HAROLD L. Ickes (1874-1952), sometime US Secretary of the Interior, said of Governor Huey Long of Louisiana (1893-1967)
that he was: "Suffering from halitosis of the intellect. That's presuming Emperor long has an intellect." Halitosis or bad breath was recently described by Meath based teacher and writer Pat Conneally as "an obstacle in the dating ritual".
Anyone who has shared a breakfast table with a garlic chewing Frenchman can appreciate this observation. Indeed it is often the mating game that provides the motivation for guys to do something about their breath. According to one dentist who spoke to this column: "My girlfriend says I've got bad breath," can be the opening gambit of not a few men's overdue deployment to the dentist's chair.
According to Dr Barry Harrington, consultant in the Department of Public and Child Dental Health in the Dublin Dental Hospital, 99 per cent of the cases of bad breath are due to gum disease: "If you've got bad breath the first thing to do is to go to the dentist." He explains that cleaning, scaling and the removal of tartar alone could solve the problem.
Dr Harrington says that men tend to go to the dentist less often than women, largely explaining why, anecdotally at least, more men than women are perceived as having halitosis. He says that the best form of mouthwash to fight bad breath is your own saliva. In the morning halitosis can come about because less saliva has been produced at night. Nasty smells result from bacteria breaking down the fur that gathers overnight in the mouth. Brushing teeth - not forgetting the tongue - after breakfast will disperse the odour in otherwise healthy mouths.
Dr Harrington believes that eating sugar free foods like fruit and vegetables regularly during the day will stimulate saliva production which keeps breath fresh. Sipping water is good too because it keeps the mouth moist. Garlic (although very good for you), onions, curries and spicy foods will emit foul smelling chemicals from the lungs. He recommends parsley as "a great neutraliser" for these odours.
Coupled with men's failure to attend the dentist often enough is their propensity to go too heavy on the drink. Halitosis can arise due to "alcohol fermentation in the stomach".
Dr Jane Renehan, lecturer in Public Health at the Dublin Dental School and Hospital, explains that a foul smelling mouth can look all right on a quick inspection. But dental decay, an open cavity, a leaking filling or a crown or bridge that's loose, in which bugs and bacteria abound, can explain the presence of bad breath.
Dr Renehan says that in older men gum disease also contributes to bad breath. She particularly advises older men to brush their tongues and clean their dentures properly. When some older people were told their dentures would last 20 years, they believed they wouldn't need to remove them even temporarily during all that time. When they finally do, their mouths can be covered in thrush. She says to men like this: "Imagine wearing your shoes and socks for years".
Dr Renehan says that many young men in their late teens and early 20s use, mouthwashes as part of their grooming. There are two types of mouthwashes. She believes that commercial mouthwashes are "expensive and not proven" and are "not a replacement for brushing" although she concedes that they could be useful for people in non fluoridated areas.
Then there's chlorohexidine. This is an anti microbial agent for someone with a bad mouth infection like thrush or for people preparing for major surgery.
Chlorohexidine, she explains, is "like Domestos - it kills all known germs. While it does the job thoroughly, it "tastes like petrol" and "blows the bacteria out of your mouth). So nasty is it to take that she advises her own students: "Never prescribe it until you taste it."
DR Renehan explains that people, being prepared for major surgery such as liver, kidney, heart or lung transplants, or people going for radiation treatment for head or neck cancers, need to take chlorohexidine because the slightest infection in the mouth could damage the success of the transplant. Dentists must ensure that these patients are "orally fit".
Chlorohexidine is so powerful that it goes on working for up to eight hours after rinsing. Treatment lasts for seven to 10 days. It's so strong it browns the teeth which need to be cleaned professionally when the chlorohexidine course is finished.
A GP and member of the Irish College of General Practitioners adds that halitosis can also be caused by smoking, tonsillitis, a large polyp or tumour in the sinuses, mouth cancer, chronic acidity or a hiatus hernia (when a portion of the stomach protrudes upwards through the diaphragm). Other possible causes include a peptic ulcer, uncontrolled diabetes and lung, liver, kidney or gall bladder diseases.
He says some patients think they haven bad breath but don't. He believes that this can sometimes indicate an obsessive compulsive disorder. Men don't often present, to the GP with halitosis but when they do it can be a "calling card for some other emotional issue".
He says: "Men don't worry about it as much as women" because of the prevalence of the "great unwashed Irish man".
Dr Richard Firth, a consultant physician and endocrinologist at the Mater Hospital, says that occasionally diabetics, whose insulin level is badly controlled can have halitosis but that in general this is not the case: "If anything their teeth will be in better condition. Diabetes is not, by and large, a cause, of bad breath unless it's badly controlled."