Bad Breath

It would not be a stretch to say that every single person has experienced bad breath at some point in his or her life.  We are all susceptible to “morning breath” or “garlic breath”, which are neither surprising nor difficult to fix.  Many people suffer from persistent bad breath which seems difficult to cure.  As with most things, finding the cause of the problem will lead us much closer to a solution.  Let’s take a look at the most common causes of bad breath.

What causes bad breath?

When you get to the bottom of bad breath, most of it is caused by bacteria.  Over ninety-percent of bad breath originates in the mouth.  The rest stems from problems in the nose, throat, lungs, or GI tract.  These problems include postnasal drip, sinus infections, tonsil stones, bronchitis and other lung infections, H. pylori infections and GERD (gastroesophageal reflux disease).  These possible causes of halitosis are greatly outnumbered by problems in the oral cavity.  While you should be aware of them and inform your doctor or dentist of the presence of any of these issues, it is important to have your dentist rule out a more likely intraoral issue first.

What happens in the mouth to cause bad breath?

• Cavities – Cavities, especially big ones, harbor lots of bacteria. When a cavity has gotten big enough to create a hole in the tooth, it collects food particles and plaque in addition to the bacteria that caused the cavity.  Think of it like a tiny kitchen trashcan.  It stinks!  Having the cavity fixed is like emptying the trashcan.
• Gum (periodontal) disease – Periodontal disease affects the gum and bone supporting the teeth. In most cases, a pocket is formed where the gum and bone detach from the tooth surface.  These pockets are also like the above-mentioned tiny trashcans, collecting plaque, bacteria, food particles, etc . . . Having the proper periodontal treatment to reduce the depth of these pockets will minimize the size of the trashcan.
• Food impaction – Perfectly shaped and aligned teeth and gums do not provide spaces for food to get caught. But let’s face it: no one is perfect.  Food impaction is the term dentists use for an area in your mouth that is consistently embedded with food debris.  If not properly cleaned out, it leads to more than just bad breath.  It can cause cavities and gum disease in that area.  If you do not feel that you are able to adequately and consistently clean an area of food impaction, please ask Dr. Chowning about your options to change the shape of the teeth so that food does not continue to be caught.
• Tongue – Tongues are bumpy. The bumps are called papillae.  The papillae vary in size and purpose.  There are some located near the back of the tongue that can be large and create lots of nooks and crannies for bacteria to collect around.  This is where cleaning your tongue can reduce bad breath.  For some people, simply swishing a mouthrinse can effectively clean your tongue.  For others, it may be necessary to brush the surface of your tongue.  And for still others, a tongue scraper is useful in cleaning any bacterial havens on your tongue.
• Surgical wounds – When you have surgery in your mouth, there is usually something that can allow for the accumulation of bacteria like an extraction socket or stitches. Because surgical sites usually hurt, it is difficult to keep them clean.  Your dentist will give you instructions on keeping the site clean, as well as some adjuncts for your post-surgical oral hygiene like a very soft bristled toothbrush or an antibiotic solution to apply to the site with a Q-tip.  Thankfully, this is a temporary problem.  Follow the post-op instructions closely so healing occurs as quickly as possible.
• Dry mouth – Saliva plays a big role in fighting bacteria; therefore, it plays a big role in fighting bad breath. If you do not have enough saliva, your dry mouth puts you at risk for bad breath and various oral diseases.  It can cause bad breath by allowing an accumulation of bacteria.  You can read more about dry mouth here.

What can I do about bad breath?

• See your dentist – It is important to rule out cavities & gum disease as the cause of bad breath because they can progress and lead to many long-term health concerns. If you do have any oral disease, proceed with treatment as soon as possible.
• Practice great oral hygiene – Keeping your teeth clean means reducing the amount of bacteria in your mouth, and therefore reducing bad breath. Add an alcohol-free mouthwash to your daily regimen.  This helps remove bacteria from all areas of your mouth.  It is important to use an alcohol-free mouthwash because alcohol has a drying effect.  Dry=bad.  Also add brushing your tongue or using a tongue scraper to your oral hygiene routine.
• Take steps to improve dry mouth – Discuss the various options with your dentist. Treatment may include using a salivary supplement, an antioxidant mouth gel, or a prescription mouthwash. 
• Chew sugar-free gum, preferably containing xylitol – Chewing gum stimulates saliva, which fights bacteria. The flavor of the gum may provide a brief, minty odor to your breath, and the improved salivary flow will keep the bad breath at bay.
• Avoid substances that have a drying effect on your mouth – Cigarettes and alcohol both reduce salivary flow and predispose you to dry mouth.

Think you may have bad breath?

Call our office at 940-382-1750 to set up a consultation with Dr. Chowning.