Bad breath is a bit of a problem. It’s difficult for some people to discuss it with anyone, especially if the other person has bad breath. In all seriousness, though, unpleasant or foul odors in one’s breath are at best a social negative, at worst a sign of real health problems. Including very serious health problems.
About 60 million Americans have a chronic problem with bad breath. The medical term for it, halitosis, is one that’s familiar to nearly everybody. It’s at least a minor concern to everyone, too, since no one wants it. There’s one person, though, with whom you can discuss bad breath freely and comfortably. Your Lake Worth dentist. And as you’ll see, you should. You may wish to have that conversation during your next office. Meantime, let’s take a deep breath and look at the causes, complications, and solutions.
WHAT’S BAD ABOUT BAD BREATH?
We’ll soon review the basic “flavors” (ugh!) bad breath comes in. First, let’s flip the coin and ask what normal breath smells like. The medical and dental research literature has very little to say about this. The best answer, therefore, is that normal “un-bad” breath has no particular odor. It’s neutral. Or, it can smell like whatever the person recently ate or drank. A few foods items, such as garlic, of course, can scent a person’s breath with an odor many find unpleasant. Unpleasant, perhaps, but not foul. There’s the thing that makes bad breath bad. Halitosis produces scents which nearly everyone would associate with decay, rotting, and waste. Scents that simply don’t belong in a human mouth.
TYPES AND CAUSES: ORAL ORIGINS
Most bad breath, perhaps 90%, originates in the mouth. The underlying cause almost always is found in less-than-ideal oral hygiene practices. In plain English, something’s rotten in there. More specifically, what’s happening is bacteria glomming on to various proteins they find in the mouth. Proteins left over from eating, drinking, and not properly cleaning up by brushing and flossing. The bacteria residents of our mouths feast on these proteins and produce volatile sulfur compounds (VSC).
As a matter of fact, you know what VSC smells like. You’ve smelled it before, and would probably describe it as a “rotten egg” scent. Not surprising. Rotting eggs, after all, produce hydrogen sulfide, a VSC which is, by the way, toxic. The chemical process in a rotting egg is similar to that in a human mouth. Bacteria break down proteins and producing stinky VSC. These sulfur compounds don’t just smell bad. They work hard a smelling bad. The “volatile” in VSC reflects the explosive, intense action of their scents. A little goes a long way.
This common type of halitosis, then, is a sign that bacteria are breaking down proteins in the mouth. The underlying villain is plaque. That’s the colorless film of goop in which the bacterial culprits live and prosper. Plaque forms on the surfaces of teeth, causing decay and cavities. It also invades below the gum line and causes gum disease. When there’s bleeding, this can make the odor even worse. Our tongues host plenty of plaque, too.
We brush and floss to prevent and delay plaque formation. Even so, it tends to build up and then harden into what we call tartar. It’s somewhere between difficult and impossible to remove tartar with self-care at home. That’s why regular professional cleanings are so important.
DRY MOUTH, BAD BREATH
The common condition xerostomia, or “dry mouth”, commonly results in halitosis. The reason is pretty simple. One of saliva’s jobs is washing away bacteria and sending them “down the drain”. Too little saliva, or no saliva, and this self- cleaning action slows to a crawl. Hence, bacteria in the mouth run wild with available protein residues. Therefore we identify anything that causes dry mouth as a cause of halitosis. Unfortunately, some of the most widely-prescribed medications tend to do just that.
BEYOND THE MOUTH
Let’s now look into some of the extraoral causes of bad breath. Halitosis which originates somewhere outside the mouth. Bad breath of this type is not directly related to dental or oral hygiene or disease. Rather, it’s generally a sign of disease somewhere else in the body. Some of these are very serious diseases.
Common infections of the upper respiratory tract can produce halitosis. These are conditions such as the common cold, sore throat, and sinus infections. What they have in common is that the excess mucous they trigger is a great food source for our bacterial friends. That’s right, proteins. Mucous is rich in glycoproteins. Guess where else we find glycoproteins? Yes, in eggs. Hence, infections of the nose, throat, and sinuses tend to produce VSC and the rotten egg experience.
But there’s more. Infections in the nasal passages and sinuses tend to clog things up. This, in turn, creates the kind of dark, warm, closed spaces fungi and viruses love. These can contribute additional odors of a cheesy character. Or even a poop-like, fecal odor.
BAD BREATH AND THE WHOLE BODY
Now we come to some of the more serious medical conditions that bad breath can signal. Some of these convey their characteristic scents through the bloodstream, to the lungs. Ammonia- or fish-like odors are sometimes symptoms of kidney disease. Sweet, fruity breath results from uncontrolled diabetes. Liver cirrhosis sometimes causes a sweet, musty breath. A sharp, acrid scent may indicate cystic fibrosis or asthma.
Our digestive tract is another organ system that sometimes curses us with halitosis. The business of the digestive system is quite nitty-gritty. There’s nothing down in there that smells at all good. It’s supposed to be a one-way street, of course. Hence, anything that blocks or reverses this traffic has the potential to foul our breath. Burping or vomiting amplifies the effect.
One type of halitosis tends to appear and then vanish on a regular, cyclical basis. Researchers are firming up the links between women’s menstrual cycles and their oral VSC levels. Yes, those same volatile sulfur compounds we discussed earlier. There appears to be a relationship between cyclical hormonal changes and VSC.
The subject of halitosis is, of course, bigger and more detailed than this brief review can cover. However, a few key practical conclusions practically leap off the screen.
First, bad breath is mostly a result of poor oral hygiene. A clean mouth tends to be a fresh mouth. The good news here is that disciplined practice of basic oral hygiene goes a long way toward preventing halitosis. Regular and proper brushing and flossing, and timely, regular dental checkups. The bad news is, well, the same news. For various reasons, a lot of us don’t seem able or willing to invest the time and effort. We pay the price in terms of decay, gum disease, and bad breath. Anderson Dental Lake Worth family dental practice, though, has resources to help patients of all ages learn solid self-care habits.
Second, your dentist is a halitosis “first responder”. Positioned to pick up on bad breath as a warning signal for non-dental, possibly serious medical conditions. Regular checkups are one opportunity for early detection. Patients are encouraged, though, to call about any halitosis symptoms, anytime. Bad breath is usually within our scope of practice. When it isn’t, we direct patients to the appropriate medical providers. As you’ve seen, that can be a real life-saver.