Why Bad Breath?!

Bad BreathMost people have occasional bad breath, especially after a long night sleeping with the mouth open, eating foods with powerful odour or smoking. The Department of Periodontology at the University Hospital in Muenster, Germany states that twenty percent of the German population has “chronic bad breath” (scientific name – Halitosis), in German also called “Mundgeruch”. A study published by the American Dental Association shows that Americans also are in high proportion suffering from the same problem and that 90% of all halitosis originates from the oral cavity itself.

This can be caused by an imbalance among different types of bacteria in the mouth, throat or upper airways. There can be up to 700 types of bacteria co-existing in the mouth but the smelliest ones accumulate in top of the tongue and in the periodontal pockets around the teeth. The deeper the pockets, the higher the amount of “Red Complex” bacteria, which is more powerful and can live in the absence of oxygen, also posing a systemic risk through the endotoxins they are releasing.

Few common mouth odours are:

  • Rotten eggs determined by Hydrogen sulfide
  • Rotten cabbage – Methyl mercaptan
  • Garlic – Allyl mercaptan & Allyl – methyl sulfide
  • Fish – Dimethylamine & Trimethylamine.

However, there are other mouth odours, which are not generated just by bacteria overgrowing in the mouth but due to serious system diseases such as GERD (Gastroesophageal reflux disease), diabetes, liver or kidney disease.

Perio-BacteriaIn these cases, the dentist is the first line of defence. During a regular check-up, he can diagnose the presence and the type of bad breath. The ones caused by periodontal pockets – the most common – can be successfully treated by removing the accumulation of hard calculus and sticky biofilm above and especially below the gum line. This has also a beneficial impact on the health of periodontal ligaments around the teeth and is preventing gum and bone recession. Combined with the Probiotics treatment it can be extremely effective.

In addition to teeth brushing, flossing and the use of mouth rinses, daily tongue cleaning is a must. If in spite of all these prophylactic measures, if a person is still experiencing a bad mouth odour, there might be leaking dental crowns which cause constant bacterial accumulation in the periodontal pockets or systemic pathology. The systemic problems require close collaboration between the dentist and the family doctor.

Costin Marinescu
Dr.-medic stom, D.D.S. (USA)