What Causes Bad Breath?

Most often, but not always, halitosis, commonly known as bad breath, is related to what you eat and your dental hygiene habits. If the problem is not chronic, it may simply be the result of something you ate during your last meal. Garlic, onions, curry, and peppers are examples of smells that cannot be easily disguised by sucking on a mint or chewing gum.

Offensive odor is produced when gases such as hydrogen sulfide, skatole, etc., are released due to bacterial activity, mostly during food intake. Some of the bacteria cannot live where there is oxygen; these are called anaerobic. Are you wondering how they can survive in your mouth? They do so by hiding in the crevices in your tongue, between your teeth, and tucked into your gums. At night, if you sleep with your mouth closed, you provide less oxygen, and they thrive, resulting in "morning breath." Bacteria that live on the tongue cause 90% of all cases. The tongue is a relatively dry part of the mouth, and its surface is covered with grooves and ridges that trap food particles, dry epithelial cells, and sinus drip. As such, it is essential to brush your teeth and tongue every morning, and never skip this routine.

Underlying Causes

If you not eating pungent foods and still have halitosis, it may be that you are not adequately brushing and flossing your teeth. By not removing all of the food particles that stick to the tongue, teeth, and gums, you are providing a growth medium for anaerobic bacteria, which will then give you odorous breath. Because you actually inhale these strong odors into your lungs, these smells are detectable hours after they were eaten – even after you have brushed. However, brushing and flossing may not prevent the odor from returning until the cause has been identified and eliminated from your body.

You are inviting gum and tooth disease as well as bad breath by not having tooth cavities filled promptly, avoiding professional dental cleanings at least once or twice a year, and not brushing the tongue as well as the teeth. In addition, dentures need to fit well to prevent bacteria from collecting in pockets under them. Oral yeast infections, gum disease, and not drinking enough water are also contributing factors. Chewing tobacco, smoking cigars or cigarettes, and holding a pipe in your mouth can all damage your teeth and gums, which also makes for unpleasant breath.

If your breath is consistently bad to the point that brushing only helps for a short time, you might have more serious problems with your gums. Gum disease is usually the result of plaque buildup, which can result in permanent damage to the jawbone and gums. It must be treated properly, or you risk losing your teeth.

Saliva in your mouth neutralizes the acids in plaque, thereby washing away food particles and dead cells that cling to the inside of your mouth. If you have a dry mouth, these particles will contribute to halitosis. Chronic dry mouth, called xerostomia, has several causes: problems with the salivary glands, breathing only through your mouth when you have a cold or congested sinuses, and side effects from medications that you may be taking.

Other Conditions that Cause Bad Breath

Diabetes – A definitive sign of this condition is when your breath is strong and sour for no apparent reason. Ketones, which are the byproducts of the metabolism of fat, are produced both when a diabetic person fasts and when he or she eats a low carb, high fat meal. Insulin is needed for metabolizing glucose, and if there is not enough to do the job, the body uses fatty acids to handle it; thereby producing this tell-tale breath odor. If you suspect this, make an appointment with your doctor. If you have already been diagnosed with diabetes, check your sugar levels daily.

Cancer – Lung and mouth cancers are sometimes detected by a device called Cyranose, which checks the breath of the patient. Chemotherapy medicines can cause dry mouth, and subsequently bad breath.

Kidney failure – Kidney disease can infuse the breath with a urine smell by excreting toxins through your lungs, which you then breathe out.

Liver failure – Liver disease can infuse the breath with a fishy odor, in much the same way as kidney failure produces a urine smell. This problem is often exacerbated by radiation treatment and chemotherapy. A common side effect of the majority of treatments for all cancers is dry mouth. Without enough saliva, bacteria will stay in the mouth, multiply, and eventually cause halitosis.

Stomach disorders – Ulcers, GERD (gastroesophageal reflux disease), Zenker diverticulum, and an obstructed bowel can affect your breath, making it smell like feces. Thankfully, these are rare conditions.

