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Bad Breath
Do you have bad breath?
Most people can't tell that they have bad breath. However, if you notice a consistent foul, metallic, dry, sour, bitter, or stale taste in your mouth, you may have the condition, also called halitosis.
Poor dental hygiene, with its resultant bacteria buildup, can cause significant bad breath. Another common culprit is smoking. It can also come from the sulfur content in foods such as garlic, onions, fish, and meat.
Some people don't produce enough saliva -- a great help in the mouth because it washes away bacteria. If you're taking an antihistamine for a cold, it can dry out the mouth, with bad breath as a result.
Synonyms
- Halitosis
Possible Underlying Causes
Bacteria on the tongue and in the mouth are the typical cause of bad breath, normally from poor oral hygeine. Another cause is from sulfur in your food -- it is absorbed into the bloodstream and passed through the lungs as you exhale.
"Morning breath" results from the lack of salivation that occurs while you sleep. This allows bacteria to multiply -- once you brush and eliminate the bacteria, the bad breath will disappear.
A number of diseases also affect breath odor. Liver failure gives the breath a musty odor. Kidney failure makes the breath smell like urine. Severe diabetes makes the breath smell like acetone, similar in smell to nail polish remover. A lung abscess will also cause strong bad breath.
Triggers of Bad Breath
- Failing to clean your teeth, tongue, and mouth regularly
- Eating garlic, onions, fish, and various meats
- Failing to have regular dental hygiene treatments
- Smoking
- Failing to have dental decay or gum disease treated by a dentist
Diagnosing the Underlying Causes
Although many serious conditions may include bad breath among their symptoms, the ones listed below are among the most common and least dangerous you are likely to experience. If the conditions below do not seem to apply to you, or if you are concerned about a symptom, seek the advice of your physician.
- Dental decay
- Gingivitis: This is characterized by red, swollen gums that bleed easily. Bacterial plaque accumulates on the teeth and gums, causing this condition.
- Periodontal disease: Also called periodontitis, this involves bad breath accompanied by bad taste, and gums that bleed easily and have pus-filled pockets around the teeth. May also cause facial pain, headache, and loose teeth.
- Sinusitis: inflammation of the sinuses with thickened mucus, causing bad breath.
- Common cold: a musty breath odor can be caused by this old enemy of mankind.
Diagnostic Procedures
Your dentist may measure the amount of gases in your mouth that make up bad breath.
Treatment Options
Bad breath usually responds best to self-care measures. Sometimes, bronchitis may be the cause, so taking medication that eliminates bronchitis may stop bad breath.
Over-the-counter aids (such as Binaca and Breath Assure) can be used, but they only mask the odor temporarily. Mouthwashes that contain high levels of alcohol will temporarily reduce bacteria, but they can also dry the mouth, leading to further odor. In rare cases, your doctor may prescribe an antibiotic to combat bacterial colonization that may be causing chronic bad breath.
Herbs
- Try chewing parsley. Rich in the green plant pigment, chlorophyll, it's a potent breath freshener. (Clorettes breath mints take their name from chlorophyll.) Chew parsley after or between meals. [1]
- Drinking mint tea can help. Peppermint and spearmint teas also freshen the breath. [2]
[1][2] Duke, James. The Green Pharmacy. Rodale Press, Emmaus, PA, 1997.
Preventing Bad Breath
- Don't smoke. Smoking is a leading cause of bad breath.
- Brush and floss several times daily. You can also lightly scrape or brush your tongue. Keeping your mouth free of bacteria will decrease odor.
- See your dentist. Have your teeth professionally cleaned at least once a year.
- Chew sugarless gum. It stimulates saliva secretion, which helps wash away bad breath.
- Drink lots of water. It helps wash away food residues that can contribute to bad breath.
- Avoid foods that cause bad breath. Coffee, alcohol, garlic, onions, aromatic cheeses, and certain meats -- especially pastrami, salami, and pepperoni -- can contribute to bad breath.
- Most mouthwashes really don't help; they only mask the odor. Some mouthwashes with zinc and sodium benzoate can neutralize the odor caused by bacteria.
When to Call the Doctor
Consult your doctor if:
- Your breath smells fruity or like nail polish remover (an acetone smell) -- it may be diabetes.
- You haven't eaten any of the trigger foods, you have good dental hygiene, and your bad breath persists.
Websites & Organizations
Academy of General Dentistry
Suite 1200, 211 E. Chicago Ave.
Chicago, IL 60611
American Academy of Pediatric Dentistry
211 E. Chicago Ave., Suite 700
Chicago, IL 60611-2616
Phone: 312-337-2169
Fax: 312-337-6329
American Breath Specialists
American Dental Association
211 E. Chicago Avenue
Chicago, IL 60611
Phone: 312-40-2500
Fax: 312-40-2800
American Dental Hygienists' Association
444 North Michigan Avenue, Suite 3400
Chicago, IL 60611
Phone: 312-40-8900
Email: mail@adha.net
California Dental Hygienists' Association
660 J Street, Suite 480
Sacramento, CA 95814
Email: info@cdha.org
Dr. Kaufman's Web Page on Gingivitis
Fresh Breath Clinic
National Center for Education in Maternal and Child Health
2000 15th Street, North, Suite 701
Arlington, VA 22201-2617
Phone: 703-24-7802
Fax: 703-24-9335
Email: info@ncemch.org
National Oral Health Information Clearinghouse
1 NOHIC Way
Bethesda, MD 20892-3500
Phone: 301-402-7364
Fax: 301-907-8830
TTY: 301-656-7581
Email: nidr@aerie.com
The Virtual Dental Center
Sources & Further Reading
Books
Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.
Fauci, Anthony J., et. al. Harrison's Principles of Internal Medicine, eds. New York: McGraw-Hill, 1998.
Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.
Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.
Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment eds. Stamford, CT: Appleton & Lange, 1998.
Articles
Attia, EL, Marshall, KG. "Halitosis." Can Med Assoc J. 126(11):1281-5. Jun 1, 1982.
Bogdasarian, RS. "Halitosis." Otolaryngol Clin North Am. 19(1):111-7. Feb 1986.
Bosy, A . "Oral Malodor: Philosophical and Practical Aspects." J Can Dent Assoc. 63(3):196-201. Mar 1997.
Duke, James. The Green Pharmacy. Rodale Press, Emmaus, PA, 1997.
Hennessy, M. "Battling Bad Breath: A New Approach to an Old Problem." CDS Rev. 90(1):46-9. Jan-Feb 1997.
Messadi, DV. "Oral and Nonoral Sources of Halitosis." J Calif Dent Assoc. 25(2):127-31. Feb 1997.
Richter, JL, "Diagnosis and Treatment of Halitosis." Compend Contin Educ Dent. 17(4):370-2, 374-6 passim; quiz 388. Apr 1996.
Rosenberg, M. "Clinical Assessment of Bad Breath: Current Concepts." J Am Dent Assoc. 127(4):475-82. Apr 1996.
Spielman, AI, Bivona, P, Rifkin, BR. "Halitosis. A common Oral Problem." NY State Dent J. 62(10):36-42. Dec 1996.
Young, K, Oxtoby, A, Field, EA. "Halitosis: A Review." Dent Update. 20(2):57-9, 61. Mar 1993.