What is Bad Breath?

Normal breath is non-invasive and has been linked to scent of "blooming chestnuts". On the other hand, bad breath is unpleasant and offensive, a "sour, bitter, metallic" taste and can vary with the cause.

Bacteria are the most common cause of oral malodor. Fungus is also involved and produces a very unpleasant and somewhat sour odor. When the mouth is dry, anaerobic bacteria are not flushed away and increase in concentration. This leads to an increase in volatility, stronger malodor, and a dry pasty taste. The reduction of flushing with saliva also leads to an increase in nutrients that are available to the bacteria. Tongue saliva becomes more basic and this environment promotes the growth of even more anaerobes. Breath odor and bad taste continue to increase.

Causes of Halitosis:

Certain foods such as onions and garlic can cause halitosis. Trapped in the lungs, the odor is mixed with the expelled air and may linger for quite some time. A temporary problem which can be improved with mouthwash.

Irregular oral hygiene, including absence of daily brushing and flossing will result in bad breath. When food and bacteria remains in the mouth, it decays. This process results in bad breath and can be eliminated with regular daily plaque and food removal.

The tongue is composed of cellular debris, blood cells and bacteria. Variation in mouth odor is related to the amount of coating that is present. The amount of coating increases as mouth odor increases, but removal of the coating and flushing will decrease odors by 50%. Tongue cleaning is an essential component of oral malodor treatment.

Periodontal disease (gum disease) is a serious bacterial infection in which poisons are released into the gum tissues and bone. This infection results in inflammation which releases odors resulting in bad breath. Treatment of the infection along with regular bacteria removal, both professionally and at home, will help eliminate halitosis of this origin.

Xerostomia (dry mouth) which is a reduction of saliva can contribute to halitosis. A reduction in saliva may result from faulty salivary glands, medications, or mouth breathing. This reduces the natural cleansing of odor causing bacteria. Treatment may include frequent water and use of products which stimulate saliva.

Regular tobacco use can result in mouth malodor. Smoking results in a greater risk of developing bad breath, gum disease, and more seriously oral cancer. Cessation of smoking is indicated.

Systematic diseases can also cause halitosis. Upper respiratory infections, diabetes, and gastrointestinal disease can all cause bad breath. Treatment may include specific oral care including tongue cleaning use of prescription strength antibacterial or fluoride mouth rinses.

Treatment of Halitosis:

Brushing, flossing teeth and Cleaning the Tongue

Antimicrobial Rinses: In general, 3-4 hour protection. Research indicates that CHX and zinc ion are very effective.

Eating/Drinking Certain Foods: Eating foods like celery and carrots can stimulate salivary flow. Drinking plenty of water is needed to produce enough saliva.

Chewing Gum: Sugar Free Gum or gum with Xylitol helps generate saliva. This should only be done for short periods of time as chewing over long periods of time may encourage TMJ problems.

Dental Check-up: Yearly evaluations to rule-out any tooth or periodontal cause of halitosis.