Bad breath
Halitosis, otherwise known as bad breath, can be an embarrassing problem and one that you may not be aware of unless someone draws your attention to it. What causes it though, and what can be done about it?
“There are a number of causes of halitosis but I would say that, 90% of the time, it’s coming from the mouth,” says Dr Peter Gannon, president of the Irish Dental Association.
“It’s usually because of a build-up of bacteria somewhere there. However, in about 10% of cases, the malodour might be coming from a throat or nose infection or acid regurgitating from the stomach. Smoking could be an issue too, as could alcohol. If you’ve been drinking the night before, for a good part of the following day you could have bad breath. Some foods can trigger bad breath too, such as garlic and onions.”
In most cases, halitosis can be successfully treated once the exact problem is identified, he states. A dental check-up is therefore an essential first step.
“It can be problems with teeth and with gums. If the bad breath is caused by gum disease, this will need treatment,” he says.
“We all develop a build-up of plague on our teeth – soft stuff that we brush away every day, but if little bits of that get left behind it forms what’s called calculus or tartar. That’s hard stuff that you can’t brush away. This can build-up and irritate the gums and your dentist will have to clean it away. Red or swollen gums, along with bad breath and teeth getting loose, are clear signs that people should see their dentist.”
Brush twice a day
Generally, what people need to do (to avoid halitosis) is brush their teeth twice a day.
“They also need to clean in between the teeth,” he says. “This could include flossing or using toothpicks or interdental brushes. Brushing the back of the tongue can help as well as some bacteria will build-up on the rough areas of the tongue. This seems to help with treating bad breath.”
But do you need a special brush?
“No, a person’s normal brush can be used for this. People can buy tongue scrapers but a normal toothbrush would do just as good a job.”
A good tip for finding out if you have bad breath is to stick your tongue out as far as you can. Lick the inner surface of your wrist. Wait four seconds and then smell where you licked.
Spunout, the not-for-profit website for young people in Ireland, also has some advice about beating bad breath:
Keep your teeth and mouth clean – brush and floss frequently.Drink lots of water and eat fresh vegetables.Brush your teeth after eating dairy products, coffee, meat, fish or strong flavours like garlic, curry or raw onion.Chewing parsley is an old cure for bad breath.Don’t smoke cigarettes – they really stink up your mouth.Visit your dentist regularly.Excessive sweating (hypherhydrosis)
Did you put a shirt on five minutes ago and it’s already damp with sweat? Is perspiration running down your forehead in situations where other people are not sweating at all? Are your hands always so sweaty that you are reluctant to shake hands with another person?
Dr Patricia Eadie is a consultant plastic surgeon based at the Aesthetic Surgery clinic in Dublin and at St James’s Hospital. As well as burns reconstructive surgery and plastic surgery, she treats people who sweat a lot.
But what causes hyperhidrosis – something that affects approximately 2%-3% of the population?
“For the vast majority, it has no known cause,” she says. “It’s just that some people’s sweat glands are more active than others. Some people do get excessive sweating following an injury, say to their hand or leg, but that would be in the limb that’s affected rather than in the armpits as such. We would normally treat people with axillary (within the armpit) hyperhidrosis.
“Some of these people really sweat an awful lot. They could put on fresh clothes and within five minutes they would be wet again. As well as underarm, hands and feet, some people have excessive sweating of the scalp and face. This can be associated with the menopause, but we’d be most aware of it happening to young people. We don’t know what causes it. It just seems to be a case of some people having more active sweat glands really.”
Primary Focal Hyperhidrosis (PFHH) is the most common form of hyperhidrosis and is defined as excessive sweating that’s not caused by physical activity and that appears in one area. PFHH most often affects the underarms, hands and feet and can cause difficulty for the person in work, school and social relationships.
Treatment options
1. Antiperspirants: The first line of defence would be antiperspirants (strong ones are available now) but for many people they don’t solve the problem and may cause irritation.
