As we all know, bad breath or halitosis can impact us socially and personally. It can make us feel a bit uncomfortable at times and even to the point of affecting our self esteem, but rest assured it happens to everyone and there are options. Numerous studies confirm that bad breath is the third most frequent reason people make an appointment to see the dentist following tooth decay and gum disease. Each year, Americans spend their money on fresh breath remedies, including gum, mints and mouth rinses. There are a number things that can promote bad breath. If you notice that you have bad breath, and its impacting your life see your dentist because it may be much more that just bad hygiene, it could be systemic, or even an infection.

In almost 90% of all cases, bad breath starts in the mouth itself. This is because the mouth is typically dry and inactive during the night. This type of halitosis “morning breath” is normal and occurs in most adults. As the day goes on the severity of the bad breath may change or intensify due to stress, or if you are eating certain foods such as (garlic, onions, meat, fish and cheese). Smoking, alcohol consumption, and prescription medication can also contribute to halitosis because it also tends to dry the mouth a condition called xerostomia. If you are fasting/dieting you will begin metabolizing or using body fat, and the distinct acetone smell of ketones may appear on the breath causing a foul smell. These type of halitosis are usually temporary and often disappearing after eating, brushing, flossing, or rinsing with mouthwash.

Did you know that there are over 600 types of bacteria found in the average mouth, with many that can produce high levels of foul odors. The most common area of originating bad breath is on the tongue. Having stated that, let us not forget that if our hygiene is not kept up, bacteria will accumulate around and between the teeth and the tongue, which will result in sulfur compounds released. Typically these odors are characterized by the “rotten egg” smell. Bacteria can also cause bone loss around the teeth or periodontal disease, which in turn causes more food/bacteria to accumulate.

There are other oral causes for halitosis, mouth-breathing, food trap areas between and under gums, faulty dental work, abscesses and unclean dentures are a few common examples. Other sources of bad breath not associated with dentition are sinus infections, and tonsillar stones. Some possible systemic conditions that could contribute to bad breath, but are rare are liver disease, lung infections, diabetes, and kidney infections.

So treatment could vary depending on the source of the halitosis. It could be as simple as better homecare, a more frequent interval for dental cleansings including possible periodontal therapy, the use of moisturizing rinses to keep mouth moist, or medical consult.

Now if you notice that even after dental treatment has been exhausted and bad breath is still persistent or chronic, it could be a sign of a more serious condition and medical and/or surgical intervention may be needed.