Bad breath, or halitosis (pronounced hal-it-toe-sis), can be a temporary condition or a long-term problem that causes anxiety and embarrassment: anxiety if it becomes an ongoing battle and embarrassment if someone suddenly tells you, “You might want to brush your teeth.”
There are a number of causes of bad breath, including, but not limited to:
- Absent or sloppy home dental care
- Eating onions, garlic, coffee, alcohol, and/or medications
- Gum disease
- Tooth decay
- Dentures and partials that have not been properly cleaned
- Tobacco products, including cigarettes, cigars, and chewing tobacco
- Dry mouth associated with medications
- Dry mouth associated with systemic problems
How do I treat bad breath?
One of the most common causes of bad breath is the accumulation of bacterial plaque and decomposing food between your teeth and on your tongue. The first line of defense against bad breath is brushing (including your tongue) and flossing. Rinsing with an antimicrobial mouthwash temporarily reduces the numbers of bacteria available to colonize on your teeth and can be a helpful tool against bad breath.
Avoiding foods that create halitosis can combat bad breath, as there is nothing that can permanently cover the breath smell of onions, garlic, coffee and alcohol, except time. During digestion, elements of these foods exit your body via your lungs; your breath will be plagued with these odors until your body eliminates them.
Regular visits to your dentist for a thorough and complete periodontal exam will reduce your chance of bad breath. Many of the bacteria that lead to gum disease are the type that produce gas with foul taste and odor as a byproduct of their metabolism. One of the first signs of progressive gum disease is a bad taste and bad breath. Control of this disease is your best defense against the odor causing bacteria.
Tooth decay can cause bad breath and can remedied by completing treatment recommended by your dentist. Replacement of defective fillings and placement of necessary crowns will repair defective margins and fractured teeth where greater numbers of bacteria can colonize. Eliminate these problems and create a healthier environment and fresher breath.
Partials and dentures should be removed daily and thoroughly cleaned with a denture cleaner (not toothpaste) to prevent bad breath. Patients with partials need to thoroughly clean the remaining teeth, especially those teeth that retain or hold the partial in place. Dentures and partials should be left out during sleep to expose the soft tissue under the appliance to the cleansing action of saliva and to allow the compressed tissue to relax.
Eliminate the use of tobacco. Tobacco in any form, and especially over long periods of time, will cause bad breath. Regular, professional cleanings and good home care will go a long way to curb the bad breath that comes from a smoker’s or chewer’s mouth; chronic smoking carries with it odor from your lungs that can manifest as bad breath. Cessation of smoking is the best way to eliminate the bad breathe associated with tobacco use. It is important to keep in mind that bad breath is the most minor problem associated with tobacco use.
A dry mouth, or xerostomia (pronounced zair-oh-stow-me-ah), is a condition that can lead to bad breath. A dry mouth invites the growth of certain bacteria. There are hundreds (possibly thousands) of medications (both prescribed and OTC) that can cause dry mouth; these include, but may not be limited to:
- Blood pressure medications
- Heart medications
- Pain medication
- Incontinence medications
- Muscle relaxers
There are also several systemic conditions that can cause dry mouth; these include, but may not be limited to:
- Chronic stress/anxiety
- Radiation to the head and neck for cancer treatment
- Diseases of the salivary glands
- Sjogren’s syndrome
- Parkinson’s disease
- Diseases of the endocrine system
- Hormonal changes associated with pregnancy/menopause
Discuss your systemic condition and medications with your physician. Because medications are designed to improve health and quality of life, and many systemic disorders carry with them larger threats than a dry mouth. Treatment with artificial saliva could possibly help curb dental complications. It goes without saying that stringent home care habits are critical.
Saliva is necessary for washing down food, neutralizing acid, beginning digestion, and repairing enamel in the initial stages of tooth decay. Soft tissue in the mouth is designed to stay moist, and when it dries out, it becomes more susceptible to infection. A dry mouth can interrupt the natural oral bacteria, causing yeast and fungus to infect the mouth. Over-the-counter solutions can be used as often as necessary, and increased fluid consumption may help keep your mouth moist.
Sugar-free mints and/or gum with xylitol (zy-luh-tahl) can stimulate increased salivary flow and help curb bad breath. Avoid natural diuretics, such as alcohol and caffeine, which slow salivary flow. Avoid gum or mints containing sugar. Sugar promotes tooth decay faster in a dry mouth because less saliva means less neutralizing of the acid produced by bacteria.