Fact Check: Can Black Pepper Be Used for Halitosis?

Claim

A Pinterest post titled, " Black Pepper Health Benefits", claims that, "black pepper can be used for halitosis." In the post, the user Deena Barger states, " Black pepper, one of the most ancient and prolifically traded of spices, having been employed for culinary and medicinal use, such as for, colds, nasal congestion, diarrhoea, anaemia, improve blood circulation, heart and lung tonic, halitosis and relieve toothache, indigestion remedy, anti-inflammatory, cholera and syphilis, mild to moderate stomach complaints, hoarseness of voice and sore throat, gingivitis, minor cuts and bruises, rinse for wounds, helps to prevent or delay food spoilage."

In addition to other claims, the post claims that black pepper can be used for halitosis.

The post can be accessed here.

Fact Check

The claim is Misleading. Black pepper, with its antioxidant, anti-inflammatory, and antimicrobial properties, may offer some benefits for managing halitosis. However, it is not a standalone solution for bad breath, as halitosis often stems from multiple causes. The strong, spicy sensation of black pepper may also make it uncomfortable for some people.

Understanding Halitosis or Bad Breath

Halitosis, also known as oral malodor/Bad breath, is an offensive odor originating from the oral cavity, leading to anxiety and psychosocial embarrassment.

It is a serious concern for the patient as it could lead to social embarrassment and leave the individual reclusive or occasionally even stigmatized. As social awareness of dental hygiene continues to rise, more people seek medical guidance to help cure this distressing ailment.

Causes of Bad Breath or Halitosis

Halitosis can be caused by various underlying factors, and addressing it requires a multidisciplinary approach to identify the root cause.

On the basis of its origin, halitosis can be broadly classified as Genuine halitosis and Delusional Halitosis.

Physiological halitosis, such as bad breath in the morning, is caused by saliva stagnation and the breakdown of trapped food particles and desquamated epithelial cells. This happens due to the buildup of bacteria on the surface of the tongue, which is clinically known as a coated tongue, along with a reduced intake of liquids.

Intraoral conditions account for 80–85% of halitosis cases. Periodontal infections are marked by a significant rise in Gram-negative bacteria, which produce volatile sulfur compounds (VSCs). The connection between anaerobic bacteria that generate VSCs and bad breath is well-established. The most common VSCs include hydrogen sulfide (H2S), methyl mercaptan, and dimethyl sulfide. The surface of the tongue serves as the largest source of bacteria responsible for producing malodorous gases. Conditions such as pericoronitis, oral ulcers, periodontal abscesses, and herpetic gingivitis contribute to an increase in VSC production.

Odontogenic infections can arise from trapped food debris in deep cavities, large gaps between teeth, misaligned teeth, poor restorations, exposed necrotic pulp, wearing acrylic dentures overnight, infections at extraction sites, and poorly fitting prosthetics. Additionally, reduced saliva production or dry mouth leads to a higher presence of Gram-negative bacteria, which increases volatile sulfur compounds (VSCs), a well-known cause of bad breath.

Temporary bad breath can also occur after consuming strong-smelling foods like garlic, onions, condiments, pickles, radishes, and spices, as well as from the use of tobacco, betel nuts, and alcohol.

Kinberg et al. published a review in 2010, in which they examined 94 patients having halitosis out of which 54 had gastrointestinal pathology suggesting that gastrointestinal is one of the common extra oral causes of halitosis.

Gastrointestinal causes like Zenker's diverticulum, Gastroesophageal reflux disease (GERD), Gastric and peptic ulcers[20] have been known to cause halitosis. Helicobacter pylori is known to cause gastric and peptic ulcers and is recently associated with oral malodor. Congenital broncho oesophagal fistula, gastric cancer, hiatus hernia, pyloric stenosis, enteric infections, dysgeusia, duodenal obstruction, and steatorrhea are some of the sources of pathological mouth odour.

Delusional halitosis, also known as monosymptomatic hypochondriasis or imaginary halitosis, is a condition where an individual is convinced that their breath has a bad odour and causes social discomfort, even though no clinician or trusted person can confirm that the odour exists.

