What is Halitosis?

More than 80 million people suffer from chronic halitosis, or bad breath. In most cases it originates from the gums and tongue. The odor is caused by wastes from bacteria in the mouth, the decay of food particles, other debris in your mouth and poor oral hygiene. The decay and debris produce a sulfur compound that causes the unpleasant odor.

What causes bad breath?

Bad breath is primarily caused by poor oral hygiene but can also be caused by retained food particles or gum disease.

Does bad breath come from other sources than the mouth?

Bad breath also may occur in people who have a medical infection, diabetes, kidney failure or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to this problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath. An odor that comes from the back of your tongue may indicate postnasal drip. This is where mucus secretion, which comes from the nose and moves down your throat, gets stuck on the tongue and causes an odor.

Why is saliva so important in the fight against bad breath?

Saliva is the key ingredient in your mouth that helps keep the odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva, allowing the bacteria to grow inside the mouth. To alleviate "morning mouth," brush your teeth and eat a morning meal. Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware, because the odor may reappear even if you've brushed your teeth.

Do certain foods cause bad breath?

Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach, and the odor is then excreted through the lungs. Studies even have shown that garlic rubbed on the soles of the feet can show up on the breath.

How do I control bad breath?

It is important to practice good oral hygiene, such as brushing and flossing your teeth at least twice a day. Proper brushing, including brushing the tongue, cheeks and the roof of the mouth, will remove bacteria and food particles. Flossing removes accumulated bacteria, plaque and food that may be trapped between teeth. To alleviate odors, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue. Chewing sugar-free gum also may help control odor. If you have dentures or a removable appliance, such as a retainer or mouthguard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouthrinses, deodorizing sprays or tablets, talk with your dentist, because these products only mask the odor temporarily and some products work better than others.

What is my dentist's role?

Visit your dentist regularly, because checkups will help detect any physical problems. Checkups also help get rid of the plaque and bacteria that build up on your teeth. If you think that you suffer from bad breath, your dentist can help determine its source. He or she may ask you to schedule a separate appointment to find the source of the odor. Or, if your dentist believes that the problem is caused from a systemic (internal) source, such as an infection, he or she may refer you to your family physician or a specialist to help remedy the cause of the problem.

 

Does a Smaller Waist Mean Smelly Breath?

Many people wanting to slim down are jumping on the low-carbohydrate diet trend in an attempt to lose weight. However, as dieters shed pounds, many are saying goodbye to carbs and hello to halitosis.

Low-carb diets work by limiting the amount of carbohydrates ingested, which allows the body to burn stored fat instead of carbohydrates. When the body burns fat as fuel, chemicals called ketones are produced. These ketones are released in the breath and urine and may result in halitosis. Ketones aren't the only bad breath culprit for this diet. The types of foods ingested also play a role.

"Most cases of bad breath originate from the breakdown of food particles that produce sulfur compounds, and from bacteria on the gums and tongue," says Academy of General Dentistry spokesperson Bruce DeGinder, DDS, MAGD. " High-protein foods can produce more sulfur compounds, especially overnight on the surface of the tongue when saliva production is diminished."

Tips to combat halitosis:

1. Drink water to wash away germs

Drinking plenty of water can help dilute the concentration of ketones, but that isn't the only benefit. Drinking water throughout the day can help cleanse teeth of excess bacteria and food debris. Bad breath can sometimes be caused by food particles caught in the teeth, and drinking water will help rinse away odor-causing particles.

2. Chew sugarless gum with xylitol

Chewing sugarless gum after meals can help keep bad breath away. Saliva production increases during chewing and this can help neutralize acid production and rinse food particles from the mouth. Chewing parsley can have the same effect because it also increases saliva production.

Sugar-free gum with xylitol can also help prevent cavities. Xylitol is a natural sweetener found in plants and fruits, and research shows it inhibits the growth of Streptococcus mutans, the oral bacteria that cause cavities.

3. Keep a toothbrush handy and brush after all meals

Brushing and flossing at least twice a day can help keep your mouth healthy and prevent odors. An AGD survey found that 75 percent of people eat at the office but less than 15 percent of them brush their teeth after eating. Cleaning the tongue with a toothbrush or tongue scraper after meals can also help alleviate odors.

