Bad Breath

We all have it, what do we do with it?

Let us review some of the causes of bad breath. Bacteria growing in the oral cavity, food rotting between teeth, scummy tongue and diseased gum tissues are the predominant cause bad breath or halitosis. I am not concentrating on dietary eliminates such as onion breath that slowly dissipates as the body eliminates it from the digestive tract. In my experience 90% of breath originates from the mouth.

Bacteria grow between the gum and teeth and on the surface of the tongue. They can double in population every 20 minutes. The overpopulation can overwhelm the host (you) not get properly cleaned away by natural forces like chewing. Infections have a very characteristic smell. I haven’t come across any abscess or chronic infection that had a pleasant odor, especially in the mouth. Bacterial waste contains hydrogen sulfide (similar to rotten eggs). It is pungent and pervasive if not contained.

Treatment of bad breath may mean a visit to the dentist for a diagnosis. You may be tested with a halimeter that can measure sulfide emissions. It is not always necessary to have a machine tell you what sensitive noses can detect. The dentist will try to determine if your bad breath is chronic or just periodic. We all have periodic halitosis. Usually, thorough and gentle tooth brushing, flossing and tongue scraping several times a day will be all that is needed. Chronic halitosis may require a dietary change to include more roughage to facilitate self cleaning of the back of the tongue.

Regular periodic visits to your dental hygienist to detect and prevent bacterial infections from getting worse and can recommend products to reduce bad breath. I favor the mouth rinses that specifically target neutralizing the sulfides with oxidizers. Chewing gums for dry mouth or just self-cleansing are great. Try the sugarless gums containing xylitol. Two gums I recommend are Hersey’s Ice Breakers Ice Cubes and Trident XTRA Care. Xylitol, aside from being an artificial sweetener, also cannot be digested by harmful bacteria. Keep hydrated and avoid alcohol-containing mouth rinses because they will dry out the mouth.

Finally, get in the habit of scraping your tongue after brushing your teeth. The tongue can be a safe harbor of bacteria and can re-infect the newly cleaned teeth in a matter of minutes. Brushing the tongue is not adequate and a specially designed scraper is recommended.

THE LINK BETWEEN PERIODONTAL DISEASE AND RESPIRATORY DISEASE by Dona Fujioka, R.D.H.

There have been studies linking periodontal disease to the other inflammatory diseases, such as cardiovascular disease, diabetes, and various other ailments. Recently, there have been studies supporting an association between periodontal and upper respiratory disease; respiratory disease, including pneumonia, acute bronchitis, and chronic obstructive pulmonary disease (COPD). Statistically speaking 9 out of 10 adults have some form of periodontitis. Because respiratory infections can be debilitating, it is important to further investigate the connection between the two conditions.

Upper respiratory infections typically occur when different types of bacteria are inhaled into the lungs. Bacteria that cause periodontitis can also be inhaled into the respiratory tract and increase the risk of infection. Studies have been shown that due to the presence of oral pathogens, the inflammatory response weakens the host’s immune system, thereby increasing the risk for developing or aggravating respiratory infection. Even though the presence of bacteria is what determines the disease, it is the host’s response to the bacteria that is essential in the initiation and progression of the disease.

It has been found that a group with respiratory disease had poor periodontal health compared to the healthy group. Despite studies showing the link between to the two conditions, more research is necessary to determine if and how the inflammatory response to the periodontal bacteria leads to the development or exacerbation of respiratory infection.



SOURCES: Donald S. Clem DDS
Sharma N., Shamsuddin H.