantities of naturally-occurring bacteria are often found on our tongue, especially at its posterior end, where they are rather undisturbed during normal routine unless one thoroughly cleans it. The back part of the tongue is also quite dry and usually poorly cleansed, and bacterial populations can thrive well on the remnants of food deposits. This provides an ideal habitat for the bacteria. Over 600 types of bacteria can be found in the average mouth, of which several dozen produce high levels of foul odours when incubated in the laboratory.

Other parts of the mouth also contribute to the overall odour. These include the space in between the teeth called the inter-dental areas and the space below the gums called as sub-gingival niches. The layer of plaque present anywhere in the mouth prompts bacterial activity on the trapped food debris, and will result in bad breath.

Poor oral hygiene

The number one cause of bad breath is poor oral hygiene. If we do not maintain good oral health by brushing twice a day, flossing and using a mouth wash, we are less likely to wash away and reduce the number of these natural bacteria, resulting in bad breath. Not removing and disturbing the bacteria in the mouth present in the plaque will also lead to dental diseases such as dental caries commonly known as tooth decay and gum diseases.

Dry mouth

The intensity of bad breath, however, can differ depending on diet and dryness of mouth. As a result of the mouth being drier whilst fasting, there is more of a potent smell.

Saliva is the natural mouthwash we were born with. Saliva helps wash bacteria and food from the mouth. Bad breath is worst when there is little or no saliva flow, which happens during a long fast. This is because whilst we are fasting we abstain from all food and drink during day light hours. As a result, our salivary flow rate is lowered causing us to have a dry mouth. If the mouth is dry and not cleaned properly, dead cells and bacteria can build up on the tongue, gums and the insides of our cheeks. These cells then start to rot and give us bad breath.

Food and drink

Certain foods, such as onions, garlic and some spices may cause the breath to smell after consuming them. Bad breath from garlic is not caused mainly from the bacteria, but from garlic itself.

The bacteria in our mouths tend to give off higher volumes of smelly gases when they decompose proteins, such as meat or fish. If bits of meat get stuck between your teeth and you do not clean them properly, your risk of having bad breath is significantly increased.

During fasting, Muslims can brush their teeth with toothpaste as long as they do not intentionally ingest the toothpaste. It is also possible to use mouthwash as long as the mouthwash is not ingested. Brushing twice a day with the correct use of a mouthwash during Ramazan and throughout the year should significantly reduce bad breath from occurring.

Maintaining good oral hygiene

The things that we can do to reduce bad breath both during Ramazan and throughout the year should now be obvious and the reasoning should be easier to understand. We have established that the main cause of bad breath is poor oral hygiene. Therefore, the main treatment for bad breath is to ensure we maintain good oral hygiene by cleansing the mouth of bacteria and food remnants. Below are the guidelines for maintaining good oral hygiene:

• Brush your teeth using a fluoride toothpaste and a soft bristled toothbrush in a circular motion gently, twice daily for two to three minutes. Clean your teeth last thing at night before bed and after breakfast each day. In Ramazan, it will be after the last meal before sleep and after Suhur. Brushing should ensure that all the tooth surfaces including the back of teeth, gum margins and the tongue are clean and plaque-free.
  
• Use an alcohol-free anti-bacterial mouthwash. Alcohol can dry out and irritate your mouth. Take a cap full of mouthwash in half a glass of lukewarm water after brushing, and rinse the oral cavity well. The area where the brush could not reach will then be cleaned by the antibacterial action of the mouthwash.
  
• Use floss, interdental brushes and tongue cleaners to aid in completely getting rid of plaque and food remnants in your mouth to get rid of bad breath.
  
• After dawn, snack on apples, pears, carrots and cucumbers. These crunchies full of fiber and roughage will cleanse the oral cavity and encourage production of saliva. Fruits that are rich in Vitamin C like oranges, berries and guavas fight gum diseases which cause bad breath.
  
• Avoid salty, sugary, fried, processed and sticky food.
  
• Cut down on diuretics like coffee, tea, soda and all other caffeinated drinks.
  
• Avoid smoking.
  
• Drink plenty of water between iftar and sehri. Take small sips, but drink frequently.
  
• Use miswak to stimulate salivary flow.
  
• Make sure that you visit your dentist at least twice a year for checkups and dental cleanings.