Bad Breath - Causes

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CAUSE - Bacterial Imbalance

Usually this is due to lifestyle choices we make every day. This imbalance usually favours anaerobic bacteria. These are bacteria that live without oxygen but rather use iron as an energy source. They get this iron by breaking down mouth tissue causing bleeding, and then removing the iron from the blood. The waste products anaerobic bacteria release are called Volatile Sulphur Compounds (VSC). It is these VSCs that are the smells of bad breath. The three main compounds are hydrogen sulphide, methyl mercaptan and dimethyl sulphide. 

Anaerobic bacteria break down proteins for energy. Some of these bacteria are normal and some can be pathogens that cause gum disease. These bacteria like to hide under the gums where they can break down gingival tissue and release blood. They also like to aggregate at the back of the tongue right at the gag reflex. Anaerobic bacteria are much more hardy than their aerobic cousins and are therefore harder to remove from the mouth. They will form into colonies within 12 hours of being in the mouth. Once in a colony they have a mechanism that protects them from disinfectant mouthwash and antibiotics. This is why normal toothpastes and mouthwash can not successfully treat bad breath. However if you use non-foaming gels as your cleaner, this enables you to access hard to reach places that normal toothpaste will not go. Also using mild alkaline mouthwash enables you to clean under the gums.

CAUSE - Poor Oral Hygiene. 

Our parents trained us to believe that cleaning your teeth is enough to keep a clean mouth. This could not be further from the truth. A proper cleaning regime needs to remove the buildup of bacteria before they can form into colonies and start to cause bad breath, tooth decay or even worse gingivitis or periodontitis. This bacteria buildup happens every 12 hours, so it is important that the proper cleaning regime be done twice a day, and a even a quick tongue cleaning after lunch to remove any trapped food debris. Remember, once the bacterial colony has formed they are protected from mouthwash and even some antibiotic.

CAUSE - Periodontal (Gum) Disease

This is the cause of the loss of bone under the gums around the teeth. This bone loss provides a gap that becomes home to many pathogenic and bad breath bacteria. The deeper the gap, the more bacteria can live in the crevice. These bacteria create a protective biofilm to stop themselves being killed by mouthwash or antibiotics. The only way to rid yourself of them is to clean them out of the pocket every twelve hours. If you do not floss your teeth twice a day. If your gums bleed when you clean or floss (even one small drop). If the floss smells when you pass it between your teeth. Then these are all signs of bacteria biofilm. Periodontal Disease smells like "poo breath". In people up to thirty years of age generally they may have gingivitis, but over this age people tend to get periodontitis, which is the more severe form of the disease. If your problem is the more serious form, or periodontitis, then you need professional intervention by a dentist or gum specialist. The reason periodontal disease causes "poo breath", is because these anaerobic bacteria release a Volatile Sulphur Compound called Methyl Mercaptan. Methyl Mercaptan not only has this distinctive smell, but it is also toxic to mouth tissue and can accelerate the gum problem. Methyl Mercaptan is probably the most offensive of all the bad breath smells. It is also responsible for the old wives tale that bad breath comes from the stomach or gut, due to its odour.

CAUSE - Nasal Mucous 

This is the next biggest cause of bad breath. The mucous that collects at the back of the throat is protein rich. The amino acids are broken down to dimethyl sulphide which has a cabbage or gasoline type of smell. Some of this mucous drips into the mouth and that part is broken down to Methyl Mercaptan or faeces smell. If you feel you have to clear your throat. If you feel you have a lump in your throat. If you cough up little white stones called tonsil stones. If you easily get a hoarse voice. These are all signs of excess mucous collection at the back of the throat or at the mouth gag reflex. You need to remember that mucous drips down the windpipe or throat all day long. Generally the body can clear mucous buildup. but if the drip is excessive, or you drink alcohol or take other drying agents. Then the mucous can thicken and stick to the throat and gag reflex.

