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How to Banish Bad Breath

At best, bad breath’s an embarrassment. At worst, it can be a sign of serious disease. In extreme cases, bad breath (also called halitosis) can cause a person to live in isolation. Many factors can cause bad breath; here are some of the most common offenders.

Oral hygiene problems. About 90 percent of bad breath originates with oral bacteria. Food debris that collects in the mouth can rot if it’s not removed promptly. In addition to brushing and flossing your teeth daily, brush your tongue every day to keep breath smelling fresh. The area at the far back of the tongue is particularly important, because this is where as much as 80 percent of odor-causing bacteria congregate. Food particles that collect on poorly fitting or unclean dentures can also cause odor.

Dental problems. There’s strong evidence that the same bacteria that cause halitosis also produce gum disease. When plaque collects under the gums, the bacteria in it release foul-smelling sulfur compounds that irritate and eventually destroy the gum tissue and supporting structures. Flossing daily to remove plaque from the gum pockets around the teeth can combat this problem.

Diet. Certain foods have long been linked to breath odor. For example, cabbage produces foul-smelling gases during digestion that are released when you belch. Although garlic is another well-known source of bad breath, it was not until 1999 that scientists explained why its scent is so persistent. A study at the Minneapolis Veterans Affairs Medical Center discovered that when you digest garlic, it releases a specific sulfur compound. This compound progresses unaltered into your bloodstream, and you may exhale it from your lungs up to three hours later. Similarly, alcohol travels unchanged through the digestive system and exits through the respiratory system. Ironically, a lack of food can also affect your breath. Extreme dieting causes changes in the body’s metabolism that result in a fruity scent on the breath.

Infection and chronic disease. Kidney failure, liver disease, diabetes, and respiratory tract infections (such as sinusitis and tonsillitis) can cause breath odor. In addition, research points to a link between halitosis and Helicobacter pylori, a stomach-dwelling bacterium that causes ulcers and other stomach problems. One small study found that among people with stomach problems and halitosis, the bad breath disappeared when H. pylori was successfully treated. In cases where the stomach bacteria persisted, mouth odor remained, even when the individuals used an antiseptic mouth rinse. A 2008 Japanese study revealed that this connection may exist even in people who show no signs of stomach illness. After scanning the DNA in the saliva of 326 people, 251 of whom complained of halitosis, researchers found evidence of H. pylori in about 6 percent of the subjects. In the individuals who had gum disease, however, that rate jumped to over 16 percent. The scientists concluded that even though H. pylori itself isn’t responsible for bad breath, the conditions that lead to gum disease (which does cause halitosis) also provide fertile ground for the colonization of the ulcer-causing organism.

Dry mouth (xerostomia). Too little moisture in the mouth allows dead cells and bacteria to accumulate on your tongue and teeth. This is also the cause of “morning breath.”
Tobacco. Smoking and chewing tobacco lend an unpleasant scent to your breath. Tobacco use also contributes to other odor-causing maladies, such as dry mouth and gum disease.

Fortunately, there’s much you can do to battle bad breath. Here are some steps you can take:

  • Brush twice a day, paying special attention to the gum line, and floss daily.

  • Brush your tongue and use a tongue scraper if necessary.

  • Rinse with plain water after meals if brushing isn’t an option.

  • Get regular professional checkups to catch and treat periodontal disease.

  • Seek medical care for underlying health problems.

  • Snack on sugar-free foods (such as carrots and celery) or chew gum sweetened with xylitol to clear away debris and keep saliva flowing.

  • Use an over-the-counter mouthwash containing zinc. Your dentist also may prescribe a rinse with chlorhexidine. Be aware, though, that long-term use of this ingredient can stain teeth.

Source: Dental Health for Adults: A Guide to Protecting Your Teeth and Gums. Copyright © by Harvard University. All rights reserved.

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