Surprising Sources of Bad Breath

Many of my patients tell me they are worried about having bad breath or halitosis and ask what they can do to prevent it.  According to Dictionary.com, halitosis is defined as the condition of having offensive smelling breath.  There are several sources of bad breath, but thankfully most are preventable.  The most common sources of bad breath are as follows:

dental plaque- the sticky white film that develops on teeth surfaces consisting of bacteria, mucus, and food.
Impacted food- Often food can get stuck between the teeth if not brushed and flossed out.  Over several days, this food begins to break down and give off foul odors.
Tonsiliths- These are small round white globs that form in the tonsils and occasionally get coughed up from the back of the throat.  Tonsiliths are an accumulation of mucus and volatile sulfur compounds (VSCs) which come from bacteria in the mouth.  The VCSs give off a smell like rotten eggs.

Now that we have addressed the most common sources of bad breath, let's talk about some sources of bad breath you may not know:

Tooth decay- Did you know that severely rotting teeth give off a distinctive odor?  Tooth decay is caused by bacteria that produce acid which erodes the teeth.  Once cavities become big enough, they can be quite smelly and this can affect the breath.  Patients also may have decay beneath old fillings or crowns as well.  Regular dental visits and routine x-rays can help alert you if you have cavities. Of course getting cavities fixed, and defective fillings and crowns replaced will help keep your breath smelling fresh.

Periodontal "gum" disease- Gum disease is also caused by certain types of bacteria.  These bacteria give off chemicals that cause gums to weaken, bleed, swell, and recede.  These chemicals also cause bone destruction which can eventually lead to tooth loss.  Gum disease usually progresses due to poor oral care habits (not brushing and flossing regularly) and infrequent dental hygiene visits.  Patients with moderate to severe gum disease tend to have halitosis associated with their disease due to the bacterial infection and tissue destruction.  There are estimates that 85% of adults have some form of active gum disease.  Early diagnosis and treatment of gum disease is recommended.

Sinus infections- Patients with seasonal allergies or who have recently had a cold may experience inflammation and swelling of the tissues inside their sinuses.  This swelling may prevent sinuses from draining properly, allowing bacteria to multiply and sinuses to become infected.  Signs and symptoms of a sinus infection may be as follows: Dull throbbing facial pain, post nasal drip, headache, toothache, colored nasal discharge, cough, congestion, fatigue, facial swelling, and fever.  Since the maxillary sinuses drain through the nose and mouth, the infection may also cause the breath to smell bad.  Patients who suspect they have a sinus infection should see their physician for evaluation and treatment.

Dentures/false teeth: Dentures are removable, custom-made appliances worn in the mouth to replace missing teeth.  Dentures are made of acrylic which, overtime can pick up stains and odors if not properly cleaned.  Food, plaque, and tartar (a hard build up consisting of bacterial plaque and minerals found in saliva) can build up on dentures, just like on natural teeth.  It is recommended that patients clean their dentures every day.  Also patients with dentures should have them professionally cleaned regularly to reduce the build up of bacteria.  This cleaning can be combined with a regular oral examination to screen for oral cancer or infection and is recommended at least once a year.

Dental Abscess- An abscess is a localized collection of pus in the tissues of the body, often accompanied by swelling and inflammation and is frequently caused by bacteria.  They form after the nerve of a tooth dies.  The nerve may die due to a deep cavity, caused by bacteria. These bacteria can infect the nerve, cause inflammation, and if untreated, cause the nerve to die.  In addition, teeth that are subjected to trauma may get disrupted from their blood supply and die.  The body recognizes the dead nerve tissue in a tooth as foreign matter and sends white blood cells to try to clear it away.  The resulting swelling and inflammation is what is known as an abscess.  The bacteria from the abscess and the dying tissue give off a characteristic smell, causing halitosis.

Acid reflux/GERD, and ulcers- Patients with acid reflux, also known as Gastroesophageal reflux disease and ulcers may have associated halitosis.  Both GERD and ulcers are serious medical conditions which need to be diagnosed and managed by a physician.

So, the question is, how do you prevent bad breath? Many of the above mentioned sources of bad breath can be prevented by having good oral hygiene.  Brushing twice a day, and flossing once a day go a long way to prevent halitosis.  Don't forget to brush or scrape your tongue to remove the odor-causing bacteria that live there.

 Avoiding sugary drinks, and sweets also helps keep bacterial plaque levels down. Be sure that the gum and mints you choose are sugar free to prevent tooth decay.   Drinking water also helps prevent dry mouth as well. Ironically mouthwashes with a high alcohol content can be drying to mouth tissues.  This dryness creates a welcoming environment for the bacteria that give off bad-smelling VSCs. Try to choose a mouthwash that is alcohol free for fresher breath.

Lastly, regular preventive dental visits and medical visits can help patients avoid conditions that contribute to bad breath.  Staying cavity free, gum disease free, and healthy are key to having fresh breath!

Happy Smiling!

Questions? Email Dr. Lisa Curry at info@currydentalcenter.com