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Bad Breath

What causes bad breath?

Bad breath, or halitosis, can be caused by tooth decay, gum disease, lack of saliva (xerostomia), certain foods and drinks, tobacco, medications or illness.

How can I tell if I have bad breath?

Bad breath is an affliction you can have and not even know it. Cupping your hands in your mouth and sniffing the air that comes out won't tell you if your breath is bad; the offending odor comes from the back of the mouth and is only forced out when you speak. Here are a few methods to try that might reveal unpleasant breath odor:

• Pull your tongue forward with one hand, and with the other, wipe the back of your tongue for about 15 seconds with a clean cotton ball. Wait a few minutes and sniff the cotton ball; if it smells bad, this could mean you have bad breath.
• Floss a few of your back teeth with a piece of unflavored, unwaxed dental floss. Again, wait a few minutes and then sniff the floss. It's likely that this is what your breath smells like.
• Do you frequently have a bad taste in your mouth? If you do, that's a clue that you might have bad breath.
• Ask for a truthful answer from a trusted friend or family member. Yes, the truth can be embarassing, but knowledge is power! Now you can do something about it! Unfortunately, none of these methods are foolproof. A visit to the dentist is the only way to find out definitively whether or not your breath has an offensive odor. Assessing the health of your gums, testing saliva levels, and even measuring the levels of volatile sulfur compounds (VSCs) in your mouth with a device called a "halimeter" are some of the methods your dentist might use to assess your breath. "If a person has persistent bad breath to the point it's disturbing themselves and other people, they should see a doctor or dentist," said Beatrice Gandara, research assistant professor at the University of Washington Oral Medicine Clinic. Chronic bad breath is frequently a sign of periodontal disease, which can lead to tooth loss; it's been linked to other health problems, as well. For these reasons, periodontal disease should never be ignored.

What are some ways to improve my bad breath?

No one wants bad breath, but everyone gets it—or at least worries about it—at one time or another. Here are some things you can do to keep bad breath to a minimum:

• Eliminate the bacteria and food particles that can cause bad breath. Floss, then brush your teeth, gums and tongue after each meal. Make this easier by keeping floss, toothpaste and a toothbrush in your desk, your purse and your car.
• If you can't brush and floss, rinse your mouth with water after eating to dislodge food and moisten your mouth.
• Have your teeth cleaned and examined by a dental professional twice a year.
• If you are certain you have bad breath, seek out a dentist who offers specialized treatment in that area.
• Learn the proper way to brush and practice what you learn.
• Drink lots of liquids, preferably water, to keep your mouth moist.
• If your mouth feels dry, chew sugarless gum to stimulate production of saliva.
• You can also chew on raw parsley—it's a natural breath freshener.
• Baking soda is an effective odor eliminator; if you can handle the taste, try brushing with a mixture of baking soda and water. Or try a toothpaste that contains baking soda.
• Try rinsing your mouth for one minute with a 50-50 mixture of hydrogen peroxide and warm water to kill odor-causing bacteria.
• Avoid mouthwashes that contain alcohol; read the label! Instead, try a mouthwash that contains chlorine dioxide. This compound doesn't just mask odor, it actually eliminates it at the source by attacking the odor-causing volatile sulfur compounds (VSCs).
• Snack on raw vegetables such as carrots, celery and red peppers. This stimulates production of saliva, and some dentists believe it can help to remove plaque from your teeth.
• To avoid stress-related dry mouth, practice "conscious relaxation" in stressful situations: breathe deeply, visualize peaceful settings, recognize parts of your body that feel tense and consciously relax them. If you can't get past the stress, chew sugarless gum or mints to keep the salivary glands going.
• Use an oral irrigation device such as a Waterpik to remove particles of food wedged between your teeth; portable models are available.
• If you wear dentures or a retainer, clean them frequently, and periodically soak them in an antiseptic solution. Bad breath that's resistant to these remedies, or that continues for an extended period of time, should be evaluated by your dentist. You don't have to live with bad breath. Recognize it, treat it, then kiss it goodbye!

I've tried everything.  Nothing works.  How can my dentist help treat my bad breath?