Bad Breath | Delmarva Dental Services

Bad Breath

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 Bad breath or halitosis has been a recorded problem for mankind for thousands of years. In Jewish Talmudic Law over 2000 years ago , mouth malodor was a motive for divorce. Chinese emperors in Old China used to ask their visitors to chew clove before personal meetings.  Ancient Greeks used fragrance in their mouths.  The Romans used mechanisms to hide halitosis, such as  perfumed tablets, chewing leaves and stalks of  plants


 Today, ten billion dollars are spent on toothpastes, mouth washes, drops, sprays, meltaways, and breath mints.    Treating bad breath in this way is like not bathing and using cologne to cover body odor.  It does not get to the root of the cause. Deodorant1   Bad breath cover-ups only last for a short period of time.  Bacteria form slime layers called biofilms. (See” Biofilms and Oral Health” and “It All Starts with Biofilms”) The bacteria deeper in the biofilm are anaerobic(oxygen hating) and are insulated from the oxygen.  The older the biofilm, the thicker the biofilm and the more anaerobes.  Bad breath is most often caused by these anaerobic bacteria which produce sulfur gas compounds. Biofilm   Since bacteria reproduce so rapidly, cover-ups only temporarily help the problem.  In order to solve the problem the bad breath bacteria must be reduced at their origin.  So let’s look at the origins.  Bad breath comes from 4 sources; the sinuses, oral cavity,  stomach, and  lungs. 4 Causes   We will review how each of these organs can contribute to bad breath.  The sinuses primarily drain to the back of the throat.  Sinus bacterial mucus buildup in the nose, related sinuses and the back of the throat is a common cause of bad breath.  Daily nose and sinus hygiene is the best prevention for bacterial buildup. (See “Sinuses and Your Teeth” and “Xylitol Nasal Rinse)Two Sinuses     The oral cavity has many places where bacteria especially anaerobic ones can hide such as the tongue, under the gums, between and in the teeth and the tonsils. Oral Cavity   If you magnified the tongue you would see it is made up of tiny hairlike projections called papilla or papillae.  They look like tall blades of grass.  Some people have taller papilla than others which tend to trap food debris and bacteria.  The taller the papilla the less oxygen reaches the base and the better the anaerobic bacteria like it. 1   Daily tongue scraping will eliminate this problem.  The oral probiotic “Evora Pro” or “Evora Plus” by Organics ( is also helpful. (See “Cavity Prevention with Oral Probiotics) Picture 7a7b Tongue Scrappers     Bacteria like to hide out just below the gum line in a place called the sulcus.  It is kind of like a moat around a castle; the castle being the tooth.  The bacteria like it best in the sulcus between the teeth because there is less oxygen.  If you have periodontal disease (gum disease), the sulcus gets deeper, from 1/3 to 3 times as deep.  This is called a periodontal pocket.  This is an ideal place far from oxygen for anaerobes to multiply.  Daily flossing will disrupt the bacteria but periodontal disease must be treated by professionals as well.   Presentation1     Teeth with decaying food particles between them, cavities, or abscesses are another source of mouth odor.  Once again daily flossing and brushing can remove food particles and of course cavities and abscesses must be treated by a dentist. (See Cavities and Their Prevention” and “Cavity Prevention with Oral Probiotics”)   Picture 9       A favorite place for bacteria, fungi (funguses) and even amoebas to hide is in any removable plastic appliances like dentures, orthodontic retainers, biteguards, and mouthguards.  Plastic has tiny porosities (holes) where organisms can hide.Cleaning these appliances with a denture cleaner such as Efferdent will solve this problem . Slide1                Invisalign tray (4)     A dry mouth can worsen the above problems because it does not wash any of these harmful substances away. ( See” Dry Mouth”) Dry Black 1       Tonsils help prevent infection. They trap bacteria and viruses that enter through the throat and nose. They store helpful bacteria which can help fight infection. Sometimes the wrong diet and improper oral hygiene can change the helpful bacteria in the tonsils to harmful bacteria. This can lead to chronic sore throats as well as odor producing anaerobic bacteria. (See “Cavity Prevention and Oral Probiotics” and ”Xylitol Nasal Rinse”)Presentation1   Gastroesophageal Reflux disease or GERD for short is the up flow of stomach contents into the throat and mouth. This obviously has an effect on mouth odor. Diet modification, the use of probiotics and seeking treatment form a gastroenterologist is recommended .                    Presentation3   Foods such as sardines and onions can release gases from the stomach during digestion. Presentation4     Smoking and alcohol will cause bad breath. Smoke, EtoH Once these substances enter the blood; they are expelled as gases form the lungs.  A breathalyzer works by measuring the alcohol in your breath from your lungs.  Uncontrolled diabetics can have  a fruity respiratory odor. Resp     Remember to determine the source of the bad breath and eliminate the cause.  Most of the time it is a sign that one of the areas listed above is not healthy.  Treating your bad breath will not only improve your health but make people around you happy as well.   See our video at

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