2. Botox (botulinum toxin type A) can be injected under the skin of the affected area in more serious cases to block the release of acetylcholine which activates the sweat glands. A special starch/iodine test is done to identify the area of maximum sweat gland activity. Local anaesthetic is used to minimise the discomfort of the injections. Dr Eadie has been performing this botox treatment for eight years.
“Botox blocks the ending of the nerve acting either on the muscle or on other glands. When it’s used for sweating problems, it lasts for about 12 months. What we find is that people come for treatment if they have a special event coming up – exams, a special interview or occasion. It can be for people in particular industries, say a dressmaker whose hands sweat a lot and she doesn’t want to damage fabric that she was handling. The cost of the treatment depends on the number of units of botox used.”
There are surgical treatments available too, mostly performed by vascular surgeons, where a particular nerve is severed in a particular area that sweats a lot, but Dr Eadie prefers botox treatment. “It is extremely effective and safe and while it has to be repeated it is not too often.”
Steps to treating excessive sweating
1. Determine if the sweating is focal (confined to one area likes armpits, soles of feet, face or palms) or generalised (all over your body).2. Check if antiperspirants available in pharmacies help.3. Talk to your doctor or consultant plastic surgeon about your condition to establish the cause, eg underlying conditions like menopause, obesity, a metabolic disorder or nerve damage. Some medication can also cause it, also overactive thyroid problems. This kind of excessive sweating is called secondary hyperhidrosis.Flatulence or belching
Is belching, flatulence or rumbling stomach a regular problem for you?
To help reduce the problem, smaller portions of these types of foods are advised, says the HSE:
Onions, cauliflower, broccoli, brussels sprouts.Beans.Fruits such as apples, pears and peaches.Wholegrains such as whole wheat and bran.Fizzy drinks.Foods that contain sorbitol (used as a sweetener in sugar-free sweets).Note: Some of these foods are important in your diet so shouldn’t be eliminated totally. Smaller portions may ease symptoms. Also, don’t overeat, don’t gulp or chew gum as you swallow more air that way, leading to wind.
“Flatulence (passing wind/farting) is very common and everyone experiences it,” says a HSE spokesperson. “It is a normal biological process, just like breathing or sweating. Most men will pass wind between 14 to 25 times a day and most women between seven to 12 times a day.
“If you have excessive flatulence, the problem can usually be controlled by making changes to your diet and lifestyle. Conditions like constipation and irritable bowel syndrome can also cause symptoms of flatulence. Medication may be required in these circumstances to help control the flatulence while also treating the underlying medical condition.”
Smelly feet
Feet can often get smelly as they contain over two million sweat glands.
The sweat itself doesn’t have a bad odour but malodour may arise when the sweat mixes with skin bacteria. To help sort the problem, here are a few tips:
Wash your feet often.Wear cotton socks (natural fibre).Don’t wear trainers.Don’t wear tight shoes.Alternate your footwear.Use a foot antiperspirant.Athlete's foot
The fungal condition athlete’s foot can also contribute to a cheesy foot smell, as well as dry flaking skin, itching and pain.
Vigilant foot hygiene is the answer, according to Podiatry Ireland: “Daily washing of the feet with soap and water, followed by thorough drying, especially between the toes, is important. Wearing dry, airy shoes and socks, not borrowing footwear from others, avoiding tight socks and using foot powder all help to keep the feet dry and infection free.”
Note: Anyone can develop athlete’s foot but it is more common in men and teenagers. As the name suggests, people who play a lot of sport are often affected because the infection is spread in places such as communal showers and changing rooms.
Useful websites
www.dentist.ie
www.podiatryireland.ie
www.hse.ie
www.aestheticsurgery.ie
www.spunout.ie
Body odour facts
Did you know that?
There are 500 types of bacteria in the gut. Some of them act on food residues and can release gases like hydrogen, methane and carbon dioxide.There is a genetic medical condition called fish odour syndrome (trimethylaminuria) that is characterised by body odour that smells of rotting fish. This is due to excessive excretion of trimethlaminuria (TMA) in the urine, sweat and breath of affected individuals. Diet change and probiotics can help.Wind is mostly passed while people are asleep.
