Having a great smile and good breath is desirable for many people in our society. While appearance is important, the doubts and insecurity of wondering if your breath is offensive is a problem that has a major impact on many relationships. Halitosis is the official name for bad breath, but we don’t have to know its proper name in order to understand the negative effects that it can have in our lives. In order to understand halitosis, we must understand the cause of halitosis and the sites of halitosis in the mouth
The Cause of Halitosis. Halitosis, or bad breath, is caused by the bacteria in the mouth which degrade or “breakdown” proteins that are present in the mouth. These proteins, and other materials which are in the mouth naturally or from foods and drinks that we consume, are the fuel that powers “bad breath”. The breakdown products of these proteins and other substances are described as “volatile sulfur compounds”, one of which is hydrogen sulfide. Hydrogen sulfide is also the same gas that is produced when one has flatulence. It has been shown that the bacteria that cause these sulfur compounds also are the bacteria that cause gum disease or periodontitis. Therefore, the bacterial plaque which causes periodontitis has to be considered as a causative factor for bad breath.
The Sites of Halitosis. Halitosis can be caused by the bacterial actions in various areas of the mouth. These areas are:
1. The tongue.
2. The teeth — on and between the teeth.
3. The gums.
4. The stomach.
1. The Tongue
The tongue has emerged as the primary focal point regarding halitosis due to the bacteria that accumulate on the tongue. Studies have shown that the bacteria on the tongue are similar to the odor-causing bacteria that are associated with gum disease. However, it has been shown that the tongue surface is an important factor in the development of bad breath in both healthy mouths or those which have gum disease.
There are two considerations regarding the tongue’s ability to cause bad breath. They are the amount of bacterial coating on the tongue, as well as the presence of deep fissures or grooves on the tongue.It is presumed that if your tongue has a heavy coating of bacteria on it (if you aren’t cleaning your tongue) there may be one hundred times the bacteria present on the tongue than if your tongue has been brushed clean. The deep fissures or grooves on the tongue allow the bacteria to hide in them and avoid the cleansing action of saliva or the oxygen in the air that you breathe.
2. The Teeth
The teeth have the potential to be covered with bacteria that cause bad breath, but if the teeth are covered with bacteria, it is reasonable to assume that the tongue is loaded with bacteria. Definitely, the teeth need to be considered as sites that harbor bacteria, especially the sides of the teeth that touch each other. These sides can’t be cleaned with a toothbrush and must be cleaned with floss. If you ever have eaten onions and tried to brush away the odor, take dental floss and clean the sides of the teeth — you will see how much odor is coming from the sides of the teeth.
3. The Gums
The gum tissues can be a significant source of the bad breath problem. The gums form a “sulcus” or “ditch” that goes around the tooth and is usually 1-3 millimeters in depth. If you have gum disease, this ditch deepens and is called a “pocket”. The bacteria that cause bad breath can get into these pockets and “feast” on the blood and pus in these depths. This can clearly cause bad breath.
**Note: If you still have bad breath after cleaning your tongue, you must consider the presence of gum disease as the source of the bad breath. Your body may be using the bad breath as a signal to tell you that there is gum infection present. When you consider that gum disease is associated with heart disease you can’t afford to overlook the possibility of gum disease.
4. The Stomach
If you have addressed the possibility of bacteria on the teeth, gums and tongue and still have bad breath, you should consider the possibility that your odor comes from your stomach. Do you have a stomach reflux problem where you regurgitate stomach acid or do you have a constant upset stomach? Does alcohol contribute to your stomach problems? You may need to see a gastro-intestinal medical specialist if you have persistent stomach problems. Is your body using your bad breath to tell you about a stomach problem?
The solution to your bad breath problem starts with cleaning your teeth and tongue better.
Brushing. Brush your tongue by sticking your tongue out and brush as far back as you can before gagging. One way to reduce gagging is to take a deep breath and hold it before brushing — holding the breath retards the gag reflex. If you feel a gag coming on, blow out the breath. There is, however, a limit regarding how far back you can brush.
Flossing. You can’t clean the sides of the teeth that touch each other without using floss to “buff” the sides of the teeth.. Flossing is very important as a technique in reducing bad breath. If the floss smells after you have used it, you are probably determining one of the sites of your bad breath — however, don’t forget the tongue.
Mouthrinses. While there are a variety of commercial mouthrinses, the use of a prescription mouthrinse like chlorhexidine (Peridex, Perioguard) appears to have better potential for helping bad breath. These mouthrinses can be used best if you use your brush to apply the chlorhexidine to your tongue and brush into the grooves. Then rinse with the chlorhexidine for 60 seconds.
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