DEAR DR. DONOHUE: My teenage son has the foulest breath I have ever smelled. It’s not for a lack of effort on his part to get rid of it. He takes a toothbrush to school and often brushes five times a day. Mouthwashes do nothing for him. What can he do? His social life is bound to suffer. – N.S.

ANSWER: Illnesses that produce malodorous breath include kidney and liver failure, tooth decay, mouth infections and lung infections. It is unlikely that a healthy teen has any serious medical problems, but he might have a dental problem, so a visit to the dentist is the first order of business.

If he obtains a clean bill of health, then mouth bacteria are the cause of his halitosis. Some bacteria produce sulfur-containing gases that are indescribably offensive. Those bacteria usually hang out on the back of the tongue. In addition to tooth-brushing, your son needs to tongue-brush as far back as possible.

Rinsing the mouth with tea eliminates bad breath for some people.

The best way of conquering bad breath is the way described by dentist Dr. Marvin Cohen of St. Louis. He outlines a battle plan that effectively eliminates the gas-producing bacteria. It involves the use of zinc chlorite and sodium chlorite (chlorite, not chloride). Commercially it is available as TriOral, a product that comes in two bottles that you mix according to directions on the label.

If it’s not available in your drugstore, ask the druggist to order you some. It is marketed by Triumph Pharmaceuticals of St. Louis.

If you would like to read the article on Dr. Cohen’s protocol, ask a librarian to obtain a copy of the February 2003 issue of Nutrition and the M.D.

DEAR DR. DONOHUE: I am a 33-year-old woman, and I have a pale white discharge from my nipples. Could this be an indication of something serious? – N.M.

Let’s deal with the cancer issue right off the bat. Cancer-caused nipple discharges usually affect only one breast. The discharge can be clear, blood-tinged or outright bloody. If, in addition to having a discharge, the woman feels a breast lump, then the suspicion of cancer rises considerably.

Noncancer causes are the more usual causes for nipple discharges, especially in women younger than 35.

Inflamed and enlarged milk ducts – mammary duct ectasia – is a common cause of nipple discharge. The ducts become clogged and produce a thick gray, green, yellow or red-brown discharge. Warm compresses can often heal it. At times, antibiotics are needed.

Noncancerous growths within milk ducts are another common cause for nipple discharge. The discharge can be clear, watery or bloody.

Breast manipulation leads to a milky or multicolored discharge. Running without a bra on is an example of breast manipulation that can bring on a discharge.

Prolactin is a hormone made by the pituitary gland at the base of the brain. It stimulates milk production and, therefore, nipple discharge. Tumors of the pituitary gland are responsible for inappropriate prolactin production.

Even at your age and with both breasts leaking, you should not dismiss this discharge until your doctor has examined you.

DEAR DR. DONOHUE: I find that if I eat four prunes a day, I can stay regular. Is that too many to eat every day? – S.P.

Prunes are newly named “dried plums.”

Four dried plums a day are not going to get you into any trouble. They have natural ingredients that work as gentle laxatives. Their fiber contributes to the laxative effect. Fiber, however, is not the sole factor involved in the laxative effect, for dried-plum juice also works.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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