Bad Breath (halitosis)

Online Dental Education Library

An estimated sixty-five percent of Americans have bad breath. Over forty-million Americans have "chronic halitosis," which is persistent bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.

Americans spend more than $1 billion a year on over the counter halitosis products, many of which are ineffective because they only mask the problem.

What causes bad breath?

Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth - on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods, such as garlic and onions, contribute to breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.

Periodontal (gum) disease often causes persistent bad breath or a bad taste in the mouth, and persistent bad breath may mean a sign that you have gum disease.

Gum disease is caused by plaque - the sticky, often colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Tobacco products cause bad breath, stain teeth, reduce your ability to taste foods and irritate your gum tissues. Bad breath may also be a sign that you have a serious health problem, such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.

Here are characteristic bad ______ odors associated with some __ these illnesses:

  • Diabetes - acetone, fruity

  • Liver failure - sweetish, _____

  • Acute rheumatic fever - ____, sweet

  • Lung abscess - foul, ____________

  • Blood dyscrasias - resembling __________ blood

  • Liver cirrhosis - resembling _______ blood

  • Uremia - ammonia or _____

  • Hand-Schuller-Christian disease - fetid ______ and unpleasant taste

  • Scurvy - foul breath ____ stomach inflammation

  • Wegner`s granulomatosis - Necrotic, ____________

  • Kidney failure - ammonia __ urine

  • Diphtheria, dysentery, measles, pneumonia, _______ fever, tuberculosis - extremely ____, fetid odor

  • Syphilis - fetid

Bad breath may also __ caused by medications you ___ taking, including central nervous ______ agents, anti-Parkinson drugs, antihistamines/decongestants, ____-__________, anti-cholinergics, narcotics, anti-hypertensives, and ____-___________.

Caring for bad breath

Daily brushing and flossing, ___ regular professional cleanings, will ________ take care of unpleasant ______. And don't forget your _____ overlooked tongue as a _______ for bad breath. Bacterial ______ and food debris also ___ accumulate on the back __ the tongue. The tongue's _______ is extremely rough and ________ can accumulate easily in ___ cracks and crevices.

Controlling periodontal disease and ___________ good oral health helps __ reduce bad breath.  If ___ have constant bad breath, ____ a list of the _____ you eat and any ___________ you take. Some medications ___ contribute to bad breath.

Improperly cleaned dentures can ____ harbor odor-causing bacteria and ____ particles. If you wear _________ dentures, take them out __ night and clean them __________ before replacing them.

If your dentist determines ____ your mouth is healthy ___ that the odor is ___ oral in nature, you ___ be referred to your ______ physician or to a __________ to determine the cause __ the odor and possible _________. If the odor is ___ to gum disease, your _______ can either treat the _______ or refer you to _ periodontist, a specialist in ________ gum tissues. Gum disease ___ cause gum tissues to ____ away from the teeth ___ form pockets. When these _______ are deep, only a ____________ periodontal cleaning can remove ___ bacteria and plaque that __________.

Mouthwashes are generally ineffective __ bad breath. If your ___ breath persists even after ____ oral hygiene, there are _______ products your dentist may _________, including Zytex, which is _ combination of zinc chloride, ______ and eucalyptus oil that ___________ the sulfur compounds and _____ the bacteria that causes ____. In addition, a special _____________ mouth rinse may be __________. An example is chlorhexidine, ___ be careful not to ___ it for more than _ few months as it ___ stain your teeth. Some __________ mouth rinses have been ________ by the American Dental ___________ for their breath freshening __________ and therapeutic benefits in ________ plaque and gingivitis. Instead __ simply masking breath odor, _____ products have been demonstrated __ kill the germs that _____ bad breath. Ask your _______ about trying some of _____ products.