Banishing Bad Breath

Stinky breath. Halitosis. Fetor oris. Whatever the name, it’s something that no one wants. Bad breath can be mildly annoying (as well as socially upsetting), and while it may be traced back to the 13-garlic-clove chicken dinner you ate last night, it can also indicate something more serious, especially if you have diabetes. Read on to learn more about halitosis, its causes, and what you can do to combat it.

What is bad breath?
If your breath smells bad to you or to others, you have bad breath, otherwise known as halitosis. We’ve probably all had it at some time or another, perhaps related to a food or beverage that we’ve consumed, or possibly we’ve woken up in the morning with what I call “dragon breath.” At its best, bad breath is unpleasant (to you and to others) and can certainly be embarrassing (who wants bad breath when you’re on a job interview or a first date?). Our society deems bad breath as something to be banished, too: just walk down the aisle of the pharmacy and witness the mouthwashes, toothpastes, and other potions to rid yourself of this condition. Unfortunately, most of these products work temporarily and, in some cases, can actually worsen the condition.


How do you know if you have bad breath?
Surprising as it may seem, you may not know if you have halitosis. The best way to check your breath is to ask a spouse, family member, or close friend to check out your mouth odor and let you know. If no one is around to help you out, lick your wrist, let it dry, and then smell it. If your wrist smells bad, you have bad breath.

What causes bad breath?
There are many potential causes of bad breath, ranging from food to oral hygiene to health conditions. Here’s a run-down of the main culprits:

Food: Food particles that get stuck in your mouth and teeth begin to break down can cause odors. In addition, some foods, like onions and garlic, get digested and then sulfur-containing compounds from them get carried through the blood and to your lungs, where you breathe them out. Brushing or flossing your teeth, or rinsing your mouth with mouthwash temporarily cover up bad breath, but won’t take it away completely. In the case of strong-smelling food, you need to let it pass through your system.

Tobacco: “Smoker’s breath” is highly unpleasant; in addition to cigarettes, other types of tobacco can cause equally bad breath, including use of chewing tobacco, cigars, and pipes. Tobacco can also stain teeth, reduce the ability to taste foods, and cause severe gum disease.

Dry mouth: Also called xerostomia, dry mouth can result from many factors, including medications, nerve damage, smoking, cancer treatments, aging, and certain health conditions, such as Sjogren’s syndrome. In adequate saliva can allow odors to build up (which is one reason why “morning breath” doesn’t exactly smell like a bed of roses!).

Poor oral hygiene: Not brushing and flossing your teeth according to your dentist’s recommendations can leave you with foul-smelling breath. Food particles can get stuck between your teeth, and even your tongue can get coated with a film of bacteria, which can lead to odor formation. Poorly fitting dentures and/or not cleaning dentures properly is another source of mouth odor. Not taking care of your teeth and gums can eventually lead to periodontitis, or gum disease, which is a serious condition. Periodontal disease affects the tissues and bone that support your teeth. In addition, inflammation and infection can set in. In the case of diabetes, inflammation and infection can cause blood sugar levels to increase.

Signs of periodontal disease include bad breath, red or tender gums, gums that bleed, and loose or sensitive teeth.

Very-low-calorie or low-carb diets: If you’re drastically cutting calories and/or carbs to lose weight, you’ll likely form substances called ketones, which are a by-product of fat breakdown, and these, too, can make your breath smell bad.

Medications: Some medications cause bad breath, including antihistamines, antidepressants, diuretics, and certain blood pressures medications.

Mouth, nose, and throat conditions: Post-nasal drip, small stones that form in the tonsils, and any infection of the nose, throat, or mouth can lead to halitosis.

Acid reflux and other conditions: Chronic reflux of stomach acid (called gastroesophageal reflux disease, or GERD) can literally leave a bad taste in the mouth and cause bad breath. Liver disease, kidney disease, pneumonia, metabolic disorders, and some types of cancer, too, may cause bad breath.

Diabetic ketoacidosis (DKA): People who have Type 1 diabetes (and some people with Type 2 who take insulin) are at risk for developing DKA, a very serious medical condition that can occur due to a lack of insulin. One of the hallmark signs of DKA is a sweet, fruity odor to the breath.

Preventing and treating bad breath
The occasional “coffee breath” is unlikely a cause for concern. But, foul-smelling breath that persists is a sign that something is amiss. If bad breath lingers, see your doctor to help pinpoint the cause and determine the treatment. To help prevent and even, in some cases, treat bad breath, try the following:

• Take good care of your teeth and gums. Brush at least twice a day, or as directed by your dentist. Don’t forget your tongue! Floss at least once a day, as well. If you wear dentures, remove them at night and clean them well. Also, see your dentist at least twice a year for checkups and regular cleanings.

• Ask your dentist about special antibacterial toothpaste and antiseptic mouthwash.

• Stop using tobacco products. Talk with your doctor about ways to help you quit.

• Keep your mouth moist. Drink plenty of water, and chew sugar-free gum or suck on sugar-free candy. If your mouth is very dry, ask your doctor or dentist about special products to keep your mouth moist for longer periods of time.

• Talk with your doctor about treating underlying conditions or infections, such as GERD, sinus infections, post-nasal drip, etc.

• Check your blood sugars regularly and aim, as best you can, to keep them within your target range. Doing so can help prevent problems like periodontal disease, as well as DKA.

• Limit foods that contain a lot of garlic, onion, or spices. Go easy on coffee, alcohol, and sugary foods, too. To fight bad breath, include these foods in your eating plan:

– Yogurt with live, active cultures (probiotics)
– Certain herbs and spices, such as parsley, basil, fennel, cloves, and anise
– Unsweetened black or green tea
– Apples and cherries
– Lettuce

Beth McCrary is a woman whose life has been affected by Type 1 diabetes. Bookmark and tune in tomorrow to learn more about her.