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WHAT CAUSES BAD BREATH?
Before we begin to explore the remedies for getting rid of bad breath, we need to have a
thorough understanding of the causes and symptoms. Some of the causes (but not all) that can
replace normal breath are:
Abscessed tooth.
Infection of the tissue surrounding a tooth that usually fills with pus
which has a very smelly odor.
Alcoholism.
Immoderate use of alcohol causes decreased production of saliva causing
dryness of the mouth. Dry mouth is a leading cause of bad breath.
Atrophic rhinitis.
This is an inflammation of the nasal mucous membrane usually a result of
nasal drip due to colds or sinusitis.
Cancers.
Cancers such as esophageal, pharyngeal, oral tumors, leukemia, pulmonary
and stomach cancer all present severe bad breath due to the decay that is taking place.
Additionally, the medical treatments for these cancers can exacerbate the bad breath.
Oral Candida.
This is a fungal infection of the mouth cavity. Also known as thrush, it is fairly common among infants, diabetics, chemotherapy patients and people with
HIV or AIDS.
Cavities.
These holes in the outer two layers of a tooth contain decay which in
turn produces bad breath.
Dentures.
Dentures are prosthetic replacements for natural teeth and are just as
susceptible to the build up of plaque which causes bad breath. Denture wearers also have a
tendency toward dry mouth which also increases the risk of bad breath.
Diabetes.
People who have diabetes may also have bad breath. This occurs because of poor control of blood sugar, the problem with most diabetics. Gum disease is a problem for diabetics. And, diabetes is a
problem for people with gum disease.
It can be difficult to determine which comes first, the diabetes or the
gum disease, but the underlying problem is clear. High blood sugar contributes to gum
disease. Diabetics have trouble controlling the high blood sugar. Gum disease is a leading cause of bad breath, hence the correlation.
The American Dental Association reports that people with type 1 diabetes
5 are at greater risk for gingivitis.
Drugs.
Certain drugs such as antihistamines, antidepressants, blood pressure
meds, steroids, cancer therapy drugs, diuretics and oral contraceptives are all known to increase the propensity for bad breath as well as an
increased risk for gum disease.
Dry mouth.
Sounds like such an innocuous little phrase, doesn’t it? Thought to be a leading cause of bad breath, dry mouth occurs when saliva production is reduced and carries
its own nasty little package of problems.
The medical term for dry mouth is “xerostomia” (pronounced
ZEER-oh-STOH-mee-ah). Saliva performs vital work in your body. It aids in digestion by using the enzymes to help break up different foods and also makes it easier to
talk.
You may not realize that it can also help to prevent tooth decay by
rinsing away food particles from between the teeth as well as the gums. Saliva also helps
you taste the food you eat and makes it easier for you to swallow that food. It is also known for
neutralizing any damaging acids.
It is believed to be caused primarily by certain medications which we
listed in the previous paragraph. The symptoms of dry mouth can include:
· Dry, rough tongue
· Poor sense of taste
· Burning sensation in your mouth
· Increased plaque
· Reduced saliva production
Alzheimer’s disease, AIDS and stroke are also attributed to causing dry
mouth as well as pregnancy and/or hormonal changes due to menopause.
Increasing fluid intake can help to re-hydrate the mouth. It’s important to keep it moist so you don’t lose all the benefits provided by saliva
production.
Food or beverages.
We will discuss this in the next section.
Foreign body in the nose.
Do you have small children?
This is a situation that requires immediate treatment to prevent serious consequences.
Gum disease/Gingivitus.
This is inflammation of soft tissue surrounding the teeth. This condition is much more serious than a single abscess.
Gingivitis is the precursor to periodontitis which is the final step of gum disease that can ultimately lead to toot loss. This will be discussed in depth a bit further on.
Hepatic encephalopathy.
This is a rare but possible cause as a result of liver
disease.
Impacted tooth.
An impacted tooth is one that rebelliously will not erupt into its proper
position and most often results in infection, which we know is another cause of bad breath.
Periodontal disease.
It’s hard to believe that in a 2002 poll of 1,000 Americans over the age
of 35, it was determined that 60% of adults polled knew little or nothing about gum disease! A
tragedy when you consider that gum disease is the leading factor in tooth loss, even healthy teeth.
Your teeth can appear to be healthy and disease free, when under the
surface gum disease can stalwartly march on creating a condition that will ultimately lead to serious tooth loss. Bad breath is a “red flag” to help determine if this problem is prevalent in your mouth.
Healthy gum tissue forms a shallow groove at the point where the tooth
meets the gum line. This disease occurs when the anaerobic, sulfur producing bacteria we
discussed earlier, become trapped beneath the gum line.
This is a perfect breeding ground for the bacteria and they will settle
in and take residence.
Not recognizing and dealing with the problem will result in serious
dental problems up to and including loss of teeth and even underlying bone disease.
If you are diagnosed with serious periodontal disease, work to save your
teeth needs to begin as soon as possible.
The first step that your dentist will take is probably what is called
“scaling and root planing.” This is a non-surgical procedure to remove the deposits of plaque on
the surface of the tooth including the root. Since periodontal disease rarely occurs in just one
tooth, this will probably need to be done to all your teeth.
The dentist will scrap the surfaces of the tooth below the gum line to
remove all traces of plaque clear down to the bottom of the pocket. He will then smooth the
surface of the root to encourage healthy gum tissue to heal. This process also discourages plaque
from reforming.
Depending on how involved your case might be, the dentist may prescribe
medication to assist in healing or control pain and potential infection.
More diagnostics are required before a prognosis of your case of
periodontal disease can be given. Each deposit of plaque creates its own “pocket” and the dentist
needs to measure the depth of the pockets that were scaled during your first visit.
Often, the scaling procedure works well to eliminate the problem and you
are free from further treatment other than normal examinations. At this point you would be well
served by employing a daily regimen of preventative maintenance to insure the disease does not return.
However, if the diseased pockets are deep and extending into actual bone,
you may need to have surgery in order to keep the teeth. If this is the case, your dentist
will refer you to a periodontist, a doctor who specializes in periodontal disease.
The periodontist will use a surgical process to aggressively penetrate
the diseased areas and ferret out the plaque and bacteria. The pockets where plaque resides must
be sealed off so the environment does not invite a return of the disease.
In some cases bone surgery or bone grafts may be necessary to rebuild
bone that was destroyed by the periodontal disease. If there was substantial tissue damage grafts
may need to be used to replace the soft tissue. This procedure involves removing gum tissue from
your palate to cover the areas where severe gingivitis has penetrated too far into the gum line.
Your dentist or oral surgeon may also recommend further treatment and/or
medications. Here is a list of FDA approved products to help combat periodontal
disease:
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