Everything You Need To Know About Bad Breath
Hello, I'm Dr. Suess at Clackamas Smiles Family Dental in Happy Valley, Oregon. I'm here to answer some questions about bad breath. What causes it? What can you do about it? What do you need to know at home?
What is bad breath? How do we define it clinically?
The answer is really subjective. You'll know if someone has bad breath, and you'll also rarely know if you have bad breath. That's kind of the evil part of it. But the reality is bad breath can come from a lot of different sources. It can come from your teeth and gums themselves. Those are the things on your teeth that can hurt your teeth or that can live around your gums.
The other part is it can come from other areas in your mouth. Let's say the tonsils or the back of the throat or the bugs that live on your tongue. There are some other sources as well. If you have acid reflux and there's a lot of acid coming up when you lie down at night or if you have GERD, that can be a big impact.
One of the other sources can come from either your bloodstream or the lungs themselves, and those are harder to track down, but fortunately they're a lot more rare. There are lots of different causes of bad breath, and you usually have to rely on the people around you to let you know that it's happening.
How do you know that you have halitosis and how is that different from occasional bad breath?
We all know if we eat something very strong, like onions or garlic, your breath can smell like that. Or if you have a mint or chewing gum, your breath can smell like that, too. That's temporary and those aren't the things that we're talking about. Really, what we're trying to track down is if you have just on an everyday basis bad breath and you realize that it's more than the people around you, this video is for you. Those are the things that you need to look for and we can get into those.
Can cavities cause bad breath?
The answer is yes, not just cavities, but other infections in the mouth. It can be infections with wisdom teeth. It can be infections in your gum tissue. It's not always food that's stuck in and around your teeth that causes bad breath. They can actually signify that there are problems with the teeth themselves.
One of the simplest would be if your mouth is generally unhealthy. You have a lot of problems going on and that can be cavities. It can be food stuck in there, but it is also part and parcel with the rotting process, the breakdown process of the tooth parts themselves and the gums that go around it. If you notice that you have bad breath and you look in there and things aren't going so well, that's your sign you should go to the dentist and get that checked out. That would be one of the big ones. Is there something in and around my teeth that's either breaking down, unhealthy, diseased, or rotting that needs to be cleaned up or taken out? That can be the source of your bad breath.
Can wisdom teeth cause bad breath?
The answer is really yes. Here's why. When the wisdom teeth come up, they're covered by skin. As they break through that skin, they leave a little pocket and things can get stuck in there. That would contribute to wisdom tooth infections. That can contribute to gum infections. That can contribute to all kinds of things getting stuck in and around those teeth.
If that's happening and there's food and the breakdown of those gum tissues as the teeth come in, that can be a cause of bad breath. If you're in a time where your wisdom teeth are coming in, you can feel that the skin is breaking down or they're pushing through the skin, that's absolutely a source of bad breath. If it's at a time when those gums are being pushed through and the wisdom teeth are coming in, it probably would serve you well to get those looked at anyway. Come on in. Those are things that we can look at and help you decide, hey, is this part of the problem? Is it a separate thing or is it something that you don't need to worry about?
Can an extraction cause bad breath?
The answer is really an extraction or some kinds of oral surgery can cause temporary bad breath afterward, particularly during your healing phase. Some of the skin dies back. Part of that healing process is cleaning up the things that are dead or damaged, but also repairing the tissue that's going to heal and become the new skin over the top of your surgery site.
During the process where the skin breaks down, the skin is taken away and dead things are removed. Your immune system is doing a lot of work, but also there are some areas where the skin and the dead tissue die back. It needs to be removed. But that doesn't smell fantastic. If you are postop, you've had oral surgery, you've had something done, whether it's a gum procedure or tooth removal, you likely will go through a period where you will have some of that tissue dying back. Unless you had a mouth rinse specifically prescribed, we actually ask most of our patients to calm down with the mouth rinse and not overdo it, especially with the strong drying alcohol-based mouthwashes.
It's likely that your dentist wouldn't want you on those if you're post-surgery. It's kind of counterintuitive, but watch for that and reach out and ask them if you have a question. Most of the time we like to stay away from the harsh, strong, or what we consider the really effective for bad breath mouthwashes. You might not want to use those right after surgery. It's a case-by-case basis, so reach out and find that out. That might be something you specifically should avoid, even though it seems like the opposite.
