My name is Kyle Hornby and I am a Kitchener-Waterloo Dentist. Each week I tackle common dental topics to raise the bar on dental health knowledge available to the public. My overall goal is to help patients to need less treatment so they can save money on annual dental fees. This week, I’d like to discuss bad breath (or “Halitosis”) as well as what can be done to eliminate it!
First let’s tackle common sources of bad breath.
Where does bad breath come from?
Well, bad breath comes from the mouth and we know that. However, it’s root cause doesn’t always originate in the mouth. This surprises many people. There are some systemic health problems that can lead to bad breath. We’ll discuss them first and then I’ll go into detail about things that go on in the mouth that contribute to Halitosis.
Bad Breath and Systemic Causes
Dry Mouth or Xerostomia
Though this may seem like a mouth-based cause, dry mouth can result from taking blood pressure meds, anti-depressants, medicinal marijuana and a host of other compounds. Dry mouth may also result from autoimmune disorders like Sjogren’s syndrome.
Saliva is nature’s tooth cleaner and, without it, more food and plaque remains in the mouth and acts as fuel for odour-causing bacteria. One of the most common causes of bad breath is stagnating food and plaque that gets caught around the gumline and in between teeth. So make sure to let your Family Dentist know if you’re experiencing dry mouth symptoms and bad breath. Incorporating more water consumption or a saliva substitute like Biotene, can help to clear food from your mouth and decrease or eliminate bad breath.
Diabetes results in a higher glucose concentration in saliva and this provides more fuel for the bacteria that cause bad breath. Additionally, high-glucose saliva provides fuel for bacteria that cause tooth decay and gum disease and both of those problems can contribute to Halitosis, too.
The first is to improve glucose control which will have overall health benefits, too. One secret that most patients have never heard of is to chew probiotic gums. These products are available at most Health Food Stores and help to re-balance the bacterial ecosystem in your mouth by increasing levels of beneficial bacteria. Many patients have noticed a distinct improvement in their breath after chewing probiotic gums for only a few days!
Can bad breath originate in the stomach? The answer is yes as many patients who suffer from stomach ulcers also note unpleasant breath. Most commonly, this is due to (again) a change in bacteria in the mouth. H.Pylori is the bacteria most commonly found to cause stomach ulcers and this same bacteria can be found in the mouth of affected individuals. H.Pylori colonization may increase the concentration of pathogens seen in gum disease and these bugs often trigger bad breath.
Most H.Pylori stomach ulcers respond well to treatment with antibiotics. Ulcer resolution can bring with it a dramatic decrease in bad breath.
Bad Breath and Root Causes Found Within the Mouth
There are a number of local causes of bad breath found within the mouth. In some cases, these can be controlled more easily compared to systemic causes like dry mouth, Diabetes and Ulcers.
Your mouth is home to a whole ecosystem including thousands of types of bacteria. This is commonly called the “Oral Microbiome”. Many of these bacteria are beneficial to our health but some aren’t. The harmful types can cause tooth decay, gum disease and bad breath. Eliminating these bacteria altogether is virtually impossible but, luckily, the key to good health is keeping these populations at stable, low levels.
Problematic bacteria feast on layers of dead tissue that we shed or turnover regularly. When healthy, the low numbers of these bacteria tend not to have a major effect. However, in greater concentrations they consume dead cells and produce bad-smelling compounds as a byproduct of their metabolism. These compounds contain sulfur and produce bad breath at high concentrations.
Luckily, probiotic gums can help to supply your mouth with a boost in beneficial bacteria. These bacteria can out-compete harmful neighbors to shift the overall microbial balance in your favour. Fewer harmful bacteria mean lower production of odorous sulfur compounds.
So consider chewing probiotic gum on a regular basis to keep bad breath under control.
There are generally 2 sources of local infection in the mouth: those originating from an area of the gums and those originating from a particular tooth. When people refer to a tooth abscess or a gum boil, these are the types of infections to which they’re referring. A local gum or tooth infection can appear as a distinct swelling or pus blister, or they may not result in any visual change at all. In some cases, there will be accompanying pain while other times there may be no pain whatsoever.
