Bad Breath

An OLD problem with some NEW answers

By Dr. Sonia Sharma

While visiting dental offices, patients generally avoids answering the question related to bad breath on the patient’s questionnaire. Embarrassment and ignorance are considered to be the main reasons for such avoidance. Most people feel that brushing regularly eliminates their bad breath, but unfortunately it takes more than that. 

The problem of bad breath ‘Halitosis’ has been around for thousands of years. It was written about in the Jewish Talmud, ancient Greek and Roman literature, and as early as 850 AD, Islamic literature offered some explanation for the origin of the teeth as well as ‘fetid breath’.  

This age-old problem has numerous causes, but in majority of the cases, the odor originates from the mouth. In the remainder of the cases, the nose, tonsils, and other ailments contribute to bad breath. Treatment for bad breath must address the source of the problem. When the mouth is the cause of bad breath, food, oral habits and dental health should be examined first. Foods or beverages such as garlic, onions, and coffee, and habits such as smoking and chewing tobacco can contribute to bad breath. Dental problems such as broken teeth that trap food, infected teeth that abscess, or untreated

Periodontal (gum) disease is common causes of bad breath. If the teeth and gums are healthy, the tongue is the most likely culprit. The back, top part of the tongue is a common and overlooked cause of bad breath. There is speculation that chronic postnasal drip that collects on the tongue becomes infiltrated with bacteria causing odor. Tongue brushing, or the use of a tongue-scraper can often alleviate this source. People who wear dentures without taking them out at night or cleaning them properly can also have bad breath. 

Abysmal oral hygiene like improper cleaning of the teeth and mouth contributes to bad breath, thus, one must brush the teeth twice daily and floss before retiring at night. It may be beneficial to chew sugarless gum and drink water throughout the day to moisten the mouth, which may reduce mouth odor. If odor persists after the teeth, gums, and tongue are clean and healthy, a germicidal mouth rinse, containing chlorine dioxide can be prescribed. If none of these measures succeed, a medical doctor should be consulted to explore other potential causes. 

The nose is the other most common cause of bad breath. Sinus infections or polyps can cause bad breath. The tonsil may be a cause of bad breath in some people; especially if small tonsillar stones called tonsilloliths are formed and collect on the tongue. Some other non-dental causes of bad breath include respiratory infections, diabetes, kidney failure, some cancers, and other disorders. One rare disorder that causes a fishy mouth odor and taste is trimethylaminuria. The stomach and intestines are commonly thought to be a cause of bad breath, but this is not the case. The esophagus is normally closed, preventing odors from the stomach and intestines from reaching the mouth. 

Bad breath is a sensitive topic that should be discussed with your dentist. Your dentist can assist you discover the most likely cause and help to alleviate the problem.

Please remember that the information is provided as a general guideline. It is NOT intended to replace professional care. Since every patient and every case may vary, consult your physician or our office for advice on your particular situation.