- Frank, a resident of Gongo la Mboto suburb in Dar es Salaam tells Your Health that he no longer wants to be connected to the feeling of stigma that he faced in the past.
For many years, 26-year-old Frank*, didn’t know that people living close to him were always put off by his bad breath, not until three years ago when his close friend, also a workmate, broke the silence.
Frank, a resident of Gongo la Mboto suburb in Dar es Salaam tells Your Health that he no longer wants to be connected to the feeling of stigma that he faced in the past.
As he narrates his story, Frank, a journalist in the city, recalls how his relationship with people, somewhat became compromised because of what he has come to know as Halitosis.
He says, “It reaches a point where I felt like people hated me. No one was ready to listen or talk to me. Whenever I spoke, it’s either people turned away or lost interest in whatever I was saying.”
But one day, Frank says that a friend approached him and revealed why it was important for him to visit a doctor in order to be treated of ‘bad mouth odour.’
“I never knew I had a problem that would require me to go to hospital. Not even my wife had intimated to me about it,’’ says Frank.
If he had understood his problem early, Frank believes that he could have saved himself from embarrassment.
“It took me time to contemplate about my problem and later went back to my friend and asked for further advice. My friend insisted that I visit the doctor. So, one day, around mid-2014, I went to Hubert Kairuki Hospital in Dar es Salaam,” Frank recalls.
He says, “That day when I arrived at the hospital, a dentist asked to open my mouth. He took a pen torch and examined all the corners of my mouth, looked at me and asked whether I was brushing my teeth regularly. I replied, yes I did, routinely.”
“That’s when the dentist revealed to me that there were plaques which had been clogged in my teeth for many years. He said they were the source of the bad smell. He gave me some medication to spray in my mouth and advised me on better ways of brushing my teeth. That’s how I got healed,’’ says Frank, with a broad-smile.
The problem of bad breath
According to Dr Christopher Ruhinda, a dentist at Muhimbili National Hospital (MNH), bad mouth odour is a dental condition caused by bacteria that live in the mouth.
“The bacteria send out volatile sulfur compounds (VSC’s) as their waste products. This is how that bad breath occurs,’’ he told Your Health during a recent interview. He adds, “Halitosis can be cured.”
“At least one out of four patients I examine each day, has the problem,’’ points out the dentist as he explains the extent of the problem in Tanzanian communities.
Through his experience, Dr Ruhinda attributes 95 per cent of the cases of people with bad breath or halitosis to the bacteria and food residues in the mouth. He says that only about 5 per cent of the problem can be caused by diabetes or other diseases.
People of all ages can suffer from the problem, he says. “If left unattended to, the smell increases and can make the victim to be uncomfortable in their social lives,’’ says Dr Ruhinda.
Mr Ibrahimu Kikoko, a resident of Tabata in the city has, at one point in his life, suffered from halitosis because of his smoking and drinking habits. He says, “I used to have a bad breath from smoking and drinking alcohol when I was at university 4 years ago. It affected me psychologically.”
Mr Kikoko says that apart from being stigmatised by other room-mates, he always quarreled with his girlfriend because of the bad breath. “Today, I hate cigarettes. They ruined my relationship with people...I remember how my roommates used to leave the room, as soon as I entered.”
“Many people hesitate to tell others how they could solve the problem,’’ he says, drawing his experience from how he came to understand dealing with halitosis.
A nurse at a medical clinic in Sinza Dar es Salaam, has once suffered from halitosis. She says that most people who face the problem are ashamed of attending clinic. “Some are prominent individuals in the society,’’ she reveals.
“I used to have the same problem in the past; I remember I went to Muhimbili National Hospital. I was taught how to brush my teeth and clean the tongue. Since that day, I never had a bad smell in my mouth again.”
Why people with halitosis are stigmatised
When Your Health went around interviewing people, there was a common complaint—stigma. Social scientists define stigma as a combination of circumstances that cause people to be humiliated by others because of certain illness or disability.
Two residents of Dar es Salaam—Mr Meshack Mzava from Mbezi Louis and Neema Simba from Buguruni said that stigma causes people not to have the courage of dealing with the problem.
Mzava said, “I know of a friend, who was stigmatised by her boyfriend just because she had bad breath and reached at a point where their relationship ended because of the problem.”
There is a belief, where Mzava comes from, that bad breath is a problem faced by people living with HIV, meaning that the stigma attached to HIV/Aids is also extended to bad mouth odour.
Ms Simba has taken the initiative to advise people on how to handle the problem. “I advise people to develop the culture of going for mouth and dental checkups in order to know whether they have the problem or not,’’ she says.
What Tanzanian researches say about halitosis
Oral malodour, as halitosis is usually referred to, by dentists, is not a problem today. Several studies have been done in the past, in an effort to address the challenge in Tanzania.
A study in the East African Journal of Public Health, published in 2010, showed the prevalence of the problem and how it is perceived among adolescents in Temeke district, Dar es Salaam.
Researchers associated bad breath with tobacco use and alcohol consumption among adolescents in secondary schools.
In 2005, a report published in the Tanzania Dental Journal showed that 92.5 per cent of patients aged above 18, who were attending dental clinic at MNH, said that there was need for more public education on oral health in Tanzania.
At least 200 patients, of whom 41.5 per cent were males and 58.5 per cent were females were randomly interviewed during the study.
Way forward from a dentist
Dr Emeria Mugonzibwa, an expert in Community Dentistry at the Muhimbili University of Health and Allied Sciences (MUHAS), added her voice to the need for public education and addressing the stigma related to halitosis in Tanzania.
She said that most of people who attend a dental clinic at the Muhimbili National Hospital (MNH) are those with pain, swelling or bleeding in the tooth but those with bad breath are very few.
She believes that people with halitosis are out there in communities but don’t turn up for treatment.
She highlighted on the need for medical doctors to act professionally in referring patients with halitosis to dentists; instead of prescribing medications that most times don’t cure the problem.
*Not their real name