Laurie,

I am a dental hygienist and an oral cancer survivor. Most bad breath problems are caused by bacteria, frequently on the tongue. You also mention that your brother has very little saliva and a dry mouth can also contribute to bad breath. Sipping water throughout the day really helps. He should avoid sucking on mints or Lifesavers which can make the dry mouth worse. I don't know if he has teeth, but if he does, he needs to keep them exceptionally clean because his reduced salivary flow makes him very prone to decay. He should be brushing, flossing, using a Water Pik and giving himself fluoride treatments if he can tolerate it every day.

Another key to fighting bad breath is a tongue scraper. You can find them in the same place you find tooth brushes in the drug store and they come in various styles, but the kind that I find the most effective can be bent into a "U" shape and are literally scraped along the surface of the tongue from the back to the front until there is no more debris to remove. The tongue harbors a ton of bacteria and if you don't clean it, it can cause a lot of odor.

There are some good gels available to help keep the bacteria levels on the tongue low. They are available in dental offices only. If you interested, e-mail me and I can probably direct you to a dentist in Maryland who can help you or have someone send you something if you want.

I hope this helps. Let me know if you have any other questions.

Barb