Bad breath
Halitosis, otherwise known as bad breath, can be an embarrassing problem and one that you may not be aware of unless someone draws your attention to it. What causes it though, and what can be done about it?
“There are a number of causes of halitosis but I would say that, 90% of the time, it’s coming from the mouth,” says Dr Peter Gannon, president of the Irish Dental Association.
“It’s usually because of a build-up of bacteria somewhere there. However, in about 10% of cases, the malodour might be coming from a throat or nose infection or acid regurgitating from the stomach. Smoking could be an issue too, as could alcohol. If you’ve been drinking the night before, for a good part of the following day you could have bad breath. Some foods can trigger bad breath too, such as garlic and onions.”
In most cases, halitosis can be successfully treated once the exact problem is identified, he states. A dental check-up is therefore an essential first step.
“It can be problems with teeth and with gums. If the bad breath is caused by gum disease, this will need treatment,” he says.
“We all develop a build-up of plague on our teeth – soft stuff that we brush away every day, but if little bits of that get left behind it forms what’s called calculus or tartar. That’s hard stuff that you can’t brush away. This can build-up and irritate the gums and your dentist will have to clean it away. Red or swollen gums, along with bad breath and teeth getting loose, are clear signs that people should see their dentist.”
Brush twice a day
Generally, what people need to do (to avoid halitosis) is brush their teeth twice a day.
“They also need to clean in between the teeth,” he says. “This could include flossing or using toothpicks or interdental brushes. Brushing the back of the tongue can help as well as some bacteria will build-up on the rough areas of the tongue. This seems to help with treating bad breath.”
But do you need a special brush?
“No, a person’s normal brush can be used for this. People can buy tongue scrapers but a normal toothbrush would do just as good a job.”
A good tip for finding out if you have bad breath is to stick your tongue out as far as you can. Lick the inner surface of your wrist. Wait four seconds and then smell where you licked.
Spunout, the not-for-profit website for young people in Ireland, also has some advice about beating bad breath:
Keep your teeth and mouth clean – brush and floss frequently.Drink lots of water and eat fresh vegetables.Brush your teeth after eating dairy products, coffee, meat, fish or strong flavours like garlic, curry or raw onion.Chewing parsley is an old cure for bad breath.Don’t smoke cigarettes – they really stink up your mouth.Visit your dentist regularly.Excessive sweating (hypherhydrosis)
Did you put a shirt on five minutes ago and it’s already damp with sweat? Is perspiration running down your forehead in situations where other people are not sweating at all? Are your hands always so sweaty that you are reluctant to shake hands with another person?
Dr Patricia Eadie is a consultant plastic surgeon based at the Aesthetic Surgery clinic in Dublin and at St James’s Hospital. As well as burns reconstructive surgery and plastic surgery, she treats people who sweat a lot.
But what causes hyperhidrosis – something that affects approximately 2%-3% of the population?
“For the vast majority, it has no known cause,” she says. “It’s just that some people’s sweat glands are more active than others. Some people do get excessive sweating following an injury, say to their hand or leg, but that would be in the limb that’s affected rather than in the armpits as such. We would normally treat people with axillary (within the armpit) hyperhidrosis.
“Some of these people really sweat an awful lot. They could put on fresh clothes and within five minutes they would be wet again. As well as underarm, hands and feet, some people have excessive sweating of the scalp and face. This can be associated with the menopause, but we’d be most aware of it happening to young people. We don’t know what causes it. It just seems to be a case of some people having more active sweat glands really.”
Primary Focal Hyperhidrosis (PFHH) is the most common form of hyperhidrosis and is defined as excessive sweating that’s not caused by physical activity and that appears in one area. PFHH most often affects the underarms, hands and feet and can cause difficulty for the person in work, school and social relationships.
Treatment options
1. Antiperspirants: The first line of defence would be antiperspirants (strong ones are available now) but for many people they don’t solve the problem and may cause irritation.
