An estimated 65% of Australians have bad breath. 90% of bad breath problems arise from the mouth itself, rather than poor diet or ill health.
Australians waste millions of dollars a year on over-the-counter halitosis products. Most of these are ineffective because they simply mask the problem, rather than treating the cause.
What causes bad breath?
Bad breath is caused by a number of factors. In most cases, it is caused by food remaining in the mouth – on the teeth, tongue, gums, and other structures. Bacteria feed on these food scraps. Bacterial cells release a sulfur compound that gives your breath an unpleasant odour. Certain foods, such as garlic and onions, contribute to breath odour. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwashes only mask the odour temporarily. Dieters sometimes develop unpleasant breath from fasting. The break down of fats in the body produces compounds called ketones which give the breath a distinctive odour.
Gum disease often causes persistent bad breath or a bad taste in the mouth. If you have persistent bad breath, see your dentist to check the health of your gums. Plaque, that sticky film of bacteria constantly forming on your teeth, can cause gum disease.
Dry mouth can also cause bad breath. Saliva performs several important roles, including cleaning your mouth of odour-causing particles. Tobacco products cause bad breath, and also reduce your ability to taste food, stain your teeth, and irritate sensitive gum tissues.
Sometimes bad breath indicates an underlying serious health problem. Here are some characteristic odours associated with illnesses
Illness | Breath odour |
Diabetes | Acetone (nail polish remover), fruity |
Liver failure | Sweet, musty |
Acute rheumatic fever | Acid, sweet |
Lung abscess, Wegner’s granulomatosis | Foul, putrid |
Blood dyscrasias | Decomposed blood |
Liver cirrhosis | Decayed blood |
Uraemia, Kidney failure | Ammonia (fishy) |
Hand-Schuller-Christian disease, syphilis | Fetid |
Scurvy | Foul |
Diphtheria, dysentery, measles, pneumonia, scarlet fever, tuberculosis | Foul and fetid |
Bad breath can also be caused by medication. Many prescription and over-the-counter medicines can cause changes in breath odour. It is a side-effect not usually listed on the fact sheet!
Caring for bad breath
The easiest way to rid yourself of bad breath is to pay close attention to your oral hygiene. Daily brushing and flossing, combined with regular professional cleanings, will take care of most instances of bad breath. Often forgotten is the tongue’s role in harbouring bacteria. The tongue’s surface is very rough and bacteria can easily accumulate in the cracks and crevices. Daily tongue scraping can make a big difference to your breath.
If you already have a good oral care routine but you still have bad breath, make a list of the foods you eat regularly and any medications you take. One or more of these could be to blame for your problem.
Improperly cleaned dentures can also harbour odour-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.
If your dentist determines that your mouth is healthy and that the odour is not oral in origin, you may be referred to your family physician or to a specialist to determine the cause of the odour and possible treatment. If the odour is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.
Mouthwashes are generally ineffective on bad breath. If your bad breath persists even after good oral hygiene, there are special products your dentist may prescribe. In addition, a special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine, but be careful not to use it for more than a few months as it can stain your teeth. Some antiseptic mouth rinses have been accepted by the ADA for their breath freshening properties and therapeutic benefits in reducing plaque and gingivitis. Instead of simply masking breath odour, these products have been demonstrated to kill the germs that cause bad breath. Ask your dentist about trying some of these products.