Friday, October 21, 2011

The Oral Health Connection: Do I Have Bad Breath? By Penny Judson-Benny ~ Registered Dental Hygienist

Bad breath or 'halitosis' has a very unpleasant odor. This odor can strike periodically or can be persistent, depending on the cause. Millions of bacteria live in the mouth and in most cases, is the primary cause of bad breath. The mouth's warm, moist conditions make an ideal environment for these bacteria to grow.
Some types of bad breath, such as 'morning mouth' are considered to be fairly normal, and they usually are not health concerns. 'Morning mouth' occurs because the saliva that regularly washes away decaying food and odors during the daytime, diminishes at night while you sleep. Your mouth becomes dry and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor.
In addition, bad breath can be caused by the following:
*Poor dental hygiene – infrequent or improper brushing and flossing can leave food particles to decay inside the mouth
*Infections in the mouth – Periodontal (gum) disease
*Respiratory tract infections – Throat infections, sinus infections and lung infections
*External agents – garlic, onions, coffee, cigarette smoking and chewing tobacco
*Dry mouth (xerostomia) – This can be caused by salivary gland problems, medications or by 'mouth breathing'
*Systemic Illnesses – Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
*Psychiatric Illness – Some people may perceive that they have bad breath, but it is not noticed by oral-health care professionals or others. This is referred to as 'pseudohalitosis'
A person may not always know that he/she has bad breath. This phenomenon is because odor-detecting cells in the nose eventually become accustomed to the constant flow of bad smells from the mouth. Others may notice and react by recoiling as you speak.
Other associated symptoms depend on the underlying cause of bad breath:
*Poor dental hygiene – Teeth are coated with plaque, food trapped between teeth, pale or swollen gums
*Infections in the mouth – Gums may be red, swollen and bleed easily, especially after brushing and flossing; pus may drain from between teeth; a pocket of pus (abscess) at the base of the tooth; loose teeth or the change in 'fit' of the denture; painful, open sores on the tongue or gums
*Respiratory tract infections - Cigarette stains on fingers and teeth, a uniform yellow 'coffee stain' on teeth
*Dry Mouth – Difficulty swallowing dry foods, difficulty speaking for a prolonged period of time because of mouth dryness, a burning sensation in the mouth, an unusually high number of dental caries, dry eyes (in Sjogren's syndrome)
*Systemic illnesses – Symptoms of diabetes, lung disease, kidney or liver disease
A health professional may notice the patient's bad breath while the patient is discussing his/her medical history and symptoms. In some cases, a likely cause may be determined. A 'fruity' breath can be a sign of uncontrolled diabetes. A urine-like smell, especially in a person who is at high risk for kidney disease, can sometimes indicate kidney failure. The medical history may sometimes reveal the source of halitosis. Certain medical conditions as well as medications that cause dry mouth may be present. It is important for your health professional to know your personal habits such as diet, whether you have a smoking or chewing tobacco habit.
Your oral health professional will examine your teeth, gums, and oral tissues. A head and neck exam, as well as breathing habits will be evaluated.
Halitosis that is caused by poor oral health can be reduced by using a proper homecare regimen. Brushing and flossing daily is critical. Tongue brushing is also very important as there is a thick film of bacteria present on the surface where the papilla and taste buds are. Periodontal disease and abscesses usually respond quickly to proper dental treatment. Bad breath resulting from chronic sinusitis may be a recurring problem, especially if it is caused by a structural abnormality.
Halitosis caused by a systemic illness may be a long term problem that can often be controlled by proper medical care.
Daily prevention caused by dental problems can easily control bad breath:
*Brush and floss the teeth and gums after meals and before bed
*Brush the tongue daily, especially before bed
*Clean dentures and oral appliances daily
*Use and antiseptic mouth rinse if needed, but this does not replace a good brushing and flossing regimen
*Get regular teeth cleaning and periodontal care
*Drink plenty of water during the day
*Chew sugar free gum
*Eat raw vegetables such as celery and carrots to help reduce plaque formation.

'Keep Your Smile For A Lifetime'!

Penny Judson-Benny, RDH, is the owner and operator of Mountain View Dental Hygiene Clinic in Black Diamond and can be contacted at 403-933-7722.

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