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Medical Edge Newspaper Column from Mayo Clinic
MOST CASES OF BAD BREATH START IN THE MOUTH
DEAR MAYO CLINIC: I have a very bad case of bad breath. I have two sets of dentures, which I alternate using. I don’t feel the halitosis is due to poor dental hygiene. What else could be causing the problem? — Ridge, N.Y.
ANSWER: The majority of bad-breath cases do derive from dental problems, so you should first consult your dentist for a thorough oral examination.
A logical suspect is your dentures, which manufacturers try to make as smooth as possible but over time may become porous. As such, they are more capable of harboring bacterial deposits, which can result in bad breath. While the combination of toothpaste and a relatively firm toothbrush may do a fair job in cleaning smooth dentures, it’s better to use a denture brush and denture paste to clean dentures that have been in service for a while.
However, brushing alone may not be sufficient. A toothbrush cannot get into all of the dentures’ crevices to reach plaque (bacteria) hiding there, and it cannot remove calcified plaque (tartar), which soon becomes hardened. So it’s important to complement brushing with soaking your dentures overnight, several times a week, in an over-the-counter preparation that removes the tartar while it’s still soft.
Going further, your dentist can use an in-office ultrasonic cleaner to soften up hardened tartar, which is then amenable to cleaning by brushing and soaking — or, if indicated, by scraping. You can also perform such procedures yourself at home, if you wish, with the aid of electrical denture cleaners that are commercially available.
On a more basic level, your dentures may not fit properly. If so, food and debris — ultimately, the sources of foul odors — will accumulate in the space between denture and mouth tissue. Similarly, it is important that you not wear your dentures around the clock. Removing them at night gives your mouth a chance to clear the material that has gathered over the course of the day.
Another oral source of bad breath, often overlooked, is the tongue. You should brush your tongue because it may be coated with bad-breath-causing materials. You can use a toothbrush to remove the coating, but even better is a tongue scraper — another commercially available product — designed to do a more thorough job.
Dry mouth, caused by reduced flow of saliva, can also lead to bad breath. A dry mouth enables food particles and dead cells to accumulate on your tongue, gums and cheeks; the debris then decomposes and causes odor. This condition is more pronounced in people who sleep with their mouths open, in smokers and in older adults. Dry mouth can also result from drugs, such as hypertension medications and antidepressants.
People suffering from dry mouth have a number of options, the simplest being to carry a bottle of water and take an occasional swig. Others include moisturizing mouthwashes, often called “artificial saliva.” A few prescription drugs are also available that stimulate the flow of the body’s own saliva, though I hesitate to recommend the use of drugs to counteract the side effects of other drugs. A better approach is to address the problem at its source.
Bad breath can come from a number of non-dental origins. The cause could be as simple as ingesting certain foods, such as onions or radishes; or drinking alcohol. Insufficient food — that is, excessive dieting — may also result in bad breath. Another very common cause is gastric reflux, whereby stomach acids and solids move up into the mouth.
There are several other potential non-dental origins, such as sinus infections, bronchitis or certain kidney conditions. As causes of bad breath, such disorders are relatively rare. Still, you should consult a physician if the dentist finds no oral sources of your problem.
— Phillip J. Sheridan, D.D.S., Dental Specialties, Mayo Clinic, Rochester, Minn.
Additional Resources:
Dental Specialties
Bad Breath
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© 2006 TRIBUNE MEDIA SERVICES, INC.
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