Do you suffer from bad breath?

Are you embarrassed or anxious about your breath?

I have been a dentist for 21 years (scary!) and I can diagnose different causes of bad breath just by talking to someone. It’s one of those knacks a dentist can develop if you have sensitive sense of smell like I do.

I recently went shopping for a new dining table for my growing family. We have more people coming over to eat and we need more surface to park our junks on but I digress. The poor young salesman who was helping me with the dining table obviously suffered from gum disease (also known as gingivitis). The truth is, I can smell the characteristic odour of gum disease from a metre away.

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Why do we get bad breath?

You can rest assured that everyone has bad breath from time to time. Transient bad breath or halitosis can be blamed on certain foods, infection in the mouth, medication, dry mouth or even allergies causing hayfever and congestion in the nose. Bad breath have different characteristic odour depending on the source and the underlying cause. Let’s break down each cause and find out what can be done to eliminate bad breath.

The causes and solutions to bad breath

Food

Certain food such as garlic, onion, some spices and even coffee often have compelling strong odours. Our mouth is full of oral bacterial flora (hopefully more good bacteria than bad ones, depending on your oral health) and the breakdown of some of these foods can increase foul odour causing bacteria.

The solution? Avoiding onion in your salad sandwich just before an important meeting might be a good idea. Selective avoidance of strong odour food types, brushing teeth and the tongue after eating, chewing sugar-free chewing gum for 5 minutes after eating, and drinking plenty of water throughout the day will help to reduce bad breath.

Smoking

Due to public health initiatives and education, there are less and less of us smoking tobacco and we are much healthier for it. I am seeing in my own practice more people quitting smoking and abstaining for longer and longer. When I do a routine oral cancer screening on these ex-smokers, I find the oral mucosa (the skin inside the mouth) change colour and become healthier within months of quitting. It’s encouraging to see the body heal itself and I always point this out using photographs to motivate my clients. Tobacco smell is one that is recognizable to anyone and quitting will obviously eliminate the bad breath as well as improve one’s sense of smell so you can enjoy your food better!

Poor dental hygiene

When was your last dental check-up? Are you long overdue for a professional scale and clean? The mouth is full of oral bacteria, some are good and some are nasty. Lack of flossing or poor brushing technique can lead to a build up of plaque and tartar. This will produce an environment in the mouth that will favour the bad bacteria causing bad breath. The solution? Check in with your dentist for a thorough dental examination and a clean for a fresh new start. I always like to spend a good deal of time showing my clients how to best floss and brush their teeth.

Dry mouth (also known as Xerostomia)

Saliva assists in the breakdown of food and lubricates the mouth. It is our mouth’s natural cleanser removing food particles that may cause odours. The amount of saliva in the mouth fluctuates throughout the day. We have a dry mouth over night during sleep (and hence, “morning breath”) and this is normal. Drinking plenty of water (2 Litres for most adults) throughout the day will rehydrate your body and increase saliva flow. Coffee and tea don’t count towards your water consumption as they have diuretic effect flushing out more water out of your body. So really, for every cup of tea or coffee, you need to drink even more water to make up for it!

Medication

Some medications can directly cause dry mouth. Some of my clients report dry eyes or dry mouth after starting on some new medications. If this side effect is profound, it may be worthwhile to speak to your dentist and your family doctor to look for an alternative. It is also important to follow the manufacturer’s instructions on how and when to take the medication. For example, after inhaling asthma preventers containing corticosteroids, one should rinse the mouth as well as gargle to eliminate the particles remaining in the back of the mouth. This will prevent oral thrush developing with its associated bad taste or smell.

Infection in your mouth 

Infection in the mouth such as tooth decay or gum infection will certainly cause bad breath.  Gingivitis or periodontitis is a medical term for gum disease. An increase in the number of bacteria responsible for gum infection will cause chronic bad breath. Signs of gum infection include swelling, tenderness, bleeding and sometimes pus coming from the gums. The solution? Unfortunately, taking antibiotics will not cure gum disease. Visiting your dentist is a good idea when you see bleeding and sore gums. A good professional clean as well as flossing and brushing regularly will maintain healthy gums and prevent tooth decay.

Other mouth, nose and throat issues 

Bad breath can sometimes come from small white stones covered in bacteria in your tonsils. Chronic inflammation in the nose and the sinuses such as hayfever, sinusitis and post-nasal drip can all contribute to bad odour. The solution? Gargling and rinsing the mouth thoroughly after any inhaler medication is wise as per the manufacturer’s instruction. Seeing an ENT surgeon or an allergist will help in managing inflammation of the nose and the sinuses. Intermittent use of an antihistamine, saline nasal sprays and nasal corticosteroid sprays can also help to alleviate the symptoms.

Other medical causes 

An uncontrolled diabetic may exhibit mouth odour similar to acetone (like nail polish remover), due to high levels of ketone in the blood. Chronic reflux of acid from the stomach (Gastro-oesophageal reflux disease, GORD) will also contribute to bad breath. Seeing you medical doctor to manage these serious conditions is a good idea.

Conclusion

Perhaps one of your loved ones have hinted about your breath. Or if you really want to self-assess, that is DIY, here is a tip when you feel like you have bad breath- lick the inside of your wrist and smell it. This is how your breath smells when you are speaking to someone. There are a myriad of reasons why someone can suffer from chronic bad breath. Start with improving your dental hygiene followed by seeing your dentist is a sure way to achieving breath of fresh air.

Do you have any remedies that have worked for you?

I would love to hear your stories and comments. If you enjoyed reading this article please share.

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