An Inside Scoop On Bad Breath

While chronic breath issues (also known as halitosis) can be very difficult to treat, not every bad breath problem is intractable—sometimes, it is possible to address a breath issue quickly and efficiently if you narrow it down to a cause. If you have breath complaints, consider the following possibilities.

Dental Reasons

Food stuck between teeth. Normal teeth brushing may not clear bits of food which can get stuck between teeth. The food then rots and becomes riddled with bacteria. Regular cleaning between the teeth can clear and prevent this problem.

Plaque, tartar (calculus) and gum disease. Dental plaque is a soft whitish deposit that forms on the surface of teeth. It forms when bacteria combine with food and saliva. Plaque contains many types of bacteria. Calculus is hardened calcified plaque. It sticks firmly to teeth. Gum disease means infection or inflammation of the tissues that surround the teeth. If your gums look inflamed, or regularly bleed when you clean your teeth, you are likely to have gum disease. The severity can range from mild to severe.

Coating on the back of the tongue. In some people, a coating develops on the back part of the tongue. It is not clear why this occurs. It may be from mucus that drips down from the back of the nose (postnasal drip). The coating can contain many bacteria. This explains why bad breath can sometimes occur in people with otherwise good oral hygiene.

Medical Reasons

Many other diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems.

Dry mouth (xerostomia)

Bad breath associated with a dry mouth is caused by a reduction in the cleansing mechanism of the mouth as a result of reduced flow of saliva. There are many causes of a dry mouth. The most common cause is after a night’s sleep (discussed above). Dry mouth may also occur: Due to a lack of fluid in the body (dehydration). As a side-effect of some medicines (for example, tricyclic antidepressants). As a symptom of some diseases (such as Sjögren’s syndrome).

Following radiotherapy to the head and neck region.

You have a stuffed-up nose

When you have a stuffed-up nose, a certain amount of bad breath usually follows. Whatever reason you may get a stuffed nose for—an allergy, a cold or anything else—you may have no choice but to breathe through your mouth while the condition lasts. Mouth-breathing, though, dries up your saliva. When there is less saliva cleansing your mouth and neutralizing odor causing bacteria, there is naturally greater room for odor.

When you have a stuffed nose for any reason, then, getting sugarless chewing gum should be your first move. It should both keep your mouth healthy and increase the flow of saliva.

You’ll never believe it, but your mouthwash can be a problem

 Many antibacterial mouthwash products contain lots of alcohol — as much as 25% by volume. While it can feel cool, tingly and fresh when you rinse your mouth out with these products, alcohol can smell stale and unpleasant after a while. Not to mention, alcohol has the effect of drying up saliva flow. When you don’t have enough cleansing saliva, bad breath is a natural consequence. If you’re planning on a date or a meeting, an alcohol-free mouthwash should be the best idea.

Your low-carb diet does its bit

For its energy needs, your body usually burns the carbs in your diet, while storing fat for later. With a low-carb diet, the idea is to deny the body its carbs so that it is forced to tap its fat reserves. The process by which fat is burned for energy, though, releases substances called ketones. These substances are excreted from the body in a number of ways, saliva being one of them. The smell of ketone breath is often likened to the stench of rotting fruit. It isn’t an oral hygiene problem — rather, it’s a metabolism artifact.

Ultra-low-carb diets such as the Atkins method do come with a breath side-effect. Other diets that allow a certain level of carbs — the South Beach diet, for instance — don’t have the breath problem because they give your body a small quantity of carbs to go on, at least.

Gram-negative bacteria

While the average person’s mouth is home to hundreds of bacterial species, gram-negative bacteria, a certain variety, tends to be responsible for most breath issues. As they go to work breaking down food particles in your mouth, they release sulfur compounds that smell terrible. Brushing doesn’t easily get rid of these bacteria, either — their usual habitat is in the crevices in the tongue.

You need to brush your tongue well to make sure that you get all the bacteria out. Cleaning the innermost parts of your tongue, near the base, usually does the job.

You have tonsil stones

The tonsils are the gatekeepers to your system — anything that you swallow, the tonsils try to disinfect or otherwise clean up. The tonsils, though, have a naturally craggy or pitted surface texture. Food can get caught in these crevices, harden over time and smell. While dentists could clean these up, they usually aren’t alert to the possibility of bad breath through tonsil stones. It’s up to you to ask your dentist to clean your tonsils up.

Finally, if you like garlic…

Garlic is used in a vast range of recipes, some making stronger use of it than others. You don’t have to be anxious about staying off all garlic every time you go out to a dinner-date, though. According to a research report called Effect of Milk on the Deodorization of Malodorous Breath after Garlic Ingestion that was recently published in the Journal of Food Science, cold milk has a noticeable diluting effect on the malodorous compounds that garlic leaves in your system.

Dr. Gerald O'Connor B.D.S., N.U.I. (hons) (Principal Dentist & Owner)

Dr Gerald O’Connor qualified with honours from University College Cork in 1998, where he achieved his Bachelor of Dental Surgery degree and was awarded the Kerr Prize for Restorative Dentistry. Following his qualification, he spent 6 years gaining experience in a dental clinic in Essex before buying his own practice in 2004. Dr O’Connor quickly added a second location in 2006 and formed the Oak Dental Group.

After returning to Ireland in 2013, he set up Killiney Dental with his long-time partner Rosemarie. Gerald has a wealth of experience in dentistry with a vested interest in modern, evidence-based solutions. He enjoys implementing new dental treatments that are minimally invasive for patients without compromising their desire for an idealised smile. Dr O’Connor currently serves on the Irish Dental Association’s Quality and Patient Safety Committee. In his spare time, he enjoys films, music, fiction writing and being anywhere in sight of the sea.