Patients do often note a salty or metallic taste associated with local infection. They will often complain of bad breath as well. The solutions for local infection vary. For a tooth abscess, a root canal treatment will be necessary to maintain the tooth. Tooth extraction or removal is also an option. For an abscess originating from the gums, the solution may be a course of antibiotics. If the gum infection is related to food or debris stuck under the gums, removal of the item will typically eliminate the odour-causing infection.
Resolving the tooth or gum infection will eliminate bad breath.
This is one of the more common causes of ongoing halitosis. If large food particles and strands are getting caught between gaps in your teeth, they can stagnate for hours causing bad breath. This is another situation where the fuel available to odour-causing bacteria is increased. To eliminate bad breath, you’ll need to either eliminate the gaps or make sure you’re flossing after every meal.
Things like garlic and onions contain oils that can contribute to mouth odours for days after consumption. Given that both are healthy foods, it’s best to continue eating them. You can minimize odours by rinsing with water after consumption. You can also consume an apple or chew gum for 2-3 minutes after to ramp up saliva production and dilute the oils contributing to bad breath.
Mouthwash and Bad Breath
If someone develops bad breath, they’ll often turn to mouthwash as a solution. The problem is that, most over-the-counter mouth rinses dry out your mouth and shift the balance between good and bad bacteria in your mouth. First of all, you need that saliva to dissolve food and plaque and carry both away from your teeth and gums. Drying out your mouth means that, after the initial burst of fresh breath, things will actually get worse. Also, most mouth rinses disrupt the beneficial bacteria in the mouth. Without good bacteria keeping things in check, the bacteria that cause bad breath, cavities and gum disease can thrive.
This means that traditional mouthwash products actually make your mouth less healthy.
So don’t rely on mouthwash as an ongoing solution for bad breath.
Tongue Scraping and Bad Breath
One of the main fuel supplies for odour-causing bacteria is the dead tissue that turns over regularly on our tongue. We shed thin outer layers and regenerate new surface layers on a daily basis. The cells we shed become a food source for bacteria. When bacteria digest this fuel supply, they produce byproduct sulfur-containing compounds that have an unpleasant smell.
We can minimize this fuel supply to odour-producing bacteria by lightly brushing or scraping our tongue a few times each week. Try to use a very light pressure technique and make sure you’re not scrubbing your tongue. A few very light pressure passes over the tongue’s surface followed by a thorough rinse can work wonders for eliminating bad breath.
Will probiotics help to eliminate bad breath?
Chewing dental probiotic gum is a great way to eliminate bad breath. These probiotics supply new, beneficial bacteria that can shift the overall balance of your oral microbiome. These beneficial bacteria will out-compete harmful, odour-causing bacteria to keep their numbers low. This new balance will favour the good bacteria that we like and reduce bad breath in the process.
The Take Home Message on Bad Breath
Bad breath has a variety of contributing factors, some originating in the mouth and some originating elsewhere in the body. Oftentimes, bad breath arises when factors shift the balance between beneficial and harmful bacteria in an unhealthy direction. When the environment in your mouth favours an increase in harmful bacteria, one possible outcome is bad breath. Minimizing the fuel available for harmful bacteria is key to controlling bad breath. This can be achieved by regular, light brushing or scraping of your tongue. Another way to control these bacteria is to improve mouth conditions so that beneficial bacteria can thrive. You can do this by chewing probiotic gums which supply more of the good bacteria that your mouth needs.
Using commercially available mouthwash dries your mouth and can disrupt beneficial bacteria in your mouth. I recommend avoiding the use of commercial mouth rinses in favour of the other, more effective solutions outlined in this article.
Thanks for reading. I hope you’ve found today’s article to be helpful!
By Dr. Kyle Hornby, Kitchener Dentist
This article is not intended to be a substitute for professional advice, diagnosis, or treatment. Accordingly, always seek the advice of your Dentist or other healthcare providers regarding a dental condition or treatment.