Health Care and Bad Breath (Halitosis)

People who have bad breath can really stink up a room. The cause of their social faux pas is due primarily to poor oral health. The technical term is halitosis; but if you mention to anyone that they suffer from that particular issue, you might just get a blank stare. Most people, however, can easily identify with the term “bad breath.” In some parts of the world, the whole country might smell—likely because most of the inhabitants are living with halitosis.

According to the Academy of General Dentistry (AGD), more than 80 million people suffer from chronic halitosis, or bad breath. In most cases it originates from the gums and tongue. The odor is caused by wastes from bacteria in the mouth, the decay of food particles, other debris in your mouth and poor oral hygiene. The decay and debris produce a sulfur compound that causes the unpleasant odor.

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, according to Colgate.

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.
• 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) — This can be caused by salivary gland problems, medications or by "mouth breathing."
• Systemic illnesses — Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
• 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."

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. More information on halitosis can be found at this site: http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Bad-Breath/article/What-Causes-My-Bad-Breath.cvsp .

It is important to practice good oral hygiene, such as brushing and flossing your teeth at least twice a day, according to the AGD. Proper brushing, including brushing the tongue, cheeks and the roof of the mouth, will remove bacteria and food particles. Flossing removes accumulated bacteria, plaque and food that may be trapped between teeth. To alleviate odors, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue.

Chewing sugar-free gum also may help control odor. If you have dentures or a removable appliance, such as a retainer or mouth guard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouth rinses, deodorizing sprays or tablets, talk with your dentist, because these products only mask the odor temporarily and some products work better than others.

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. More information on bad breath issues can be found at this website: http://www.knowyourteeth.com/infobites/abc/article/?abc=W&iid=306&aid=1254 .

According to US News & World Report, there are several kinds of natural remedies, like chewing parsley, eating herbs like rosemary or drinking black tea. The important thing is to find out the cause of your bad breath before committing to one of these remedies or picking up a bottle-of-mouthwash-a-day habit. Not only are these temporary fixes, but they could prevent you from catching serious dental or medical issues. You can find more material at this site: http://health.usnews.com/health-news/health-wellness/articles/2014/01/08/how-to-prevent-and-treat-bad-breath .

Halitosis affects an estimated one in four adults, not to mention the scores of us with healthy mouths who go the extra mile to ensure that our exhales don't offend, according to http://health.howstuffworks.com/wellness/oral-care/problems/halitosis.htm . Then there are those who experience the fear of bad breath -- halitophobia -- so intensely that their dentists may refer them to psychologists.

As a result, the oral hygiene industry is booming. Grocery store and pharmacy shelves are packed with a vast array of products to slay those oral odors, including gums, sprays, toothpastes and more. One of the most common products people purchase to combat halitosis is mouthwash. The British Medical Journal recommends using solutions with chlorohexidrine gluconate, which is proven to kill pesky bacteria. Rinsing with it at night preps you for a fresher-smelling morning since dry mouth that occurs when you sleep fosters bacteria production.

Not surprisingly, what you put into your mouth during the day can also influence the olfactory impact of your breath. Drinking water throughout the day is not only good for your body, but also good for your breath. It washes away bacteria and particles that prompt halitosis. Certain foods including parsley, fennel seeds and carrots can freshen your mouth as well.

Bad breath is no laughing matter, as typically you are the one laughed at if it’s your mouth. Do yourself a favor and practice good oral hygiene. If you still have problems, see your dentist or doctor to find out if your halitosis stems from a medical issue or some other reason. It pays to have “minty fresh breath.

Until next time.