It’s one of the daytime nightmares of social interaction. It could have been first-hand experience that’s subsequently seared and smeared itself into your brain. It could have been a confronting olfactory memory from a long-ago conversation, that went for far too long  –  even if it literally lasted less than a minute. It may have never happened at all; and yet it remains as common a fear as public speaking. Having bad breath is embarrassing enough  –  for some, not knowing you have it, gives heft to the mortification that no amount of mouthwash will ever wash away.
 
Since people can smell their own breath in two ways (when the odour flows through the back of the mouth, and also through the tip of the nose) as the recipient of someone’s really unpleasant breath, there’s instant confusion.
 
How can they not know? Is it just that they don’t care?
 
Bad breath can be the result of having eaten something strong tasting like onion, garlic or fish – the usual suspects. Dehydration can be a cause; as can more serious issues like a gum infection, tooth abscess or ill-fitting dentures. Orthodontic devices, which includes crowns, bridges and any type of braces, can wedge food particles in places and allow bacterial growth. It can produce the unfortunate situation of bad breath, also referred to as halitosis.
 
It’s a term that emerged in the 1920s, an etymology of Latin derivation with ‘halitus’ meaning ‘breath’ and the suffix ‘osis’ descriptive of a condition or disease. American merchandiser and advertising executive Gerald Lambert (1886-1967) apparently found the term in an old medical journal and used it to bring greater attention to the affliction of bad breath by giving it a more scientific and medicinal term.
 
Why he wanted to do that, was to bring a strong sense of social disgrace to having noticeable breath. It was for what ended up being a very successful advertising campaign for Listerine mouthwash  –  a product of his father’s company Lambert Pharmacal, which later became Warner-Lambert Pharmaceutical Co. It’s a word that brought a 60% increase in sales translating to a revenue conversion of $US115,000 to $US8 million in just seven years.
 
An incredible financial breath of fresh air from not-so-fresh breath. Prior to that, Listerine had basically been a product in search of marketable and profitable use.
 
Created in 1879 by St Louis chemist Joseph Lawrence, its trade secret mix included menthol, eucalyptol and thymol. Its name pays homage to English medical scientist Dr Joseph Lister (1867-1912), experimental pathologist and pioneer of antiseptic surgery and originally sold as a surgical antiseptic and wound treatment. In 1914, in its over the counter and distilled form, Listerine was sold as both a floor cleaner and cure for gonorrhoea.
 
How that happens is anybody’s guess; and it’s no doubt an early lesson in consumer brand confusion. Early 20th century house guests prone to cupboard snooping would have been severely challenged in coming to any conclusion for its presence; its only surety animated afternoon conversation fuel over dry sherry and finger sandwiches. 
 
It is said that Listerine invented halitosis, rather than mouthwash. Unnervingly, the most pressing question is how it’s possible to not know that you have it. If everyone else within close proximity can tell, how is it that the person who has it can be so blissfully unaware?
 
Our olfactory system is designed to detect changes in our environment, and it’s worth noting that everyone is prone to having differences within that process. When the tiny molecules that smells give off are present for a period of time  –  and that can be for a minute, five minutes or an hour  –  the nose receptors that relay that stimuli to the brain’s sensory neurons stop responding, because it’s no longer new information.
 
When the value of pleasant, unpleasant or indifferent is assigned to a smell, tht in itself actually changes how long we’re able to detect it. Research tells us that when a person perceives a smell to be ‘bad’, they’re likely to identify it for longer than one that is noted as being ‘good’.
 
With apologies, to illustrate that you only have to think of bad bathroom versus bread bakery to appreciate which one the mind immediately and most distinctly recalls.
 
From a survival perspective, this is a design to alert us to potential danger.
 
If an odour is registered in an environment and in the breathing of it nothing detrimental happens, we don’t need to pay attention to it and therefore quickly lose the ability to identify it. It’s the dynamic of ‘nose blindness’   –  the phenomenon of being acclimatised to new or intense odours; and it explains why it’s more than possible to not be able to tell that your own breath is far from agreeable. Particularly if it’s a chronic rather than temporary condition.
 
