What to do about your bad breath

Chronic bad breath can have a profound effect on a person's self-esteem and daily life.

• Chronic bad breath is a problem for up to 80 million people


• Halitosis has many causes, including bacteria on the tongue


• There are steps you can take to cure bad breath

Editor's note: Dr. Anthony Youn is a plastic surgeon in metro Detroit. He is the author of "In Stitches," a humorous memoir about growing up Asian-American and becoming a doctor.

(CNN) -- I'm sitting cramped in the window seat of an airplane, awaiting takeoff for a flight that will bring me from Detroit to Los Angeles.

The large man in the middle seat has his arm draped over the arm rest, leaving me leaning and squashed against the side of the plane. I don't know how I'm going to endure four and a half hours like this.

Then it gets worse.

He starts to talk. The stench hits me like a sledgehammer to my face.

Halitosis. Dragon breath. Stank mouth.

Millions of Americans suffer from bad breath. For most, it's a problem that only rears its ugly head in limited situations, such as in the morning or after eating pungent food.

But for some -- up to 80 million people, according to the Academy of General Dentistry -- halitosis is a problem that is ever-present, no matter whether they brush and floss their teeth, rinse with mouthwash or suck on mints. Chronic bad breath can profoundly affect a person's self-esteem and daily life, even to the extent that that person may isolate himself for fear of embarrassment.

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So what causes bad breath?

Bad breath can emanate from many, many sources (PDF). Certain foods, such as garlic, can become digested, absorb into your bloodstream, travel to your lungs and reappear as bad breath. Other contributors to halitosis include poor dental care, dry mouth, tobacco products and certain medications and medical conditions.

But what about those people who don't have any of these contributors? Why do these millions of people still have constant bad breath?

If this describes you, it's very likely that your bad breath is caused by bacteria living on the back of your tongue.

These little critters create a foul-smelling gas (called volatile sulfur compounds) that resembles the smell of rotten eggs. Unfortunately, these bacteria usually live so far back on your tongue that brushing your tongue with a normal toothbrush can't reach them.

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Fortunately, there is a solution that appears to work for many bad breath sufferers. Here are four simple steps to, hopefully, curing your halitosis:

Rinse with a mouthwash containing chlorine dioxide. Then gargle with your tongue sticking out. Studies show that chlorine dioxide is very effective at neutralizing the stinky volatile sulfur compounds created by oral bacteria.

Scrape the back of your tongue using a specialized tongue scraper/cleaner (can be purchased at your dentist's office or online) and going from back to front.

It may help to pull your tongue out with the fingers of one hand and scrape with the other hand. The farther back you scrape off those little critters, the more effective this will be. Rinse the tongue cleaner after each scrape.

Floss and brush your teeth with your regular toothpaste, taking care to brush the rest of your tongue and the inside of your mouth.

Consider rinsing one more time with the chlorine dioxide rinse, keeping with the instructions on the bottle.

Before embarking on a treatment regimen for your bad breath, make sure to check with your dentist to confirm that your halitosis doesn't have a medical cause.

Otherwise, these four simple steps can hopefully save you unnecessary embarrassment and make you a much better seatmate on a plane.

Video: What to do about bad breath