Bad Breath (Halitosis): Why It Happens and How to Get Rid of It

Introduction

Ever worried about your breath before an important interview, a date, or a big meeting? Bad breath (aka halitosis) is one of the biggest motivators for brushing our teeth. In fact, it is reported that up to 25% of adults have had bad breath at some point. But here’s a breath of fresh air - bad breath is often very fixable.

So, What Exactly Is Bad Breath?

“Bad breath”, or halitosis, refers to a persistent, unpleasant odour from the mouth. Like tooth decay, pesky bacteria in the mouth are often responsible. They break down some of the food particles left around, and release what are called Volatile Sulfur Compounds (VSCs). Common VSCs include hydrogen sulfide (H2S) and methyl mercaptan (CH3SH). These compounds are what give your breath the foul smelling component.

In combination with these smells, our noses have an interesting feature called “olfactory adaptation”. If there is a familiar smell, after a while, our nose and our brain get less sensitive to that smell. In the context of bad breath, if you’ve had it for a while, you may not even be able to smell it yourself and know that you have it! But that doesn’t mean you have to be completely unaware of the smell. One handy trick is to floss in between a couple of teeth and quickly sniff the floss - the result might make you curl your nose, but it gives you an idea of what’s going on in your mouth!

Common Causes of Bad Breath (Halitosis)

Poor Oral Hygiene

This seems to go without saying, but if your mouth isn’t cleaned effectively, those pesky VSC-producing bacteria hang around and thrive for longer, and your breath will be worse as a result. So making sure to brush twice a day, and floss once a day will limit the amount of these bacteria, and give you fresher breath.

Dry Mouth (Xerostomia)

As we mentioned in a previous post, your saliva is one of your mouth’s best defense systems against harmful bacteria - both the bad breath and decay-causing kind. In the case of bad breath, it neutralizes acids and it washes away the debris that bacteria would feed on. It’s like your own little personal car wash! But what if you have xerostomia (dry mouth)?

Dry mouth means due to a variety of causes (medication, salivary gland blockage, mouth breathing), your mouth is producing less saliva than normal. This means that your defense system gets a bit weaker, and bacteria can have a little more fun - including those VSC-producing bacteria.

Diet

You are what you eat, and this applies to your breath as well. For example, foods with garlic and onions contain sulfur, which can contribute on its own to bad breath. The sulfur in these foods enters the bloodstream and eventually the lungs, and while it is NOT harmful, it definitely makes the breath more foul. In addition to this, not eating (ie, fasting), or going on a keto diet can also have an impact on the breath. If you fast long enough (or avoid carbs), your body eventually relies on fat to provide energy, through a process called ketosis. This process can give your breath a chemical or metallic tinge. Please note: if you notice this smell on your breath and are NOT fasting, stay tuned - there’s another potential cause for it.

Gum Disease (Periodontitis, Gingivitis)

Now we’re looking at gum disease, which is one of the most common ailments in the general public. According to the CDA, about 7 in 10 Canadians will develop gum disease (gingivitis, or its bigger sibling, periodontitis) at some point in their lives. We will cover how gum disease works exactly in a future post, but for now, it’s important to know that the link between gum disease and bad breath is undeniable - bad breath is one of the major symptoms of gum disease. In fact, gum disease is the #1 cause of bad breath.

So how does that happen? Well, on a simple level, gingivitis and periodontitis result in inflammation of the gums. This means that your gums “puff up”. When this happens, it gives more hiding places to VSC-releasing bacteria (it’s hard to reach into puffed up gums to clean them!). So these bacteria can continue to thrive, and cause bad breath.

Smoking and Tobacco

Smoking tobacco is well documented as having numerous negative effects on the mouth - these effects range from delayed healing, gum disease, dry mouth, and of course, bad breath. In fact, smoking is found to significantly increase the risk of halitosis. Smoking generally causes the population of “good bacteria” in the mouth to decrease, while “bad bacteria” (including the bad breath kind) flourish. As well, the smell of cigarettes isn’t exactly appealing.

Medical Conditions and Diseases That Cause Bad Breath

It goes without saying that oral health and total health are very closely linked - our mouth can tell a lot of stories about the rest of our body! Here are a few examples, and if you ever suspect any of these apply to you, we recommend speaking to your family doctor!

• Sinus infections or postnasal drip - it’s not the best feeling when you’re stuffed up and have a runny nose. Remember that feeling when mucus seems to be dripping into the mouth? That’s known as post-nasal drip. That mucus creates a great environment for bacteria to thrive, which often means bad breath.

  
  

• GERD (gastroesophageal reflux disease, or acid reflux) - ever have those moments where it feels like your food is coming back up and you get a nasty sour taste? This happening once in a while is nothing of concern, but that sour taste does show up in the breath. If this is something that happens regularly, you may have GERD, and we recommend speaking with your family doctor.

