Bad Breath, or halitosis, is an embarrassing problem that affects millions. To combat it, many people use breath mints, chewing gum, sprays and mouthwashes. In fact, Americans spend billions of dollars each year on these products — even though they offer only a temporary fix. Getting rid of persistent foul odors on the breath in a lasting way requires a little detective work on the part of dental professionals.

Bad breath can affect anyone temporarily — think of “morning breath,” or the way your mouth smells after eating onions or drinking coffee. Some people, however, exhale noticeably unpleasant odors throughout the day, every day. That's when it is important to find the cause of the problem, so a lasting solution can be achieved.

Causes

Most often, bad breath originates in the mouth, from trapped food particles that are then processed by oral bacteria. The most common location for mouth-related bad breath is the back of the tongue, where large quantities of naturally occurring bacteria can thrive on food remnants, dead skin cells and post-nasal drip (mucus coming down your throat from the nose). The waste products of these bacteria include volatile sulfur compounds (VSCs), which have a smell resembling rotten eggs. Other places where bacteria and food particles can be trapped are between the teeth, beneath the gums, and in oral appliances or dentures. Poor oral hygiene sets the stage for these problems, as well as for tooth decay and gum disease, which can also cause foul odors.

It's possible for other health conditions and habits to affect your breath. Halitosis may occur in people who have a sinus or bronchial infection, an oral yeast infection (which can be caused by antibiotic use), or even a systemic (general body) disease such as diabetes, kidney failure or a liver malfunction. A chronically dry mouth (xerostomia), which is often a side effect of certain medications, and tobacco use can also contribute to this problem. Even stress, dieting and hormonal changes can affect your breath.

How Dentistry Can Help

Since bad breath most often originates in the mouth, the dental office is the best place to start in your quest for consistently better-smelling breath. After a thorough examination, any of the following might be recommended:

• Oral hygiene instruction. It might be that you could benefit from a demonstration of how to brush and floss more effectively, or how to better clean your dentures. You can also be instructed on how to use a tongue scraper to clean the back of your tongue if necessary.
• Professional dental cleaning. Food particles, bacteria and calcified deposits can become trapped where you can't reach them — but special dental instruments can. Regular professional cleanings are a great way to promote good oral health in general and good-smelling breath in particular.
• Treatment of tooth decay. Bad breath may be caused by large, open cavities that need to be filled, or old, defective fillings that need to be repaired.
• Treatment of gum disease. More advanced forms of gum disease cause the gums to separate from the teeth, forming pockets in which bacteria can thrive. If you have gum disease, you may need periodontal (gum) therapy, which can include a deep cleaning of the roots of your teeth, antibiotics, and, in advanced cases, periodontal surgery.
• Treatment of infection. Infection that doesn't originate in your mouth needs to be treated by the appropriate medical professional. Whatever the cause of your bad breath, we are here to make sure you get the treatment you need.

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