Bad breath?

Bad breath, sometimes known as halitosis, is a common problem that can affect anyone of any age. Most people experience short periods of bad breath at some point in their lives and it is estimated that up to 50% of people suffer from persistent bad breath.

In most cases bad breath is caused by bacteria in the mouth living off food debris, and is frequently a sign of gum disease. Eating strongly flavoured foods, such as onions and garlic can cause your breath to smell unpleasant, as can smoking and drinking a lot of alcohol. Occasionally bad breath can be a result of an infection or illness, or a result of taking some kinds of medication.

Good oral (mouth) hygiene alone can usually prevent and treat bad breath. Your dentist can advise you on how to improve your oral health and refer you for further investigation if it is thought there may be another cause for your bad breath.

Causes

There are a number of different causes of bad breath:

Poor oral hygiene

The most common cause of bad breath is poor oral hygiene.

Naturally occuring bacteria that coat the teeth, tongue, and gums can cause plaque (the soft white deposit that forms on the surface of the teeth), gum disease and ental decay. These bacteria combine with saliva and food in the mouth to break down food particles and proteins, this process releases an unpleasent smelling gas. If you do not brush and floss your teeth regularly, any food that is trapped between your teeth will will be broken down by the bacteria and cause bad breath.

The rough surface of the tongue can also harbour these bacteria so, as well as brushing your teeth, cleaning your tongue can help to control bad breath.

Medical conditions

Medical causes of bad breath are rare, but they can occur.

Dry mouth (xerostomia) is a condition that affects the flow of saliva. This can cause bacteria to build up in the mouth and cause bad breath. Dry mouth can be caused by salivary gland problems or continually breathing through the mouth instead of the nose. As you get older you may produce less saliva which can then lead to bad breath.

Other medical conditions that can cause bad breath include:
• infections in the lungs, throat or nose,
• bronchitis,
• sinusitis,
• diabetes,
• liver or kidney problems, and
• gastritis and food reflux.

Crash dieting, fasting and low carbohydrate diets, such as the Atkins diet, can also cause bad breath. The breakdown of fat produces chemicals called ketones that can be smelt on the breath.

Food and drink

Eating strongly flavoured foods, such as garlic, onion and spices often cause your breath to smell. Strong smelling drinks, such as alcohol and coffee, can also cause bad breath. This type of bad breath is usually temporary and can be easily avoided by not eating or drinking these types of food or drink. Good dental hygiene also helps.

Medicines

Sometimes, certain medication can cause bad breath. Medicines that have been associated with causing bad breath include nitrates (sometimes used in treatment of angina), some chemotherapy drugs and phenothiazines (tranquilizers). You should discuss possible alternatives with your GP.

Smoking

If you smoke, your breath is likely to smell of stale smoke. As well as making your breath smell, smoking also causes staining, a loss of taste and irritates your gums, increasing your risk of gum disease, which is another cause of bad breath. Stopping smoking will lower this risk and prevent smoke-related bad breath.

Diagnosis

The easiest way to find out if you have bad breath is to ask a close and trusted friend, or family member, for their honest opinion. Visit your dentist to confirm that you have bad breath and get a diagnosis of the likely cause.

If your bad breath is being caused by poor oral hygiene, your dentist will be able to clean your teeth and give you advice about how to keep your teeth and gums healthy. Regular dental check-ups help to spot signs of tooth and gum decay early on and to prevent bad breath developing.

If you have bad breath you could try keeping a diary of all the foods you eat and any medication you are on, and take this to your dentist at your next check-up. On the basis of the diary, your dentist may be able to suggest ways to solve the problem.

If you have changed your dental hygiene routine and still think you have bad breath, you may need to visit your GP to check the cause of your bad breath. There may be an underlying medical cause for the problem that needs further investigation.

You should not try to mask the smell before visiting your dentist or GP, as this will make it more difficult to find out what is causing the problem.

Treatment

The treatment for bad breath depends on what is causing it. The simplest and most effective treatment is usually to improve your dental hygiene. To avoid bad breath, you need to keep your mouth and teeth clean by regularly brushing your teeth and gums, flossing in between teeth and keeping your tongue clean.

How can your dentist help?

Your dentist can recommend the best way to clean your teeth and gums and show you any areas you might be missing.  Regular check ups with your dentist will make sure any plaque is removed from your teeth, especially in all those hard to reach areas. It will also make sure any signs of gum disease are noted and treated early on.