Bad Breath & Dry Mouth

Bad Breath

Otherwise known as halitosis, bad breath plagues millions of people. We’ve all had it at one time or another, but our shared experience doesn’t make it any less embarrassing.

The five main sources of bad breath are (a) the food we eat, (b) the normal bacteria in our mouths, (c) harmful bacteria in gum disease (d) dry mouth and (e) medical conditions.

1. Situational Bad Breath: food
2. Regular bad breath: Bacteria as the culprit
3. Bad Breath caused by Gum Disease
4. Dry mouth syndrome
5. Medical conditions

Many foods are known to cause bad breath: garlic, onions, cabbage, just to name a few. Some of these contain sulfur compounds which can cause bad breath. Sulfur compounds are released as the foods are being digested and then travel into the bloodstream and finally the lungs. When we exhale, these smelly compounds are expelled and cause bad breath. Diets high in protein and sugar also have been associated with bad breath.Obviously, you can avoid situational bad breath by avoiding these types of foods.

Poor oral hygiene allows food particles to collect on the surfaces of the tongue, between the teeth or along the gingival (gum) line that surrounds the teeth. Naturally occurring bacteria in your mouth then also collects in these areas and break down those food particles, releasing chemicals that have a strong odour.

The particular type of bacteria that grow in the absence of oxygen e.g. in between the teeth, under the gums, under plaque and food debris and in the biofilm and down deep in the tongue crevices are the ones that create volatile sulfur compounds (VSC) and cause more routine bad breath. They also cause gingivitis (gum disease). Chlorine Dioxide tooth pastes and rinses neutralize these compounds, thereby ridding you of bad breath and creating a healthier oral environment, but does not treat the cause of the problem.

If you avoid odor-causing foods, frequently clean your teeth, gums and tongue, keep your mouth moist and you still have bad breath, it may be a sign of periodontal disease. Gum disease (gingivitis) and periodontal disease (periodontitis) are major causes of bad breath and are the worst type of dab breath.

Normally there is a small gum space around your teeth. This space normally measures about 1-3 mm in healthy gums. With gingivitis and periodontitis patients often have pockets deeper than 3 mm; the deeper the pocket, the greater the space where the bacteria can hide. Any pocket deeper than 3 mm is nearly impossible for you to keep clean using only your tooth brush and floss. That means the majority of bacteria living in pockets deeper than 3 mm are never disturbed or destroyed. These bacteria are the ones who create the Volatile Sulfur Compounds (VSC) previously mentioned that cause bad breath and gum disease.

Other symptoms associated with periodontal disease include:

• Swollen or bleeding gums
• Tender gums
• Loosening and shifting teeth
• Sensitive teeth
• Pain when you chew
• Pus or discharge from the gums
• It’s now known that untreated periodontal disease puts you at greater risk for heart disease, stroke, diabetes and low birth weight babies.

Normal saliva flow has a rinsing effect in the mouth and gets rid of food particles and bacteria. Reduced saliva flow causes a dry mouth. There are many conditions and medications that contribute to dry mouth. Medications, like high blood pressure meds, anti-anxiety, anti-depressants, radiation and chemotherapy, can cause saliva flow to decrease, sometimes dramatically. There are certain auto-immune diseases that permanently damage the salivary glands and have a devastating effect on the saliva flow. Besides being uncomfortable, decreased saliva flow puts you at greater risk for cavities, gum disease and bad breath.

Alcohol consumption, smoking, breathing through your mouth, dieting, fasting and talking for long periods of time can also contribute to bad breath. In all of these cases, frequent sips of water can help wash away the bad bacteria, dilute and remove VSC and keep your mouth moist. Reduction in saliva flow is the main cause of “morning breath”.

Many breath mints work more so because they stimulate saliva flow rather than just cover up breath odours. Sugar-free tart mints, like lemon or other citrus-flavored ones, work especially well to stimulate saliva flow. Chewing sugarless gum is a fairly good option after a meal if you cannot brush your teeth right after. Many gums and mints now contain xylitol, a sugar substitute, which has been shown to prevent tooth decay by creating an inhospitable oral pH for cavity-forming bacteria.

For some patients, frequent water consumption, mints and gums may not be enough to stimulate saliva flow. For these patients we prescribe special products designed to alleviate the symptoms of a dry mouth condition. It is important to avoid alcohol-containing mouth rinses.

Bad breath can be a by-product of certain health conditions. It may result from infections in the nose, throat or lungs, chronic sinusitis, recent tooth extraction, chronic bronchitis (as in emphysema), disturbances in your digestive system or postnasal drip. The latter is caused by allergies, common colds, hormonal changes, medications and pregnancy can create a thick nasal discharge. If this mucus constantly drips down the back of your throat, it can build up on the back of your tongue. This mucus coating then covers the bacteria that cause bad breath, in addition to serving as a food source for them.

How to treat or prevent bad breath:

Good oral hygiene: Knowing the cause is half the battle in fighting bad breath, and the best weapon you have is good oral hygiene. Caring for your mouth will help limit food residue and plaque build-up and reduce the risk of developing tooth decay and periodontal disease. We recommend that you brush your teeth twice a day with fluoride-containing toothpaste and clean between your teeth once a day by using an interdental cleaner such as floss. Brush your tongue too, to remove bacteria and plaque that contribute to oral odours (especially on the back of the tongue, where most of these bacteria are found).Chlorine Dioxide toothpastes, mouthwashes and breath sprays are very effective in treating bad breath. Chlorine Dioxide is an oxygenating compound, thereby creating a hostile environment for the bad breath bacteria and neutralizing the VSC compounds that cause gum disease and bad breath. There are a number of brands available over the counter.

• Good denture hygiene: If you wear removable dentures, take them out at night and brush them thoroughly with a denture cleanser (not toothpaste that produce scratches) before replacing them the next morning. You can soak them once a week in a denture cleanser to remove odours.
• Pay us or our hygienists a visit for a careful and discreet examination to diagnose the cause of your bad breath.
• Regular visits to our dental hygienist. During your hygiene visit, the hygienist uses an ultrasonic cleaner, like the Cavitron which will gently and comfortably disrupt the biofilm and tartar deposits and flush it, the bad bacteria and the VSC away.
• Special treatment for dry mouth syndrome.

Can I tell if my breath smells bad?

Since we become accustomed to our own odors, it’s nearly impossible to tell if your own breath smells. Cupping your hands over your mouth and nose and breathing out may not be a viable way to tell if you have bad breath, nor is licking your hand and smelling it. Most of the bad breath is created at the back of your mouth and pushed out while you are talking.

If it’s too embarrassing for you to ask a trusted friend or loved one if your breath smells, you can always ask us: your dentist or hygienist. We can tell if you are at risk and what can be done to help you.

 

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