Bad breath? Certain types of probiotic bacteria can help

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When it comes to persistent bad breath, the types of probiotic bacteria found in fermented foods like yogurt, sourdough bread and miso soup may help alleviate the offending odor, suggests a new study.

An analysis of previous studies revealed that certain bacteria taken as supplements, including Lactobacillus salivarius and Lactobacillus reuterican help freshen breath, according to the report published Tuesday at the BMJ Open.

Bad breath, or halitosis, “is the third disease that most leads patients to the dentist, second only to [cavities] and periodontal disease,” write the Chinese researchers.

One of the main causes of persistent bad breath is gaseous mixtures of sulfur and other elements, known as volatile sulfuric compounds, produced by bacteria in the mouth, researchers note.

Would it be possible to neutralize the effects of these compounds?

To take a closer look at whether probiotic bacteria can help control bad breath, researchers scoured the medical literature for studies on the subject. Ultimately, they found seven clinical trials that involved a total of 278 people ages 19 to 70.

The severity of bad breath in the trials was assessed by measurements of the compounds detected in the mouth, along with a score that indicated how strong the bad breath odors were at various distances from the mouth.

When the researchers pooled the data from the seven studies, they found that compounds related to smelly breath were significantly decreased in participants who consumed probiotics, compared to those who received placebos. The improvements were not permanent, however, lasting about four weeks.

While the findings were encouraging, the researchers note that the original studies were relatively small.

“Further high-quality randomized clinical trials are needed in the future to verify the results and provide evidence of the effectiveness of probiotics in the treatment of halitosis,” they said.

The findings make sense, said Dr. Alessandro Villa, chief of oral medicine, oral oncology and dentistry at Baptist Health South Florida’s Miami Cancer Institute. What is not known is whether replacing real foods like yogurt or pickles will have the same positive effect as taking a supplement.

It would be reasonable for a person with bad breath to do a small experiment — for a week or so — to see if consuming such fermented foods could make a difference, Villa said.

Fermented foods and probiotics are made up of beneficial live microorganisms, but it’s important to know what types and amounts of bacteria they contain, said Dr. Martinna Bertolini, assistant professor in the department of periodontics and preventive dentistry at the University of Pittsburgh.

“One thing to consider is that consuming dairy products to include a probiotic-rich diet can also lead to increased consumption of carbohydrates and sugars and lead to increased plaque and biofilm buildup,” Bertolini said via email.

Nutritionist Perri Halperin said people with persistent bad breath should see a dentist for possible underlying health issues.

“It could be indicative of health issues that aren’t necessarily dental issues,” said Halperin, clinical nutrition coordinator at Mount Sinai Hospital in New York.

Possible causes of bad breath include:

  • gum disease
  • cavities
  • Certain foods, such as garlic
  • Problems with the tonsils
  • Kidney disease
  • severe diabetes
  • Dry mouth

Dry mouth, a condition in which the body doesn’t produce adequate saliva, can be a result of poor hydration, as well as medications, such as some used to treat high blood pressure and diabetes, Villa said.