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Like many on here, I have explored countless routes to investigate the cause of my BB to try and cure it. I thought it came from my nose (post-nasal drip), my gut (acid reflux), allergies, and dry mouth. In the end, it was none of these things. Here are some things I had done while trying to cure my BB, based on what I thought were the causes:
Sinuses/Allergies
- Surgery: Nasal Polyp Removal
Surgery: Deviated Septum correction
Surgery: Nasal passage widening using balloon sinoplasty to widen nose and help breathe through nose
Nasal irrigation devices to wash sinus using baking soda/salt solution
Allergy Medications
Allergy Testing and Allergy Shots
- All Acid/PPI medications (omeprazole, pantaprozole, etc.)
Multiple stomach endoscopies
Silent Reflux (LPR) Test
Surgery: LINX implant - a titanium ring now permanently sits on my stomach/esophagus to prevent reflux.
Multiple H. Pylori Tests (negative of course)
- Tried dry mouth meds (salagen and evoxac)
Have spent thousands of dollars over the years on Dry Mouth lozenges from Biotene, ACT brand, etc.
Mouth covering tape to prevent mouth breathing
- Antibiotics
Probiotic toothpaste
Essential oils
Chlorhexidine Mouthwash
Castille soap
Bleach and hydrogen peroxide
Several hundreds of dollars worth of oral probiotic lozenges found on Amazon
The list goes on. You name it, I've tried it.
I took the test, and discovered that I had really high levels of two or three halitosis-causing bacteria, that reside in the gum line: Fusobacterium Nucleatum, Prevotella Intermedia, and Tannerella Forsythia. In addition to this analysis, the Bristle team offered a treatment plan and recommended that I use SmartMouth Clinical Strength mouthwash for 2 weeks, and afterwards, repopulating with oral probiotics for several months, to try and change my oral microbiome over time. I tried using the SmartMouth mouthwash, and it helped somewhat for sure, but only temporarily. I knew that it was doing something, and ended up going off the deep end: spending hundreds of dollars more on SmartMouth mouthwash over the course of several months, because I became dependent on it to mask my BB enough for me to go out of the house.
After some further investigation, I came across a different oral microbiome test that was based out of Canada, called OraVital. Similar to Bristle, OraVital does a microbiome test via saliva, and comes back with results (which in my case, matched the same bacteria I had discovered in the Bristle test). However, additionally, they offer a 3 week antibiotic treatment plan (amoxicillin/metronidazole mouthwash and gum ointment), followed by chlorhexidine mouthwash. This was much stronger than what Bristle offered. I did the treatment, and it helped enormously when I was on it. However, sadly, the BB returned when I completed the antibiotic solutions. I was sad and defeated once again.
Next, I came across a third oral microbiome test, by a company called Viome, called the Oral Intelligence Test. This test does the saliva sample, but doesn't give you a list of the bacteria they find. However, they give you an oral probiotic lozenge that is supposed to be custom for you. I noticed the strength of the oral probiotic lozenge to be 30 billion CFU. This was a clue for me, because other probiotic lozenges that I came across online were only in the range of 3-6 billion CFU. The fact that this was 30 billion meant that more probiotic bacteria were needed to combat the problem.
I ended up taking the Viome oral probiotic lozenges for some time, but experienced only modest results. However, they did help somewhat with my morning breath when taken before bed. But the BB always came back.
Over the course of time, it dawned on me. This problem is more severe. It requires more effort to remove the bad bacteria, and more effort/strength to repopulate with good probiotic bacteria.
It was then that I had a revelation that made all the difference. Instead of relying on oral probiotic lozenges, with their relatively minimal strength, why not use extremely high doses? I resorted to trying probiotic powder instead of lozenges. The dosages in some of these powders was over 100 billion CFU per scoop.
The Bristle test indicated that the bad bacteria I have were sensitive to reuterin, which is produced by the probiotic L. Reuteri. I came across L. Reuteri powder on Amazon. Additionally, I came across L. Salivarius powder as well, which a probiotic that produces a compound called saliviricin that kills bad bacteria as well.