CAUSE - Dry Mouth

This is a common trigger for bad breath. Dry mouth increases mouth acid and deprives the mouth of oxygen. This in turn degrades the quality of your saliva, and then finally increases growth of anaerobic bacteria that cause halitosis. Dry mouth is made worse by many lifestyle choices. If you use commercial mouthwash, many will contain alcohol or acid that can cause dry mouth. If you drink alcohol. If you drink a lot of coffee. If you take prescription medication. If you do a lot of exercise. If you are diabetic. If you suffer from Sjogrens Syndrome. These are all typical things that can lead to dry mouth. You must have healthy saliva to avoid dry mouth. Treatment of dry mouth can be via a number of different avenues. But all treatments should be aimed at creating a good amount of healthy saliva. Firstly you should identify the reasons that you have this condition. There is a simple test that the dentist can do at your check up visit to determine if you suffer from dry mouth or if you are at risk form this ailment. If you test positive to dry mouth then you can stimulate your saliva by chewing sugar free gum for 5 minutes after meals. You should also avoid alcohol and reduce your caffeine intake.

CAUSE - Ketone Diets

These will cause a particular type of bad breath called "Hunger Breath" or "Ketone Breath". When you starve yourself of carbohydrates, the body will begin to break down fats and release ketones. This activity is called ketosis. This particular compound can be extremely smelly and difficult to remove. The smell is of a type of acetone or artificial breath. Ketones are released from the body either through the lungs or through urination. Your breath can still be fresh even when you diet. I advise my patients to eat small packages of food during the day that contain carbohydrates such as rice crackers with a cup of tea sweetened with xylitol. These things will ensure you have adequate carbohydrate intake during the day and avoid the release of ketones into your breath. The xylitol can actually have an antibacterial effect. Unfortunately dieting and bad breath treatment do not go together. But even if you are on a diet this does not mean you cannot have fresh breath. Remember 90% of the proteins being broken down to bad breath smells are already in your mouth, in coatings on the teeth and gums. So if you are going to diet then this just means you need to have an extremely strict cleaning program to ensure you remove the biofilm (coatings) at least twice a day from the mouth. Then just make sure your dieting is not fasting as this causes the ketone release we are trying to avoid.

CAUSE - Medicines

Generally all medicines can cause bad breath as they tend to dry up your saliva. Saliva is your body's means of protecting you against tooth decay and bad breath. Seven out of the top ten prescribed medicines have dry mouth as a side effect of usage. Typically, they are the antidepressants, high blood pressure medicines, antihistamines, decongestants, indigestion, hormone replacement medicines, birth control pills. Try and avoid acid foods such as coffee, and fruit juice as this can make your dryness worse.

CAUSE - Dairy Products

Milk, cheese, yoghurts, ice cream, are probably the worst offenders for your breath. Milk and egg yellow contain the amino acid Cysteine that breaks down to Hydrogen Sulphide or rotten eggs. Cheese contains Methionine that breaks down to Methyl Mercaptan and gives you "poo breath". Coffee and nuts create acid in the mouth and so stimulate quicker bacterial growth increasing your halitosis. So these are the food groups to avoid. Avoid all animal milks and cheese. Skim milk is as bad as cream, as the protein content is usually about the same, even though the fat content is considerably different. Also some people are lactose intolerant and can not digest dairy products properly. Again other foods such as garlic and onions will create bad breath instantly. This is because, on a molecular basis, they already contain the sulphur compounds (Mercaptan) produced by bad breath bacteria. Also any foods that contain sugar can add to breath problems. This is because sugar is an excellent nutritional medium for the bad breath bacteria. Again other foods such as garlic and onions will create bad breath instantly. This is because, on a molecular basis, they already contain the sulphur compounds (Mercaptan) produced by bad breath bacteria. Also any foods that contain sugar can add to breath problems. This is because sugar is an excellent nutritional medium for the bad breath bacteria. 

REMEMBER OUR GUARANTEE - Bad Breath is easily treatable in the privacy of your own home, or at our clinic for those who prefer a professional overview. If you start our treatment at home and do not achieve the results you are expecting,  we offer you a Free Consultation at our Edgecliff Clinic to review your individual case.