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MEN’S HEALTHY MAGAZINE 1. What are volatile sulfur compounds, and why do they cause bad breath? What role does sulfur play, and why does it stink so much? Volatile sulfur compounds (“VSC”) are a family of gases which are primarily responsible for halitosis, an unpleasant odor emanating from the mouth. VSC are gases originated from degradation by oral bacteria of sulfurcontaining substrates found in the tongue, food debris, saliva and epithelial cells of the mouth. The waste products produced by some oral bacteria are sulfur compounds and it is this type of odoriferous waste product that usually is the root of a person's breath problems. The term "volatile" simply describes the fact that these compounds evaporate readily, even at normal temperatures. The extreme volatility of VSC explains how these compounds have the ability to offend those around us, instantly. The stench associated with rotten eggs is caused by the sulfur compound hydrogen sulfide. This specific characteristic or smell of the sulfur gas is the reason because it stinks so much. 2. How does anxiety affect VSC? I know the article mentions that an exact cause is not known, but what are some possible explanations? First of all, I’d like to highlight that in the great majority of cases, bad breath originates from alterations in the mouth itself such as gingival inflammation and tongue coating. There are also nonoral conditions including infection of the respiratory tracts and some metabolic diseases. However, many patients complain about halitosis without any clinical evidence, what sometimes frustrates the patient. So, after some researches, it has been speculated that psychological symptoms have been point out as factor inducing bad breath. A possible explanation is that in the presence of a stress/anxietyreaction the salivary glands may produce great concentration of salivary proteins. Each salivary protein may have distinct action on the formation of oral malodor. For example, the mucin, a salivary protein secreted in stressful situation allows the retention of proteins and desquamated cells in the oral cavity, which are major source for oral bacteria. Another possible reason is that, when an anxiety or stress process becomes CHRONIC (which wasn’t the case of our article) the patient might develop a salivary flow reduction. Thus, a decreased salivary flow weakens the normal cleansing mechanism of the mouth and its consequences is the increased amount of tongue coating and microorganisms, which are two of the possible explanatory factors for the generation of bad breath. But this general view still deserves further studies and still is merely a hypothesis. 3. The article mentions that stress reduces salivary flow (although it also says that this was not observed in the study). Why does stress reduce salivary flow? Saliva is secreted by an active process regulated by the autonomic nervous system and anxiety increases the secretion of adrenaline which acts in the salivary gland decreasing the salivary flow. Have you ever felt dry mouth during a stressful situation, a public speech for example ? In fact, this is an adaptive mechanism. During a stressful situation, in order to save energy, the body commands just the necessary systems to provide survival. Since the salivary glands are part of the digestive system, which isn’t the most important in such condition (stress), the organism suppress all secretions including the salivary glands, saving energy for the central nervous system and muscular system, for example. It allows everyone facing a new challenge to survive. It’s the so called “fight or flight” response to stress. 4. If a person is facing a stressful situation, how can he minimize this anxiety/VSC reaction? What techniques or tricks a person can use? The first step is try to maintain a good diet with plenty of fruits and water. Firstly because fruit is rich in acids and it’s know that an acid environment is better for minimized the malodor production. Second drinking enough water, is a good start in treating salivary flow reduction and this process will help the normal cleansing of the mouth. Believe it or not, in our clinic (at Unicamp-University of Campinas) we treat patients with dehydration ! Another very helpful technique is cleaning the tongue surface everyday. It’s important to remember that the tongue harbor large amounts of bacteria, food debris and blood components. The degree of tongue coating also plays a significant role in the breath odor formation. Dental flossing is also very important since many foods debris hides between teeth and can, therefore, contributes to the bacterial metabolism. 5. What is the best way to get rid of bad breath (besides the traditional methods such as brushing, flossing, using mouth wash, and chewing gum/mint)? Why? Cleaning the tongue reduces levels of VSC and removes microorganisms responsible for generation of breath malodor. Of course there’s no tricks for minimize bad breath. There are specific treatments to solve the problem. The best way to do is looking for a specialized Dental Clinic that deals with halitosis-patients. The clinician is able to detect the exact reason for the development of halitosis and therefore to supply the definitive treatment. SP - 105937-00002 - 555025v1