- L. Reuteri Powder: https://amzn.to/44LMcPx
L. Salivarius Powder: https://amzn.to/3KnX64Z
One thing to note here is that, for the probiotic bacteria to have optimal effect, you need to clean your mouth and tongue before using them. I read in a scientific study that they found probiotics had a significantly higher benefit when used after tongue scraping/brushing. I use both a tongue brush and then a tongue scraper, before I do the probiotic rinse. I also do not eat or drink water for at least 30 min after rinsing.
Within weeks of doing this, I noticed the bad taste in my mouth was gone, when I tried to search for it. My perceived 'dry mouth' was gone, and my saliva flow had increased significantly. I always thought I had dry mouth, but I came across scientific articles online which suggested that the bad bacteria is what was actually causing that feeling. Bad bacteria change the pH of your mouth and cause that taste and feeling of dryness. They reduce salivary flow.
I was encouraged by the results, and I then started doing additional research. There were other healthy probiotic strains out there that were good for the oral microbiome and for combatting bad bacteria. One that I came across was Weissella Cibaria. This bacteria is naturally found in the mouth, and can colonize it. L. Reuteri and L. Salivarius, on the other hand, are just passing through the mouth and do not stay there. Therefore, they can help the oral microbiome by killing bad bacteria, but do not have a permanent residence there. If you don't have a solid presence of good bacteria in the mouth, the bad bacteria that is wiped out can grow back. This is what happens when we use antibiotics. Sure, they're able to kill off bad bacteria, but even the small remnants can multiply back rapidly if there are not enough good bacteria to outcompete it. To get Weissella Cibaria, I found an oral probiotic lozenge that has a patented form called OraCMU:
- Weissella Cibaria Lozenge: https://amzn.to/3UH6ULR
I have gotten really big into fermented foods. I am constantly on the hunt for fermented foods and will try to have them whenever and wherever I can, as much as I can. They're not the most appetizing, and can smell pretty bad, but they are working to permanently shift my oral microbiome over time. I even got a yogurt maker off Amazon and began making my OWN L. Reuteri yogurt using a starter culture, half and half, and fiber powder (inulin). This will help create a lasting effect to permanently alter my oral microbiome to prevent bad bacteria from ever coming back.
The role of probiotics in curing oral imbalance cannot be understated. I have read multiple studies relating to probiotic research regularly, which has only begun exploding in the scientific industry in recent years. This is a really exciting time. After years of very limited progress on fixing halitosis, it seems that probiotics is the solution to combating the issue. One thing to note is that it takes time to rearrange your oral microbiome. It didn't get this way overnight. Getting out of it is the same.
In addition to populating the mouth with good bacteria, it is EQUALLY important to keep up with a regimen to clear the mouth of the bad bacteria, which must be done regularly and in parallel with the probiotic regimen. Every morning and night, I do the following routine:
- Tongue brushing with a Tung brush or orabrush (and go as far back as you can go)
Tongue scraping with a metal scraper (as far back as possible)
Brushing with Nano-Hydroxyapatite toothpaste which is beneficial for oral pH, removing biofilms, and mineralizing teeth. Some brands I use are Carifree and Boka -- https://amzn.to/44NGRav
Flossing. I use the REACH Floss Stick.
Tongue Brushing/Scraping again.
Probiotic routine. For mornings, I do the powder. For evenings, I just take a couple of lozenges. I take the Weissella one, and/or well a Viome one that I have leftover from my Viome subscription. I also take them randomly throughout the day.
Occassionally, I will use the SmartMouth Clinicial version of mouthwash for a nice cleanse of bad bacteria. There is a regular version and a clinical version, the clinical one is much more effective -- https://amzn.to/3ULAvUE . It is important not to overdo this because it can disrupt the good bacteria as well in addition to the bad.
And that's about it. That's where I'm at now, and I will continue doing this routine for the coming year, because I have seen in the past how resilient this bad bacteria is. My goal is to continue hammering it down with probiotics, and not just to wipe it to oblivion, but to build a healthy diverse microbiome of good bacteria that will prevent it from ever growing back and out of control again. I still experience halitophobia - the fear of bad breath and reactions - even though I don't experience any. My mouth is moist and sweet. My saliva is flowing. But the fear of a reaction is a psychological condition, because it is what I've known for 20+ years. I hope to be able to shake it off over time through many positive interactions.
Good luck to all and God Speed!