What dental treatments are available for bad breath?
The answer is it depends on what it comes from. If you have something wrong like a disease, a metabolic disorder, or something's going on, whether that's diabetes or some other condition, then using mouthwash isn't going to solve your bad breath. If that's coming from your bloodstream, it's coming from your body, it's coming from your lungs and your disease process, that should be checked out on its own. That's the position where your dentist should probably work hand-in-hand with your physician or at least introduce you back to the medical community to say, "Hey, we need help tracking this down.
There might be something else going on." A really particular example of this is if somebody has reflux, acid reflux, gastroesophageal, you lie down at nighttime, you may not even feel it, but you can have those telltale signs on your teeth. It also has a huge impact on your breath. If you're waking up and you're like, gosh, I just have this chronic bad breath and I can't track it down and you get the all-clear from your dentist, you need to start looking at things like acid reflux, like systemic disease. Are those at play? The answer is you got to work hand-in-hand with your physician sometimes to track those down, but your dentist can point you in the right direction.
Is there a mouthwash or a toothpaste or a product that can help with bad breath?
The answer is, yes, there are tons of products that are really good at helping for bad breath temporarily. There's not a lot of products that help with bad breath long-term. Here's why. Usually, the products that we use, people want instant satisfaction. They make them very strong but very drying. They're based with alcohol and mint and all of those things that just sort of nuke the bacteria in our mouth. For about 25 to 35 minutes, things smell fine. It's great. But have you ever noticed that after using a strong mouthwash about 45 minutes or an hour later, your breath goes back to feeling and smelling as bad or worse than it did before?
The reason is most of those products are drying. You're taking away all the moisture from the mouth and it's killing the good bacteria that can help to control the bad bacteria. That's going the wrong direction. Don't sacrifice the long-term good for just 30 minutes of fresh breath. What you're going to want to instead use is a product that restores the pH, restores the natural hydration, is free of alcohol, and isn't overly strong.
Think of products that are more like probiotics, products that are more like moisture replacement, products that are more pH neutral. Those are the things that you're going to want to use because they have a better long-term effect and not so much of that short-term minty boost, but in the end, you're going to be better off for using those.
What are some home remedies that are good for fighting bad breath?
One of the things that you can do at home is make sure you're staying away from acids. Make sure you have adequate nutrition and adequate hydration. Make sure that the products that you use aren't drying, don't contain alcohol, aren't overly minty, and aren't overly strong. You can use probiotics, you can use natural yogurts, you can use other things that help support our natural bacteria, things that are moving away from overly strong and trying to destroy all the bacteria.
We've discovered that's the wrong approach and that's not something that's going to give you fresh breath that lasts for a long time. That's something to give you a little bit of a boost, but then probably leave you worse off than you were before. Your home products are going to be the things that control pH, avoid acid, avoid drying, and restore the natural biome of your teeth, things that are more like probiotics.
Is it possible to get rid of bad breath permanently?
The answer in most cases is yes. If you have something like acid reflux going on, if you have too much acid in your system, if that's having a negative effect on the good bacteria in your mouth, then yes, by controlling that, you can have a huge impact on your bad breath. On the other hand, if it's coming from systemic disease, you have diabetes, you have some other, you know, kidney or liver dysfunction going on, then by all means, you need to look into that and find out what's going on.
If it's something as simple as tonsil stones and bacteria and food debris impacted in those, then those can also be either rinsed out or in more significant cases, the tonsils themselves can be removed. Yes, in almost all cases, there can be a solution for bad breath. It just depends on what your individual cause is. With those three or four big categories, that's something that should be looked into. You won't necessarily know at home what that cause is. So visit your local dentist, find out what the contributing factors are, and do that deep dive. Find someone willing to have the conversation with you, like, hey, this is what could be going on and helps you find your answer.
At Clackamas Smiles Family Dental, your dental health is our priority. If you have any questions, don't hesitate to call our team at 503-786-3000, or you can email us at [email protected]. Our staff would love to talk with you!