medical information

Bad Breath

What is bad breath?

The culprits of bad breath are gram-negative anaerobic bacteria, microorganisms that live and function in an oxygen-deprived environment. These organisms naturally exist in the mouth, says Susanne Cohen. The bacteria ingest protein particles and metabolize them, producing sulfur gases.

"That rotten-egg smell," says Swaroop.

Bad breath Causes & symptoms

Accumulation of plaque on the teeth is a major cause of bad breath. Plaque is a mucus film that mixes with food particles, saliva, and bacterial residue in the mouth. Bad breath can also be caused by any number of other problems. These include sores in the mouth, infected tonsils, tooth or gum disease , fermentation of food particles in the mouth, sinus infections , and badly cleaned dentures. Conditions that may cause bad breath are not only limited to the oral and nasal areas. Other possible sources of the problem might be indigestion , lung infection, kidney failure, tuberculosis, syphilis , liver disease, stomach and intestinal problems, stress , dehydration, zinc deficiency, and cancer .

Cigarette smoking can also lead to bad breath, not only in the smoker, but also in someone constantly exposed to secondhand smoke. A diet high in fats, spicy foods, or one that includes coffee may contribute to un-pleasant breath odors. Medications causing dry mouth or dehydration may also be a source of problems, since the flow of saliva helps clean out the mouth. Antihistamines, decongestants, antidepressants, anti-anxiety medications, diuretics, and some heart medications may have a dehydrating effect, and could be a cause of bad breath.

Diagnosis

The easiest way to determine if one has bad breath is to ask a friend who is trustworthy and discrete, or to ask a doctor or dentist. A test that can be attempted on one's own, is to cup a hand over the mouth, exhale, and then inhale through the nose while smelling the breath. A physical examination by a doctor or dentist may be used to diagnose other problems that may be causing the bad breath.

BAD-BREATH MYTHS

Myth: Tongue scrapers are just another ploy to get you to spend money. Fact: Scraping your tongue is one of the more important things you can do to fight bad breath. However, most experts say running a toothbrush over your tongue works just as well. Myth: Medications dont lead to bad breath. Fact: Some antidepressants and antihistamines can cause bad breath, says Swaroop. "They make the mouth dry and promote bacterial growth on the tongue. Myth: Flossing is important for your gums, but it doesnt have much to do with bad breath. Fact: If food is trapped between your teeth, it becomes a breeding ground for the bacteria that cause bad breath. "Normal brushing just cannot do it alone, Bremer says.

Myth: People who have chronic bad breath practice poor dental hygiene. Fact: Many chronic bad-breath sufferers do an excellent job of brushing and flossing, mainly because they are overly concerned about their breath.

ST. LOUIS – Breath mints, breath strips, mouthwash, toothpaste. It's a multibillion-dollar industry. Why? Because bad breath leaves a bad impression. But the truth is, it could also be a sign of bad health.

"Bad breath could be because of a problem in the sinuses, mouth, lungs, kidney or airways," says Dr. Prabhakar Swaroop, a gastroenterologist at St. Louis University Hospital. "If someone comes to me with persistent bad breath, I start looking for other causes of it."

He says that recently, a patient complained to him of having bad breath. After several tests, it turned out that the patient had an infection in his lungs. "The halitosis led us to that."

Halitosis is another word for bad breath. It can be an embarrassing problem for those who have it.

"It's such a devastating disease," says Susanne Cohen, a dentist for 21 years in the St. Louis area and co-owner with her father of a company that makes Smart Mouth, a mouthwash that promises to eliminate bad breath 24 hours a day with regular use.

"When they walk into a room you can smell them. It's so embarrassing; it affects their social life, their business, even their love lives."

In the United States, more than 25 million people seek treatment from dentists for bad breath, according to an Encyclopaedia Britannica entry written by dentist Marvin Cohen, Susanne Cohen's father and a leading expert on halitosis.

He says the problem is so serious, ancient civilizations used to refer to it as a "curse."

While for many people bad breath just means it's time to brush your teeth after that morning cup of coffee, for others it's a chronic problem caused by an underlying illness or by no known reason.

"A lot of people think that if someone has a chronic bad-breath problem, they don't take care of their teeth," says Susanne Cohen.

"They assume bad odor is associated with lack of adequate dental health. But that's not necessarily true. Many if not most people who have chronic halitosis have immaculate care. They've been afflicted for so long and spent so much time trying to find a cure."

How to Prevention Bad-Breath

A healthy diet, high in fresh fruits and vegetables and whole grains, should be eaten. Processed foods such as sugar and white bread and grains contribute to plaque formation and should be avoided. Spicy foods such as onions, peppers, garlic , pastrami, salami, pepperoni, anchovies, and others should be avoided. Plenty of water should be consumed throughout the day to avoid dehydration and dry mouth. Water should be consumed after taking any food or drink to wash away residues that may accumulate with plaque.

The teeth should be brushed and flossed daily after meals. Toothbrushes should be changed monthly, since there may be a tendency for bacteria to accumulate on them. Baking soda is a good choice to use for cleaning the teeth when bad breath is a problem. The baking soda makes the mouth pH less hospitable to odor-causing bacteria. Gentle brushing of the tongue should also be included in the routine of daily oral hygiene, since the tongue itself may harbor tiny particles of food. A device called a tongue blade can be useful for cleaning the tongue. It may be available from a store that sells Asian or Middle Eastern products. An oral irrigation device, such as a Water Pik, is recommended to more thoroughly remove food and debris from the teeth. Mouthwashes are often helpful, especially those containing zinc. A dentist should regularly check the health of the gums and teeth for disease. A dental hygienist should clean the teeth regularly, especially if there is an increased tendency to form plaque.