2. Botox (botulinum toxin type A) can be injected under the skin of the affected area in more serious cases to block the release of acetylcholine which activates the sweat glands. A special starch/iodine test is done to identify the area of maximum sweat gland activity. Local anaesthetic is used to minimise the discomfort of the injections. Dr Eadie has been performing this botox treatment for eight years.
“Botox blocks the ending of the nerve acting either on the muscle or on other glands. When it’s used for sweating problems, it lasts for about 12 months. What we find is that people come for treatment if they have a special event coming up – exams, a special interview or occasion. It can be for people in particular industries, say a dressmaker whose hands sweat a lot and she doesn’t want to damage fabric that she was handling. The cost of the treatment depends on the number of units of botox used.”
There are surgical treatments available too, mostly performed by vascular surgeons, where a particular nerve is severed in a particular area that sweats a lot, but Dr Eadie prefers botox treatment. “It is extremely effective and safe and while it has to be repeated it is not too often.”
Steps to treating excessive sweating
1. Determine if the sweating is focal (confined to one area likes armpits, soles of feet, face or palms) or generalised (all over your body).2. Check if antiperspirants available in pharmacies help.3. Talk to your doctor or consultant plastic surgeon about your condition to establish the cause, eg underlying conditions like menopause, obesity, a metabolic disorder or nerve damage. Some medication can also cause it, also overactive thyroid problems. This kind of excessive sweating is called secondary hyperhidrosis.Flatulence or belching
Is belching, flatulence or rumbling stomach a regular problem for you?
To help reduce the problem, smaller portions of these types of foods are advised, says the HSE:
Onions, cauliflower, broccoli, brussels sprouts.Beans.Fruits such as apples, pears and peaches.Wholegrains such as whole wheat and bran.Fizzy drinks.Foods that contain sorbitol (used as a sweetener in sugar-free sweets).Note: Some of these foods are important in your diet so shouldn’t be eliminated totally. Smaller portions may ease symptoms. Also, don’t overeat, don’t gulp or chew gum as you swallow more air that way, leading to wind.
“Flatulence (passing wind/farting) is very common and everyone experiences it,” says a HSE spokesperson. “It is a normal biological process, just like breathing or sweating. Most men will pass wind between 14 to 25 times a day and most women between seven to 12 times a day.
“If you have excessive flatulence, the problem can usually be controlled by making changes to your diet and lifestyle. Conditions like constipation and irritable bowel syndrome can also cause symptoms of flatulence. Medication may be required in these circumstances to help control the flatulence while also treating the underlying medical condition.”
Smelly feet
Feet can often get smelly as they contain over two million sweat glands.
The sweat itself doesn’t have a bad odour but malodour may arise when the sweat mixes with skin bacteria. To help sort the problem, here are a few tips:
Wash your feet often.Wear cotton socks (natural fibre).Don’t wear trainers.Don’t wear tight shoes.Alternate your footwear.Use a foot antiperspirant.Athlete's foot
The fungal condition athlete’s foot can also contribute to a cheesy foot smell, as well as dry flaking skin, itching and pain.
Vigilant foot hygiene is the answer, according to Podiatry Ireland: “Daily washing of the feet with soap and water, followed by thorough drying, especially between the toes, is important. Wearing dry, airy shoes and socks, not borrowing footwear from others, avoiding tight socks and using foot powder all help to keep the feet dry and infection free.”
Note: Anyone can develop athlete’s foot but it is more common in men and teenagers. As the name suggests, people who play a lot of sport are often affected because the infection is spread in places such as communal showers and changing rooms.
Useful websites
www.dentist.ie
www.podiatryireland.ie
www.hse.ie
www.aestheticsurgery.ie
www.spunout.ie
Body odour facts
Did you know that?
There are 500 types of bacteria in the gut. Some of them act on food residues and can release gases like hydrogen, methane and carbon dioxide.There is a genetic medical condition called fish odour syndrome (trimethylaminuria) that is characterised by body odour that smells of rotting fish. This is due to excessive excretion of trimethlaminuria (TMA) in the urine, sweat and breath of affected individuals. Diet change and probiotics can help.Wind is mostly passed while people are asleep. 
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