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Bad breath, also known as halitosis, is breath that has an unpleasant odor. This odor can strike periodically or be persistent, depending on the cause. In many people, the millions of bacteria that live in the mouth (particularly on the back of the tongue) are the primary causes of bad breath. The mouth’s warm, moist conditions make an ideal environment for these bacteria to grow. Most bad breath is caused by something in the mouth.

Maintaining proper oral health can help reduce or eliminate bad breath.

Some types of bad breath, such as “morning mouth,” are considered to be fairly normal, and they usually are not health concerns. The “morning mouth” type of bad breath occurs because the saliva that regularly washes away decaying food and odors during the daytime diminishes at night while you sleep. Your mouth becomes dry, and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor.

In addition, bad breath can be caused by the following:

Poor dental hygiene — Infrequent or improper brushing and flossing can leave food particles to decay inside the mouth.

When a person does not brush or floss their teeth thoroughly, food particles that may remain in the mouth can rot and cause foul odors. In addition, food particles over time can promote the growth ofbacteria, which can also cause foul odors. The bacteria can also lead to tooth decay and gum disease.

Foods with strong odors also affect the air a person exhales. Foods commonly known to contribute to bad breath include onions andgarlic, exotic spices (such as curry), some cheeses, fish, and acidic beverages such as coffee. Foods are absorbed into the bloodstream and then transferred to the lungs, causing noticeable odors when exhaled. These foods may also cause stomach and gastrointestinal upset and belching, which can contribute to bad breath. In addition, certain supplements, such as fish oil capsules, can contribute to bad breath.

Low-carbohydrate diets may also cause what is known as “ketone breath.” So-called “low carb” diets cause the body to burn fat as its energy source. The end product of making this energy is ketones, which cause a fruity acetone-like odor on the breath when exhaled.

Infections in the mouth — Periodontal (gum) disease

Respiratory tract infections

Throat infections, sinus infections, lung infections

External agents

Garlic, onions, coffee, cigarette smoking, chewing tobacco

Dry mouth (xerostomia)

Bad breath can also be caused by decreased flow of saliva, which is a vital part of the digestive process and removes odor-causing particles in the mouth. Also called xerostomia, dry mouth may be caused by medications, breathing through the mouth, or salivary gland problems.

Systemic illnesses

Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others

Dentures or Dental Appliances

Dentures or dental appliances, such as braces, can contribute to bad breath. Most often, it is due to food particles that are not properly cleansed from the appliances. Loose-fitting dentures can contribute to sores and localized infections in the mouth, which can cause bad breath.

Psychiatric illness — Some people may perceive that they have bad breath, but it is not noticed by oral-health-care professionals or others. This is referred to as “pseudohalitosis.”

Symptoms

A person may not always know that he or she has bad breath. This phenomenon is because odor-detecting cells in the nose eventually become accustomed to the constant flow of bad smells from the mouth. Others may notice and react by recoiling as you speak.

Other associated symptoms depend on the underlying cause of bad breath:

Poor dental hygiene — Teeth are coated with film or plaque, food debris trapped between teeth, pale or swollen gums

Infections in the mouth — Gums may be red, swollen and bleed easily, especially after brushing or flossing; pus may drain from between teeth; a pocket of pus (abscess) at the base of a tooth; loose teeth or a change in “fit” of a denture; painful, open sores on the tongue or gums

Respiratory tract infections — Sore throat, swollen lymph nodes (“swollen glands”) in the neck, fever, stuffy nose, a greenish or yellowish nasal discharge, a mucus-producing cough

External agents — Cigarette stains on fingers and teeth, a uniform yellow “coffee stain” on teeth

Dry mouth — Difficulty swallowing dry foods, difficulty speaking for a prolonged period because of mouth dryness, a burning sensation in the mouth, an unusually high number of dental caries, dry eyes (in Sjögren’s syndrome)

Systemic (bodywide) illnesses — Symptoms of diabetes, lung disease, kidney failure or liver disease

Diagnosis

A dentist or physician may notice the patient’s bad breath while the patient is discussing his or her medical history and symptoms. In some cases, depending on the smell of the patient’s breath, the dentist or physician may suspect a likely cause for the problem. For example, “fruity” breath may be a sign of uncontrolled diabetes. A urine-like smell, especially in a person who is at high risk of kidney disease, can sometimes indicate kidney failure.

Your dentist will review your medical history for medical conditions that can cause bad breath and for medications that can cause dry mouth. Your dentist also will ask you about your diet, personal habits (smoking, chewing tobacco) and any symptoms, including when the bad breath was noticed and by whom.

Your dentist will examine your teeth, gums, oral tissues and salivary glands. He or she also will feel your head and neck and will evaluate your breath when you exhale from your nose and from your mouth. Once the physical examination is finished, your dentist may refer you to your family physician if systemic problems are the most likely cause. In severe cases of gum disease, your dentist may recommend that you be seen by a periodontist (dentist who specializes in gum problems).

You will need diagnostic tests if the doctor suspects a lung infection, diabetes, kidney disease, liver disease or Sjögren’s syndrome. Depending on the suspected illness, these tests may include blood tests, urine tests, X-rays of the chest or sinuses, or other specialized testing.

Expected Duration

How long bad breath lasts depends on its cause. For example, when the problem results from poor dental hygiene, proper dental care will begin to freshen the mouth immediately, with even more impressive results after a few days of regular brushing and flossing. Periodontal disease and tooth abscess also respond quickly to proper dental treatment. Bad breath resulting from chronic sinusitis may be a recurring problem, especially if it is caused by a structural abnormality of the sinuses.

Bad breath the results from a systemic illness may be a long-term problem that can often be controlled with proper medical care.

Prevention

Bad breath caused by dental problems can be prevented easily. Daily maintenance calls for brushing your teeth, tongue and gums after meals, flossing, and rinsing with mouthwashes. Regular visits to the dentist (at least twice a year) should be made for dental examinations and for professional teeth and gum cleaning.

Bad breath also can be combated by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles. Other products that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, raw carrots and celery.

Treatment

The treatment of bad breath depends on its cause.

Visit your dentist promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. Also, visit doctor if you have bad breath along with a fever, sore throat, a postnasal drip, a discolored nasal discharge or a mucus-producing cough. Even if you have none of these associated symptoms, call your dentist or physician if your bad breath continues despite a good diet and proper dental hygiene.

If you have diabetes, gastroesophageal reflux disease (GERD) or chronic liver or kidney disease, ask your doctor how bad breath can be a sign that your underlying medical condition needs immediate medical attention.

By Omar Sydney

Kigalihe.com