Here are some facts about bad breath or halitosis:
- 90% of bad breath is influenced by what is happening in the mouth and not in the stomach.
- Most people are not aware that they have bad breath.
- Bad breath may signal a medical disorder.
- Some medications can play a role in causing halitosis.
- Sulphur- producing bacteria normally found in the mouth cause halitosis.
- The gums and tongue are the most common sites where bad breath originates.
Bad breath can be of great embarrassment. If you are concerned about halitosis, contact your dentist. A proper dental examination can help determine the cause, or causes, and a treatment plan can be developed to help eliminate the problem.
Sometime it may be easy to determine the cause of halitosis:
- Infrequent brushing and flossing.
- Sleeping with dentures.
- Not brushing the tongue and/or gums as part of your oral hygiene practice.
- Periodontal disease.
- Old fillings that may need restoring
- Dental abscess
- Extruded or drifted teeth
- Oral thrush or oral cancer
Because 90% of bad breath is dental related, an accurate diagnosis is likely inmost cases. Bacteria that occur naturally in the mouth cause bad breath. These bacteria, called anaerobes, eat the foods we eat and give off volatile sulphur compounds that cause bad breath. The more anaerobes a person has, the more sulphur produced, the greater the halitosis. If you don’t brush and floss between your teeth, foods remain in the mouth, and attract bacteria that cause bad breath. If you sleep with dentures or don’t clean them properly this does not give your gums and tissues a chance to ‘breathe’, bacteria increase, so does sulphur, and bad breath will result.
Persistent bad breath or a bad taste in the mouth can be one of the warning signs of periodontal disease. Basically, periodontal disease or gum disease is an infection of the tissues that surround and support the teeth. Unfortunately, gum disease can be silent, causing few noticeable symptoms. If plaque (a soft, thin, film found in the mouth) is not properly removed, bacteria (the main component of plaque) accumulate around and under the gums and on the tongue. This provides a fertile environment for the development of halitosis. In some cases the gums become inflamed, red, swollen, painful and even bleed-either spontaneously or when brushed or flossed. (Contrary to what some people believe, occasional bleeding of the gums is not normal.) As gum disease progresses, plaque deposits increase, harden to tartar, and cause the gums to pull away from the teeth, and the bone around the teeth to dissolve, creating gum pockets and allowing more bacteria to accumulate at a deeper level on the root. Amazingly this process is mostly painless. While these bacteria are destroying bone they are also producing the sulphur compounds that cause bad breath. Hidden under the gums and on the back of the tongue, these bacteria flourish making the gums and tongue the #1 site for the development of halitosis.
Defective fillings, extruded teeth, dental abscesses and oral cancer can contribute to bad breath by promoting the accumulation of bacteria and/or food particles which in turn promote the accumulation of sulphur compounds.
Sometimes the cause of halitosis is not dental related:
- Certain foods
- Xerostomia or dry mouth
Dieters may develop halitosis when they have infrequent meals. Diets low in carbohydrates or that have no carbs can produce a state of hunger that leads to a condition called ketoacidosis which can produce bad breath as the body breaks down its reserve of fat and protein. Certain foods like garlic, onion, radishes, cabbage and cauliflower, to name a few, can cause bad breath. In fact garlic is so powerful that garlic odour on the breath can be detected after garlic is rubbed on the feet!
Many of us are familiar with smoker’s breath. The odour from tobacco occurs for two reasons. First, tar, nicotine and other noxious substances accumulate as a brownish stain on the tongue, teeth, cheeks, etc and cause a smell. Secondly, tobacco has a drying effect on the tissues of the mouth.
Dry mouth or xerostomia is another condition that can cause bad breath. Under normal conditions, saliva cleanses the mouth and removes food that causes bad breath. Saliva also serves to balance the acid level of the mouth. Dry mouth occurs when the flow of saliva decreases because of medications, salivary gland problems, mouth breathing, age or during sleep (morning breath). When we sleep, or breathe with our mouth open, our saliva flow diminishes. A reduction in saliva flow decreases the acidity in the mouth and this allows the bacteria that cause bad breath to grow.
Certain medications can cause bad breath: antihistamines, decongestants, antihypertensives and antidepressants to name a few.
Sometimes the cause of bad breath is medically related:
- Respiratory diseases
- Liver diseases
- Kidney diseases
- Systemic diseases
If your dentist rules out all the above causes, bad breath may signal a medical disorder. Chronic sinusitis can produce very bad breath because nasal discharge from your sinuses go down the back of your throat Infections of the lung can also cause bad breath. Several other diseases can cause distinctive breath odor. Kidney failure can cause an odor similar to urine, and liver failure can cause an odor described as ‘fishy’. People with uncontrolled diabetes have a ‘fruity’ breath odor. Chronic reflux of stomach acids from your stomach into your food pipe (gastroesophageal reflux), and hiatal hernia (a protrusion of the stomach into the chest cavity) can produce bad breath.
Maintaining a healthy smile is essential to reducing or preventing bad breath. Most people can improve or prevent bad breath by practicing proper dental hygiene, including these steps:
- Brush your teeth after you eat. Keep a toothbrush at work.
- Floss at least once a day to remove food from between your teeth.
- Brush your tongue, gums, cheeks and roof of the mouth to remove dead cells, bacteria and food debris.
- If you wear a denture, clean it once a day as directed by your dentist. Try to take the denture out at night.
- Drink plenty of water and avoid too much coffee, sodas or alcohol.
- Sugarless chewing gum can stimulate saliva, washing away food particles and bacteria.
- Change your toothbrush every 2 months.
- Some dental aids can be considered in the fight against halitosis:
The toothbrush you use should be effective and comfortable – an ultrasonic or an electric toothbrush can be considered for those who may not have the dexterity to use a manual one.
A water- pick or a hydromagnetic irrigator, while not the final answer, can be a valuable addition to the home care techniques for eliminating halitosis.
A tongue scraper can be one of the most valuable tools in fighting halitosis.
If you feel you must constantly use a breath freshener to hide unpleasant breath, see your dentist. Your dentist may recommend using a special antimicrobial mouthwash.
At least twice a year, see your dentist to get your teeth and dentures examined and professionally cleaned.