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Bad Breath and Its Relationship to Oral and Systemic Diseases
“About 75 percent of bad breath or “halitosis” is caused by the mouth itself. Other causes include gastric problems, sinus infections or severe gum disease,” says Mark Wolff, DDS, Ph.D., director of operative dentistry at the State University of New York at Stony Brook.
One of the key successes in treating bad breath is determining the cause. Once your dental professional determines what the cause is then treatment for it can then begin1.
Bad breath can be caused by the following:
- External factors – foods such as onions and garlic, beverages like coffee and alcohol, and smoking
- Poor oral hygiene – where plaque and food debris is left on the teeth
- Oral disease – gingivitis and periodontal disease
- Dentures – plaque and food debris can form on dentures, which need to be cleaned daily
- Tonsils – cryptic areas (crevices) in the tonsils can allow food debris to become lodged in the tonsil area
- Respiratory tract infections – throat, sinus and lung infections
- Dry mouth (Xerostomia) – can be caused by salivary gland problems, medication, mouth breathing, radiation therapy and chemotherapy
- Systemic diseases – diabetes, liver, kidney, lung, sinus diseases and gastrointestinal disorders
How does Oral Disease Relate to Systemic Disease?
Recent research suggests a relationship between oral disease and systemic diseases (diabetes, cardiovascular disease, stroke, respiratory infections and Alzheimer disease) and other medical conditions. When the gum tissue becomes inflamed causing gingivitis to occur, inflammatory mediators called cytokines that are in the gum tissue can enter your saliva and can also become aspirated into the lungs. Bacteria that are responsible for periodontal disease can also enter the circulatory system around the teeth and travel to other parts of the body. Oral bacteria may cause secondary infections or inflammation of other tissues or organ systems in the body (2).
Who Should You See If You Have Bad Breath?
If you believe your diet is causing bad breath, then consult with a dietician or nutritionist who can work with you to modify your diet. If you have poor oral hygiene and are suffering from gingivitis (inflammation of the gum tissue in your mouth) or have periodontal disease (bone loss around the teeth sometimes referred to as “pyorrhea”), consult your dentist and periodontist and work with your dental hygienist to improve gingivitis and thorough oral hygiene instruction at home. The tonsils and respiratory infections will need to be followed by your physician or a specialist such as an ear, nose and throat physician or pulmonologist. A large majority of people in the United States are suffering from dry mouth due to medications they may be taking, salivary gland dysfunction and those who may be going through radiation and chemotherapy treatment for cancer therapy. Please consult your oral maxillofacial
surgeon, your physician or oncologist for their professional recommendations for prescription or over-the-counter products that can alleviate dry mouth symptoms. Those patients who are diabetics, have liver or kidney conditions, and gastrointestinal disorders should see their physician, urologist or gastroenterologist for their insights on how bad breath can be reduced regarding these systemic diseases. Contact your dentist office for a recommendation of which dental or medical professional you should see for your bad breath condition.
References:
1. Ooh, That Smell: What to Do if It’s Coming From You – Dentists Discuss Treatments for Bad Breath. Reviewed information at hhttp://www.webmd.com/news/20010809/ooh-that-smell-what-to-do-if-its-coming-from-you.
2. The oral cavity plays an important role in the overall health of the body. Reviewed information at www.oralsystemicconnection.com.
What is Good Oral Hygiene?
Good oral hygiene results in a mouth that looks and smells healthy. This means:
- Your teeth are clean and free of debris
- Gums are pink and do not hurt or bleed when you brush or floss
- Bad breath is not a constant problem
If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.
Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.
How is Good Oral Hygiene Practiced?
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.
Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.
In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:
- Brushing thoroughly twice a day and flossing daily
- Eating a balanced diet and limiting snacks between meals
- Using dental products that contain fluoride, including toothpaste
- Rinsing with a fluoride mouthrinse if your dentist tells you to
- Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.
Proper Brushing Technique | ||
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Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline. |
Gently brush the outside, inside and chewing surface of each tooth using short back-and-forth strokes. |
Gently brush your tongue to remove bacteria and freshen breath. |
Proper Flossing Technique | ||
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Use about 18" of floss, leaving an inch or two to work with. |
Gently follow the curves of your teeth. |
Be sure to clean beneath the gumline, but avoid snapping the floss on the gums. |
Brushing your teeth is an important part of your oral hygiene routine. For a healthy mouth and smile the ADA recommends you:
- Brush your teeth twice a day with a soft-bristled brush. The size and shape of your brush should fit your mouth allowing you to reach all areas easily.
- Replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won’t do a good job of cleaning your teeth.
- Make sure to use an ADA-accepted fluoride toothpaste.
The proper brushing technique is to:
- Place your toothbrush at a 45-degree angle to the gums.
- Gently move the brush back and forth in short (tooth-wide) strokes.
- Brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth.
- To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.
- Brush your tongue to remove bacteria and keep your breath fresh.
Of course, brushing your teeth is only a part of a complete oral care routine. You should also make sure to:
- Clean between teeth daily with floss or an interdental cleaner. Tooth decay-causing bacteria still linger between teeth where toothbrush bristles can’t reach. This helps remove plaque and food particles from between the teeth and under the gum line.
- Eat a balanced diet and limit between-meal snacks.
- Visit your dentist regularly for professional cleanings and oral exams.
Getting sick?
Change your toothbrush!
Toothbrushes can house a number of bacteria.
At the onset of an upper respiratory infection,
sinus infection or cold, get a new toothbrush.
When you’re feeling better, get another one.
Change your toothbrush at least once a
month when you are healthy.
Dental Tips for Heart Patients
Always inform your dentist if you suffer from any heart condition.
-
Explain the nature of your problem and if it is under control.
- List all medications you are taking.
-
Speak with your physician about your dental care and treatment.
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