  
  

• Diabetes - remember when we mentioned the metallic/chemical “keto breath”? Well here’s the other potential cause of it, and it’s mostly seen in Type 1 diabetics. With a lack of insulin, your body has trouble metabolizing carbs - so it turns to metabolizing fatty acids, which in turn produce ketones, and that “keto breath”. If this is something you notice, we recommend urgently seeing your family doctor, as this can be a serious complication of diabetes known as diabetic ketoacidosis (DKA).

  
  

• Liver or kidney disease - if either your liver or kidneys aren’t functioning properly, that means that waste isn’t being filtered out of your blood effectively. This waste can stick around in your bloodstream, and can actually affect your breath. One specific example is seen in liver disease, and is known as “breath of the dead” - this is a musty or sweet smelling breath (and is a sign of liver disease).

  
  

Well, now we’ve spent so much time talking about what causes bad breath, and you are probably wondering - how do I fix it? You don’t have to hold your breath, as we’re about to talk about that!

How Do I Get Rid of My Bad Breath?

Brush and Floss Consistently

As we discussed earlier, gingivitis and periodontitis are the #1 cause of bad breath. So dealing with gum disease will go a long way to fixing your bad breath. Brushing twice daily, and flossing once daily will ensure that those VSC-producing bacteria are washed away before they cause trouble. And don’t skip the tongue! Research has shown that tongue scraping can reduce the presence of VSCs (volatile sulfure compounds) by about 40%! But be careful - scraping the tongue too hard can harm your taste buds on the tongue! A plastic tongue scraper (or even your toothbrush) is more than adequate to get the job done.

Stay Hydrated

Dry mouth can also cause bad breath - in order for your body to produce saliva, it needs to be hydrated! Make sure you get enough water daily so that your body is well equipped to fight those pesky bacteria producing bad breath. Typically, 6-8 cups per day (or more) is considered an adequate intake for most people. Here is some more information about daily water intake, and how to ensure you’re getting enough (it can vary from person to person!).

Use Mouthwash (but not all are equal)

While it’s not essential, mouthwash can make a difference and give you that fresh breath feeling so you can confidently go about your day. That being said, some mouthwashes are better than others! Specifically, look for mouthwashes that contain chlorhexidine, zinc, or cetylpyridinium chloride (CPC) - these are proven to reduce the presence of VSC-producing bacteria. While chlorhexidine typically is only available via prescription, mouthwashes that contain CPC and/or zinc include: Crest Pro Health, Listerine Total Care, Therabreath Healthy Gums, and Listerine Clinical Solutions. And if in doubt - check the label for those ingredients!

You Are What You Eat

In a previous post, we covered how eating sugary foods often can make bacteria in your mouth thrive. This is also true when it comes to bad breath. If you eat sugary foods throughout the day, it makes it tough for your mouth to clear out the debris and bacteria, which can result in bad breath. While you can definitely enjoy that tasty snack, we recommend not snacking throughout the day.

Crunchy fruits and veggies (apples, pears, carrots, celery), in addition to being healthy overall, can also sometimes act as “natural toothbrushes”, and scrub your teeth and gums clean. Incorporating these into your diet can help combat bad breath, not to mention all of the other health benefits!

Quit Smoking

Smoking is generally regarded as the #2 cause of bad breath, and we have gone through how it does so. With that said, if you are a smoker, quitting can prove very beneficial, not only to your breath, but your overall health. So if you’ve been considering quitting, let us know! We have some resources to help with smoking cessation.

Chewing gum

There are many sugar-free gums that can actually stimulate saliva production, in addition to giving you that minty-fresh breath. Specifically, gums containing Xylitol (e.g. PUR, found at Superstore and Winners) promote saliva production and actually provide some anti-cavity benefits.

Visit Your Dentist Regularly

And of course, this post wouldn’t be complete without a shoutout to all the awesome dental teams out there. Regularly visiting your dentist is important - they can help find and resolve many issues that come up with your oral health, including bad breath. If you’re in our neighbourhood (even if you aren’t but want to drive on down), give us a call at 780-440-4800 or book online!

When to See a Dentist or Doctor

Now, sometimes there are situations that aren’t in your control - but you do control starting the process of addressing these issues. If you do many of these things in this post - brush regularly, use mouthwash, eat a healthy and balanced diet, and see your dentist regularly, something else may be going on. This is when we recommend visiting your dentist and bringing up your concerns.

If you suspect you may have health conditions mentioned in this article, such as diabetes, liver or kidney disease, or GERD, we recommend seeing your family doctor to have these concerns addressed.

Putting it All Together

As we’ve discussed, bad breath is very common - almost everyone at some point has dealt with it. The good news is, getting to the bottom of it and fixing it are both very doable. It often starts with making sure your oral health regimen, including brushing and flossing, and your diet, are in order. And if you’re doing well on all those fronts but you still notice that foul stench, it would be wise to get some outside help - be it from your dentist or your family physician. And as always, “be true to your teeth, or they will be false to you!”