Certain scent fragments have heavier molecular weight; making them less likely to swiftly disintegrate in the atmospheric surrounds. Short-chain fatty acids have a high molecular weight that’s responsible for strong smells like sweaty feet or aged cheese for instance. It’s this molecular density that has the odour linger longer than anyone with stinky feet, or a liking for Vieux Boulogne would prefer: one of which at least, will ban you from French public transport.  
 
When it’s caused by something short-term, like what they’ve recently eaten, most people are aware of their bad breath. Over time however, it’s very common to lose that ability when bad breath is persistent and possibly arising from longer term issues like dental disease, sinus or tonsil infections or gastrointestinal disorders.
 
Olfactory adaptation happens when there’s a break from the odour and sensory neurons in the brain have the opportunity to recalibrate. The capacity to notice the halitosis returns.

This is very different from having a smell disorder which is usually caused by illness or injury. Hyposmia is diminished olfactory ability; anosmia leaves sufferers with no sense of smell at all. The late great INXS frontman Michael Hutchence had the permanent impairment of anosmia after being punched in the head by a taxi driver in Copenhagen, five years before his death.
 
So entwined is the connection between smell and desire, it motivated German writer Patrick Süskind’s 1985 horror fiction Perfume. A sensationally and superbly sensate story, it spans three decades beginning in 1738.  Possessing no odour of his own, its protagonist Jean-Baptiste Grenouille has prodigious olfaction, as he learns the art of perfumery, through the streets of Paris he gradually and murderously captures human scents. Not just any: he covets particularly rare human beings, whose wondrous aromatic essence inspires love.
 
As a self-confessed sensualist, Hutchence was fascinated by the book and famously gave his girlfriend at time, Kylie Minogue, a copy. It’s been suggested it was the later anosmia that brought about a significant personality change, depression and increasingly self-destructive behaviour in him. He mentioned that completely losing the ability to smell and taste anything at all, had left him “floating in space”.
 
Since publication, Perfume has sold more than 20 million copies across 49 languages. Such is its magnificent magic realism, it has been credited as the flint of imagination for the 27 Club member Kurt Cobain’s Scentless Apprentice  –  a singularly powerful piece of grunge hard rock, and the second track of Nirvana’s 1993 final studio album, In Utero.
 
Often where there’s magic, there’s myth and there’s mystery. And although there are few real mysteries about bad breath, there are some mistaken beliefs.
 
Being able to tell that you have it by breathing into your cupped hand, is one of them. 
 
The reason it doesn’t work is because your breath isn’t coming from the back of your throat as it does when you’re talking. It misses the gaseous odours produced at the back of the tongue  –  the most common area from which bad breath originates.
 
The methods doctors use to test for bad breath are sniffing 5cm from the patient’s mouth or from a spatula scraping of the back of the tongue; or by incubating a petri dish of a saliva sample for five minutes at 37°C. 
 
It’s also not true that halitosis is always caused by a problem elsewhere in the body. For the small percentage whereby this is the case, it’s absolutely atypical for bad breath to be the only symptom.
 
Reaching for the mouthwash is another misconception in treating halitosis; no matter how Gerald Lambert’s advertising campaign wiped the floor at the time.
 
The mint or clove additives will certainly temporarily disguise it, but with most oral rinses containing alcohol, there’s great debate about its worth. There’s the negative disruption it causes to the oral microbiome; as well as it contribution to drying out the mouth  –  a known factor in the halitosis stakes.
 
Interestingly, not everyone who thinks they have bad breath actually does.
 
One study quantifies that as 27%. Basically, it’s a misinterpretation of why people turn away, or step back when they’re speaking. Maybe they’re intolerable on another level  –  but clearly, it’s not their breath. Moreso, these are not the usual reactions to bad breath anyway: mostly people stop breathing through their nose and pretend it’s not happening.
 
If it is happening, and you wouldn’t have known it was you it was happening to were it not for a nice and honest friend, understand that it’s normal to be embarrassed; but be comforted too. Only a true friend puts their awkwardness aside because what they really care about, is you. 
 
So see your dentist, have it checked out and everything will come up roses. Maybe even buy some for that kind and considerate friend. 

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