The Secret of Fresher Breath

by Mary Mieth Lontchar, RDH, MA

Halitosis, dragon breath, oral malodor, bad breath – no matter what you call it, it can be embarrassing and a difficult subject to discuss with friends, family, and co-workers. Do you think you may have bad breath? If you answer “yes” to any of the following questions, you may have it.

How do I know if I have bad breath?

1. I usually have a bad taste in my mouth.
2. I frequently use mouthwash, breath mints, etc.
3. My mouth often feels dry.
4. I smoke.
5. I don’t brush and floss my teeth daily.
6. I have sinus, respiratory, or gastrointestinal problems.

What Causes Bad Breath?
You’re not alone if you have bad breath, nearly half of the population admits to occasional halitosis. Ninety percent of all bad breath begins in the mouth. Poor brushing and flossing habits, gum disease, food impaction, unclean dentures, tooth decay, oral cancer, and throat infections are causes of bad breath.

Volatile sulfur compounds (VSC) have been identified as the main source of bad breath. When you eat, the bacteria and enzymes in your mouth start breaking down the food particles. This creates by–products that include volatile sulfur compounds that smell like rotten eggs. VSCs grow mainly on the very back portion of the tongue, where the surface is the roughest.

Most bad breath is a short-term concern and can easily be corrected. Some causes are:

• Plaque, that sticky film of bacteria that continually forms on teeth, tongue, and dental appliances (dentures, orthodontic retainers) in the mouth. When plaque combines with food particles after a meal, the food is broken down producing a foul odor.
• Habits of smoking or chewing tobacco and mouth breathing can cause halitosis. Bad breath caused by tobacco stays with you even when you’re not smoking or chewing. Tobacco use can stain the teeth, irritate the gums, and increase the likelihood of gum disease and oral cancer. People that continually breathe through their mouth may have a dry mouth that can result in bad breath.
• Certain food and drink can cause bad breath. These include garlic, onions, curry, cabbage, coffee, and alcohol. The foul breath will last until the body has eliminated the food or drink.

Often a person is unaware that they have bad breath. Halitosis of this nature may indicate a serious dental or medical illness that requires diagnosis and treatment. Problems that can cause bad breath are:

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• Oral diseases usually caused by poor oral hygiene. The result may be tooth decay or gum disease, the most common and treatable cause of bad breath. Bad breath associated with gum disease is due to pockets that form in the gums around the teeth. As the pockets get deeper, food and bacteria have more places to hide. The cycle begins when the bacteria grow, react with the food, and produce more and more VSC.
• Mouth dryness occurs when the amount of saliva is decreased. Saliva helps with the mouth’s natural cleansing of odor-causing bacteria. When salivary flow decreases, bacteria is able to grow more rapidly. Chronic dry mouth may be caused by various medications or due to a disorder of the salivary glands.
• Medical disorders can also contribute to halitosis. People with poorly controlled or undiagnosed diabetes produce a sweet, fruity, acetone breath odor. Liver disorders, leukemia, and gallbladder dysfunction may also be a cause of breath odor.
• Gastrointestinal problems, such as reflux, indigestion, or hiatal hernia, contribute to bad breath.
• Sinus or respiratory infections, such as sinusitis, bronchitis, and pneumonia, contribute to bacterial overgrowth that often results in bad breath. Most of the time, people are unaware of the offensive impact their breath has on others.
• Psychiatric reasons may explain halitosis. An individual may be concerned about mouth odor, but actual ‘bad breath’ isn’t noticeable to others. The person truly believes they have bad breath when actually they do not.

How can halitosis be treated?
Fresh breath is a result of a healthy mouth and body. Treating halitosis means treating the underlying cause. A dentist can help identify the cause of bad breath. If it is due to an oral disease, he or she will develop a treatment plan to eliminate the cause or may refer you to a professional who specializes in breath analysis. The dentist may also suggest a complete physical examination to rule out any medical condition that may contribute to halitosis.

What Can You Do To Prevent Bad Breath?
Fresh breath comes from a clean, healthy mouth. Maintaining good oral hygiene habits are necessary to guarantee fresh breath. Brushing your teeth and tongue daily plus flossing, will remove food debris and bacterial plaque. If you wear an orthodontic retainer or partial denture, clean them thoroughly every day. Regular dental visits for a professional cleaning and examination will help guarantee fresher breath.

The Secret to Fresher Breath: Brush after each meal and floss every day.

If bad breath is still a problem consider these additional ideas:

• Brush your tongue, or use a special tongue scraper, to remove food and plaque. Gently clean as far back as you can. When done on a regular basis, scraping or brushing the tongue will produce short-term fresher breath.
• Avoid certain food and drink that cause you to have bad breath. These foods include onions, curry, and garlic. Avoid alcoholic or caffeinated drinks as they dry your mouth and may lead to bad breath.
• Stop smoking. If you smoke or chew tobacco, stop. Ask a health care professional for tips on kicking the tobacco habit.
• Clean your dentures. Dentures can absorb odors in the mouth. Brush them with a commercial denture cleaner every day. Unless your dentist tells you differently, remove your dentures at night and soak them in water or a special solution.
• Keep your mouth moist. If your mouth feels dry, suck on sugar-free candy, chew sugar-free gum, and drink at least 8 glasses of water a day.
• See your dentist for regular visits for professional cleanings and checkups. This ensures that both your breath and your oral health are at their best. If your dentist determines that your mouth is healthy but bad breath is still present, you may be referred to a physician for a medical examination.

Other important facts about bad breath:
Mouthwash is not a good solution to bad breath. Most mouthwashes only mask odors for a short time. Within 15 minutes, the odor returns. Most over-the-counter mouthwashes have a high alcohol content that may dry the mouth – making bad breath even worse! A dentist may prescribe an antibacterial mouth rinse to help control plaque and lessen bad breath.

Some bacteria are necessary in the mouth. While too much bacteria can lead to a foul odor, a small amount helps control the level of harmful organisms, preventing the growth of a yeast-like organism.

Bad breath can also signal a medical problem. If your breath does not improve with dental treatment, or if you have other health concerns, it is important that you see a physician.

As many dental professionals have said, “Bad breath is better than no breath at all.” However, halitosis is a problem that most people experience at one time or another. Bad breath can be a bother and a handicap, but it doesn’t need to strain your social and professional life. Treatments are available, starting with daily tooth brushing and flossing.

Sources:

• American Dental Association
• Spielman AI, Bivona P, Rifkin BR: Halitosis: a common oral problem. NYSDJ,62(10):36–42, 1996.

Last Updated October 2004