If halitosis continues, a general dentist or doctor can help determine the source of the odor. Halitosis can sometimes have more serious causes. "Ketone breath is also used to describe a fruity smell on the breath that can be an indication that a person may have diabetes," says Dr. DeGinder. "This can originate when the body is breaking down fat particles because there is not sufficient glucose present as fuel for energy."

Do You Have Traveler's Breath?

In addition to racking up frequent flyer miles, some travelers may also experience bad breath, and possibly a condition known as "tooth squeeze," while flying the friendly skies.

Bad breath while traveling happens when the salivary glands slow down the production of saliva, which allows bacteria to grow inside the mouth and bad breath to develop. Many travelers alter their food intake while at the airport and on the plane, and then will ignore their oral care hygiene routine. "Many people increase their fast food and soda intake while traveling," says J. Nick Russo, DDS, FAGD, past president of the Academy of General Dentistry. "This leaves food particles in the mouth that produce a sulfur compound and cause bad breath."

On the other end of the spectrum, bad breath can also be associated with hunger or fasting, which is also a common habit of some frequent fliers. "Even if you have brushed your teeth, but have not eaten a meal all day, 'morning mouth' may reoccur later in the day," says Dr. Russo.

Another condition that may happen while traveling but is less common than bad breath is known as "tooth squeeze," or barodontalgia, which describes a toothache or dental pain resulting from any change in barometric pressure during flight. The pain may, or may not, become more severe as altitude is increased, but descent almost invariably brings relief. The toothache often disappears at the same altitude at which it was first observed on ascent.

"Common sources of this difficulty are abscesses, cavities or fillings," says Dr. Russo. He advises any holiday travelers who experience a toothache at high altitudes should see a dentist without delay for examination and treatment.

Tongue Scrapers Only Slightly Reduce Bad Breath

Bad breath is a common problem for many people, given the wide variety of substances traveling through our mouths daily. Some people avoid offensive foods and drinks, chew gum, use mouth rinses, or eat mints to mask unpleasant odor. Others cannot escape bad breath quite so easily. At least 40 million Americans suffer from halitosis. Unfortunately, there is no standard treatment for it.

According to a study in the September/October issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal, halitosis is a term used to describe any disagreeable odor of expired air. Bad breath is a generally accepted term for foul smells emanating from the mouth. Oral malodor is a term reserved for unpleasant smells originating from the oral cavity. "A common reason for bad breath is post-nasal drip, which coats the back area of the tongue with bacteria-rich mucous," says AGD spokesperson, June Lee, DDS, MAGD. "A tongue scraper is often effective in relieving oral malodor caused by sinus drainage."

The study reviewed literature examining the effects of using tongue scrapers to brush the tongue, rather than using a toothbrush to scrape the tongue. Data revealed that a tongue cleaner/scraper demonstrated a significant difference in reducing volatile sulfur compounds (VSC) levels, which are produced when bacteria and amino acids interact to produce bad breath.

Though there is no standard treatment, bacteria-causing halitosis can be reduced by brushing or scraping the middle and back of the tongue. Tongue scraping can lower VSC concentration, subsequently reducing oral malodor. However, that reduction is only short-term, and not an absolute solution for eliminating malodor. The authors of the General Dentistry article feel that future research is necessary to determine what role undetected odorants may play in oral malodor, as well as more well designed, randomized clinical trials to compare the effectiveness of tongue scrapers, toothbrushes, and mouth rinses on reducing VSC levels.

Despite the short-term reduction, Dr. Lee feels that tongue scrapers are a good tool for the short-term. "Tongue cleaners and scrapers are straightforward and comfortable to use, easy to transport, and inexpensively priced. Cleaning the tongue is quickly and easily accomplished. Everyone from children to elders should be able to incorporate this technique into their oral care regimen."

Bad breath basics:

• Halitosis is a general term used to describe any disagreeable odor of expired air, regardless of its origin.• Bad breath is a generally accepted term for foul smells emanating from the mouth.• Oral malodor is a term reserved for halitosis originating from the oral cavity.