Bad Breath Causes
You're probably familiar with the odor of people who have "smoker's breath." Much of this smell is caused by tar, nicotine, and other stinky compounds found in tobacco smoke that accumulate on a person's teeth and oral soft tissues (tongue, cheeks, gums, etc).
Short of quitting smoking, there's no way to eliminate smoker's breath, although practicing immaculate oral hygiene can help to minimize it.
How smoking compounds a person's breath problems
Smoking creates other risk factors. For example, tends to dry out oral tissues. A decrease in oral moisture diminishes the beneficial washing, diluting and buffering effect of saliva on oral bacteria and the waste products they create.
It's also known that people who smoke are at greater risk for having problems with periodontal disease (gum disease).
Everyone, even including people who don't really have much of an odor problem, probably notice that their breath is least pleasant in the morning, when they first wake up. The words "sour" and "stale" are often used to describe what's noticed.
This happens because during the night a person's mouth tends to dry out, due to the body's natural tendency to lower the flow of saliva as we sleep. And if you snore or sleep with your mouth open, this drying effect, and thus your morning breath, can be even more noticeable.
In most cases morning breath can be expected to disappear after a person has performed their morning oral hygiene and has had a chance to rehydrate their mouth.
Teachers, lawyers, or anyone else who must speak for extended periods of time often notices this same type of drying/souring event.
People who breathe through their mouth, or are fasting or else are under stress (conditions that can reduce salivary flow), may find they have a chronically dry mouth and thus persistent problems with breath odors.
Why oral moisture is so important
An explanation for this phenomenon lies in the fact that the moisture in our mouth helps to keep it clean.
The presence of oral fluids encourages us to swallow. And with each swallow we take we expel bacteria from our mouth, as well as the food and debris on which they feed.
Oral moisture dilutes and washes away the smelly waste products that oral bacteria produce. Saliva is the body's natural mouth rinse. It contains compounds that kill bacteria and buffer their stinky waste products.
So, when our mouth dries out, each of these mechanisms is inhibited. The net result is one where the conditions for bacterial growth are enhanced, while the neutralization of odoriferous bacterial waste products is diminished.
Everyone knows that certain foods and beverages have a reputation for causing bad breath. Some of the most notorious ones are garlic, onions, alcohol and spicy foods in general.
How foods can cause bad breath
When we eat, our digestive system breaks down the food we have consumed into its component molecules. Some of them have a very unpleasant odor.
As these molecules are created, they are absorbed into our blood stream so they can be distributed throughout our body as nourishment.
As our blood travels through our lungs, some of these molecules are released into them. As a result, as we exhale, they get expelled with our breath too.
"Non oral" bad breath
While experiencing this type of condition can be annoying and embarrassing, it's not the main concern of the pages of our topic. It's often referred to as "temporary" or "transient" halitosis. Additionally, it's classified as a type of non-oral malodor, meaning the source of the person's breath problems don't originate in their mouth.
This condition will resolve on its own, typically within 48 hours, as your body completes the process of breaking down and utilizing, or else excreting, the offending compounds. You can control this type of malodor simply by avoiding or minimizing your consumption of certain types of foods.
Untreated dental conditions can be the cause of or contribute to a person's breath problems.
Active infections, such as those associated within abscessed teeth, partially erupted wisdom teeth (pericoronitis) or dental implants (periimplantitis), can be at fault.
Teeth that have large voids (due to decay or fracture) can trap enough debris and bacteria that they become the source of foul odors.
Sinus conditions can cause breath problems.
Upper respiratory infections and allergies can create a postnasal drip that falls onto the back portion of a person's tongue (via the opening behind the soft palate). This discharge often has a foul taste and smell. What's worse, the bacteria that cause bad breath can use it as a food supply.
As a compounding factor, people who have a sinus condition will often have a stuffed up nose and will need to breathe through their mouth. This drying effect can create an environment that promotes bad breath. Additionally, sinus sufferers are likely to take antihistamines, a type of medicine that's known to cause mouth dryness.
Other upper respiratory infections
Tonsillitis (an infection of the fleshy pieces of tissue on each side of your throat) or pharyngitis (infection of the throat itself) can be the source of breath odor. As a tip-off that this is the case, you may also notice a sore throat, difficulty with swallowing or enlargement of the lymph nodes in your neck or under your jaw.
Gingivitis and periodontitis (two forms of gum disease) frequently lie at the source of a person's breath odor. It's the second most common cause.
Ask any dentist, the odor coming from the mouth of a person with active periodontal disease can be so distinctive that a dentist can correctly diagnose their condition even before they begin their examination.
Who's at greatest risk for odors associated with gum disease?
Gingivitis (inflammation of the gum tissue) is common in all age groups when proper oral home care (brushing and flossing) is not practiced.
Periodontitis (inflammation of both the gum and bone tissue that surrounds the teeth) is typically more of a problem for "older" people (such as those over the age of 35 and beyond).
That means, the older we get, the more likely it is that our breath issues are related to the health of our gums.
How gum disease affects your breath
It's both the waste products of the microorganisms that cause gingivitis and periodontitis, and the by-products associated with the inflammation that they create, that produce the volatile sulfur compounds that cause breath malodor.
Additional factors with periodontitis
Advanced forms of periodontitis typically result in serious damage to the bone that holds teeth in place. As it occurs, deep spaces form between the teeth and gums (termed "periodontal pockets," see illustration). They provide the ideal anaerobic living environment for the types of bacteria that cause bad breath.
Research has found that the amount (as measured by weight) of odor-causing coating that's present on the tongue of people who have periodontitis is greater than those who don't. Studies have also determined that the level of volatile sulfur compounds coming from this film is four times greater for people that have periodontal disease than control groups.
The above information suggests that in the case of breath odor associated with gum disease, the cure lies in both resolving the periodontal issue and instituting a regimen of effective tongue cleaning.
Some medical issues are known to be associated with the presence of mouth odors. If a person's bad breath persists after they have consulted with their dentist and tried the usual simple solutions, then a consultation with their medical doctor may be indicated.
Your doctor will of course know what types of conditions to look for. But, in general, they will evaluate you for problems associated with your respiratory (pulmonary or bronchial), hepatic (liver), renal (kidney), endocrine (glands that produce hormones) and gastrointestinal (stomach and intestine) systems.
Medical conditions and medications are categorized as "non oral" causes of bad breath. And while these factors can be an aggravating or even the fundamental cause, in the majority of cases the origin of a person's breath problems is in their mouth and a solution should be first looked for there. Research suggests that roughly 85 to 90% of all cases of halitosis have an oral origin.