Dehydration – Drinking too much coffee, tea, alcoholic beverages, and soft drinks can result in dehydration. Anything that contains caffeine (yes, even chocolate) also has a high level of acid, which leads to a bitter taste in the mouth and foul breath. Quench your thirst by drinking an adequate amount of water throughout the day, and chew sugarless gum or suck on sugarless candy to stimulate saliva and freshen your breath.

Ketoacidosis – You don't have to be diabetic to have this problem. Skipping meals or fasting can cause the same sour, fruity mouth odor.

Sinus infections, mononucleosis, strep throat, tonsillitis – All of these conditions drip bacteria into the throat, which then manifests as foul breath. This issue will clear up as soon as the infection does.

Upper respiratory infections, bronchitis – These lung conditions cause a problem, because as you cough up the infected matter, your breath is contaminated.

Allergies – When you have allergies you have a two-fold problem. Untreated, they cause coughing, a runny nose, and watery eyes. If you don't take anything for the condition, you can develop a sinus infection, sore throat, and lung infections, all of which can cause halitosis. By treating allergies with antihistamines, you clear up all of those symptoms and end up with a very dry mouth, and possibly the same end result. This may easily be resolved by drinking plenty of water.

Diet and Food

High protein diets that exclude carbs can be devastating to your breath. Eating candy and cake to get your carbohydrates should be avoided. Raw vegetables, fresh fruit, brown bread, rice, or pasta will give you the carbs you need to freshen your breath, without negatively impacting good nutrition.

Getting Proper Treatment

The good news is that underlying causes can usually be treated and controlled once there is an understanding about why they occur. There are more than 170 different forms of bacteria that thrive in your mouth. Developing a good dental hygiene routine and treating any underlying conditions are important to keeping bacteria under control.

The development of good oral hygiene habits is needed to limit any causes that originate in the mouth. To help treat and prevent these issues, you should brush twice a day, including teeth, tongue, and inside the cheeks, and floss often. Replacing your toothbrush regularly (several times a year) is a good idea. If you wear dentures you should remove them at night; after you awaken in the morning, they need to be cleaned before wearing them. Visit your dentist to rule out periodontal disease or dry mouth.

Most people brush their teeth twice a day, when they rise in the morning, and before they go to sleep at night. Dentists recommend brushing your teeth after every meal, because this is the most effective way to ensure that your mouth will stay clean enough to prevent halitosis. Even the short time between dinner and sleep is enough time to allow bacteria to begin accumulating on the food particles that remain in your mouth. Most people only brush for 30 to 45 seconds, while dentists recommend that you spend a full two minutes brushing your teeth.

There are also homeopathic remedies for halitosis. Instead of treating just the symptom, the mental, emotional, and physical aspects are treated at the same time. The theory is that by balancing the body, there is no longer a shelter that viruses and bacteria can hide in.

In addition to regular brushing and flossing, there are several natural products that homeopathic doctors recommend be added to water to gargle or wash your mouth. Oleum caryophyllum is aromatic, and homeopaths claim that it reduces both bad breath and toothache. Cinnamon, diluted with water and gargled will sweeten the breath and is recommended for soothing bleeding gums. Rhus glabra, when gargled, eases ulcerative lesions and has the added bonus of improving the smell of flatulence and stool.

Although gum and breath mints may help temporarily after you have eaten odorous food, dealing with the underlying causes is the only solution for long-term relief of chronic halitosis. Drinking plenty of water, avoiding too much caffeine, quitting smoking or chewing tobacco, and eating raw vegetables and fruits will keep plaque levels down between dental cleanings.

Good oral hygiene and trips to the dentist will take care of most of your breath problems. If you have allergies, taking antihistamines will help, but you need to increase your water intake to combat dry mouth. If you are following these suggestions and still have chronic bad breath, it is time to visit your family doctor to investigate other possibilities.

The Bad Breath Bible by Dr. Katz, which is available online, can provide you with a good start to combatting this problem.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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