A lot of patients ask me this question in one form or another: “How do I stop bad breath?” Many times they’ve been admonished by a loved one or kids, and it’s frequently a source of embarrassment or shame. Fortunately, getting a handle on the problem isn’t rocket science, but it does involve a little science. There may be more than one reason behind the odiferous breeze.
When wind moves across the land around us, it picks us the scent of whatever it touches. It could be sweet lilac or a pile of cow manure, but odor particles bind to receptors in our noses and send a message to our brain.
As our warm air rushes out of our lungs and across the linings of the throat and mouth, it has a similar effect. Any odors incorporated into the tissue or teeth are picked up and carried out to waiting noses. Garlic carries a special reputation due to powerful compounds with a distinctive smell profile. “Coffee breath” also leaves a clear trail in the air.
Sometimes, bad breath arises from medical conditions. Diabetes, chronic bronchitis, liver disease, or respiratory tract infections can create distinctive odors. Common prescription drugs often reduce saliva production and result in a dry mouth problem. If you haven’t had a physical in a year or two with blood tests, it’s always a good idea to check these possibilities. If you’re taking an anti-depressant or high blood pressure medication and your mouth is dry, that could be contributing to the problem. But don’t stop taking your medication, just remember to let us know.
While bad breath can come from systemic or medication sources, odds are it’s all about good ol’ bacteria. Our mouths thrive with bacteria and their by-products, including gases. Certain bacteria produce a sulfur gas that notoriously smells bad and easily mixes with passing air. But just because so many bacteria make the mouth their home, it doesn’t mean bad breath has to be a constant problem.
When you wake up in the in the morning, you’re announcing yourself with morning breath. During your sleep, saliva production reduces by 90%. This arid, still environment encourages bacterial overgrowth and sends a tough odor out to the world.
Cavities, unhealthy gums, excessive tartar, or unclean dentures are all bacteria-related problems as well. There’s a difference though. These problems need to be checked and treated by your dentist. So if you’re dealing with bad breath, you need to make sure you’re current on your dental check-ups. Gum disease often bears a distinctive aroma that can’t be brushed away. These problems are don’t always lead with pain or discomfort, and odor can be your only obvious warning sign.
Maybe you’re a dental warrior. You practice excellent brushing and flossing. You’ve spent an hour with your favorite hygienist in the recent past. But you feel frustrated because bad breath continues to be a curse.
Sometimes we overlook one of the most obvious landscapes in the mouth: The tongue. If you could look at the top of the tongue under a microscope, you’d find highly textured surface projections that support taste and tactile sensation. Think of a carpet. But consider what comes out of a carpet after shampooing, even when it looks fairly clean on top.
The shag carpet of the tongue traps a slurry of food compounds, bacteria, and dead cells. A lot of junk ends up trapped, and that’s usually a big contributor to bad breath in conscientious patients. So if we turn our attention to properly cleaning the tongue like we clean our teeth and gums, things are bound to improve.
Use your regular toothbrush as far back on the tongue as you can tolerate. Work the sides and the top vigorously. Make sure you add your favorite toothpaste to add a fresh slurry to the job.
The best way to really trim clean the tongue is to get a tool that’s made for the job. Tongue cleaners are a pretty simple design, but they work really well. It’s a little bit like using a thatching rake across your lawn and pulling up the dead stuff. A tongue cleaner might be your long awaited secret, and starting your day with this little device is certainly worth a try.
You may naturally reach for a mouthwash if you’re trying to eliminate bad breath. In the end, you may end up making matters worse. Most rinses are alcohol-based, which causes the mouth to dry out a little and reduces the natural cleansing of saliva. Rinses also work a bit like perfume. If you have body odor, perfume will cover it up but the problem is still underlying. You might mask bad breath for a short time with a rinse, but you’ll soon be disappointed.
One exception to the rule includes alcohol-free rinses that are designed to work in a different way. They contain a comp0und that neutralizes sulfur gas, establish a neutral pH, and eliminate 99% of the odor-causing bacteria within seconds. Closys products are approved by the American Dental Association, and I have a long track record of using these unique formulas with patients struggling with bad breath.
Be extra cautious using other masking techniques like mints or other candies and methol lozenges. Most of these contain sugar and make the mouth more acidic. If you didn’t have cavity problems before, you soon could. Xylitol sweetened candies are a good alternative if you choose to use a product like this, and a few good options can be found online or in your local pharmacy. Xylitol has a host of benefits we’ll discuss another time, but it’s a safe choice for most people.
At this point, you should have a few simple ideas to help with the head-scratching question, “How do I stop bad breath?” To sum it up, just think through the following: