Bad breath: A symptom of an underlying medical condition

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Everybody worries about their breath from time to time — like after a meal filled with plenty of onions and garlic. But for some people, though, the worry never goes away. They buy mouthwash by the gallon and pop breath mints by the handful, but they still worry that their breath is bad. And they’re still afraid to get close to people — even the ones they love most.

If that sounds like you (or someone you care about), there are some things you should know. For starters, you need to understand you’re not alone. In fact, experts estimate a full 25 percent of Americans experience severe bad breath every single day. Second, you need to know your bad breath isn’t a mystery. Today’s dentists know exactly what’s causing it. Finally, you need to hear the good news that help is on the way — in the form of safe, smart strategies you can use to put an end to your worries and let you enjoy fresh breath for life.

The truth about bad breath

Researchers have found that in just 10 percent of cases or less, bad breath is caused by an underlying medical condition like diabetes, reflux, sinusitis, certain kinds of cancer, and liver or kidney failure. Dry mouth, which can be caused by certain medications, can cause bad breath as well, because saliva helps to keep your mouth clean.

In an estimated 90 percent of cases, though, bad breath originates in your mouth — where it’s easy for us to diagnose and treat.

Two main causes The two primary causes of bad breath are (1) dental hygiene that misses the places where odors can grow and (2) periodontal (gum) disease.

You see, when food or plaque remains on or between teeth it attracts bacteria that produce bad smelling chemicals called Volatile Sulfur Compounds. The tongue is also a very large contributor to bad breath. The cells on the top of your tongue have long appendages called papilla. When the cells inside your mouth die and are shed, some get down in the spaces between the papilla and produce these same chemicals as they break down. These compounds include hydrogen sulfide — the chemical that makes rotten eggs smell so awful. Better dental hygiene can help reduce both of these causes.

What’s more, food and plaque on teeth irritate your gums and cause inflammation leading to the gaps and pockets around the teeth that are a primary sign of gum disease. These gaps and pockets then collect even more plaque and bacteria.

Plus, your tonsils can also trap food and plaque and cause the same kind of problems.

Fortunately, all these problems are very treatable. The first step is a thorough exam that includes a medical history, full mouth X-rays, examination of your tongue and tonsils, a gum (periodontal) exam and an oral cancer screening. Then, if needed, we’ll begin phase one gum infection therapy and preliminary treatment of cavities. If your tonsils have collect food and plaque, they may have to be removed and you’ll need a referral to an ENT physician. And you’ll need instructions to help you learn everything you need to know about how to clean your mouth and tongue effectively every day so that bad breath doesn’t have a chance to return.

And you need to know that ordinary mouthwashes can actually make the problem worse. Most contain alcohol which draws water out of the tissue in your mouth and increases inflammation. You need to rinse with an alcohol-free rinse or just plain salt water.

• • •

Dr. Donald Johnson founded Heartfelt Family Dental in Coeur d’Alene to help patients with their dental needs and live free with no limits! His office is at 114 W. Neider Ave., near Costco. The website for more information is www.heartfeltdental.com and the office phone is (208) 667-4551. Schedule an appointment today!

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