Pseudo-halitosis refers to when patients believe they have bad breath, even though they do not actually have the condition. Through diagnosis and treatment, they eventually come to understand that they do not have the issue.

Halitophobia is the fear of having bad breath, affecting about 0.5–1% of the adult population. These individuals require psychological counselling and should be given adequate time during their consultations.

Health Benefits of Black Pepper

Black pepper is part of the Piperaceae family, which consists of more than 1,000 species commonly found in tropical and subtropical regions. Its active compound is piperine, and it also contains volatile oils, oleoresins, and a variety of alkaloids. The primary alkaloids in black pepper include piperine, chavicine, piperidine, and piperetine.

Black pepper possesses antioxidant, anti-inflammatory, and antimicrobial properties, and it may also help prevent or alleviate gastrointestinal issues. By increasing the production of hydrochloric acid in the stomach, black pepper aids digestion by stimulating histamine H2 receptors. Additionally, it has diaphoretic effects, encouraging sweating, and diuretic properties, promoting urination.

Black pepper and its active compound, piperine, have been shown to enhance the bioavailability of certain phytochemicals, such as curcumin and catechins. The mechanisms behind this effect include promoting faster absorption, protecting these compounds from chemical reactions in the gastrointestinal tract, and shielding them from oxidative damage. This, in turn, improves the effectiveness of both drugs and phytochemicals by enhancing their delivery and utilization in the body.

Furthermore, black pepper exhibits neuroprotective potential, inhibits lipid peroxidation, and enhances antioxidant status. Piperine, in particular, has demonstrated the ability to lower mean arterial pressure in a dose-dependent manner. Additionally, piperine (administered at 20 mg/kg/day) has been found to reduce blood pressure by blocking voltage-dependent calcium channels.

Can Black Pepper Be Used For Halitosis?

Black pepper offers numerous health benefits, including its antioxidant, anti-inflammatory, and antimicrobial properties. Additionally, several studies have suggested that black pepper may have antihalitosis properties, though its role is often unclear or used in combination with other ingredients. There is no scientific evidence or medical agreement supporting the use of black pepper alone to treat halitosis. Furthermore, without addressing the underlying cause, halitosis cannot be effectively treated due to the variety of factors involved. Additionally, black pepper produces a sharp, spicy, and tingling sensation in the mouth, similar to other peppers, which poses a challenge for its use in treating halitosis.

A randomised control trial conducted by Kalyana-Chakravarthy Pentapati et. al. found that novel herbal dentifrice containing cloves, cinnamon, black pepper, bakul, mayaphal and camphor was found to be a suitable alternative for managing plaque, gingivitis, and halitosis.

A study article published in Cosmetics mentioned that black pepper, along with other essential oils such as ylang-ylang, cedarwood, lavender, hyssop, niaouli, peppermint, clove bud, sweet marjoram, scotch pine, patchouli, bitter orange, myrrh, tea tree, and cajuput tree, showed moderate inhibition, indicating a reasonable level of effectiveness against S. mutans and S. sobrinus, that produce volatile sulfur compounds (VSCs).

Another study published in the Research Journal of Pharmacognosy discussed dental formulations from traditional Persian pharmacy, such as “Gharagher,” “Mazmazeh,” and “Sonoun,” used for the treatment of halitosis. The article highlighted that these formulations included Piper nigrum L. (black pepper) from the Piperaceae family, along with other ingredients known for their antihalitosis properties.

While black pepper may have some antihalitosis properties, there is not much scientific evidence that supports the use of black pepper as a therapy to treat halitosis, neither is there medical consensus amongst the dental fraternity on its use for treating bad breath. 

Medical Dialogues Final Take

Black pepper offers several benefits, including its antioxidant, anti-inflammatory, and antimicrobial properties, which may help with managing halitosis. However, using black pepper on its own is not considered a scientific or a medical solution for bad breath. Halitosis can have multiple underlying causes, and effectively treating it requires addressing those factors. Additionally, the sharp, spicy sensation black pepper creates might not be comfortable for everyone, making it less ideal for regular use in managing bad breath. Maintaining proper oral hygiene and understanding the root causes of halitosis is key for managing the condition effectively. Hence the claim that black pepper can be used for halitosis is Misleading.