Bad Breath

• Bad breath, or halitosis, is characterized by an unpleasant odor of themouth.
• Causes of bad breath includefood,tobaccoproducts, poordental hygiene,healthproblems,dry mouth,oralinfections, dental problems, or medications.
• Symptoms of bad breath include unpleasant odor ortasteinthe mouth,dry mouth, or white coating on thetongue.
• Treatments for bad breath include proper dentalhygiene, mouthwash,sugar-free gum, quittingsmoking, and changing bad habits.
• Bad breath can usually be prevented by propertoothbrushing, quittingsmoking, and avoiding foods that cause bad breath odors.

The definition of bad breath, or halitosis, is an unpleasantsmellcoming from the mouth. Halitosis can occur on occasion, or it can be achroniccondition. It may be caused by foods a person eats, poor oral hygiene, diseases, or other factors.

There are many risk factors and causes for halitosis, and evenhealthypeople have bad breath on occasion. Some common causes of halitosis include the following:

• Food: Food is aprimarysource of bad odors that come from the mouth. Some foods, such asgarlic, onions, spicy foods, exotic spices (such as curry), some cheeses, fish, and acidicbeveragessuch as coffee can leave a lingering smell. Most of the time the odor is short lived. Other foods may get stuck in theteeth, promoting the growth ofbacteriaand dental plaques, which causes bad breath odor. Lowcarbohydratediets may also cause "ketonebreath." These diets cause the body toburnfatas its energy source. The end-product of making this energy is ketones, which cause a fruityacetone-like odor on the breath when exhaled. This fruity odor in a diabetic mightindicateuncontrolledbloodsugars.
• Tobacco products:Smokingandchewing tobaccocan leave chemicals that remain in the mouth. Smoking can also precipitate other bad-breath causes such asgum diseaseororal cancers.
• Poororal health: When a person does not brush or flosshis/her teeth regularly, food particles remaining in the mouth can rot and cause bad odors. Poor dental care can lead to a buildup ofplaquein the mouth, which causes an odor of its own. Plaque buildup on the teeth can also lead to an unhealthy condition calledperiodontal(gum)disease. When plaque hardens, it is referred to astartar(calculus). Tartar holds bacteria that can irritate the gums and lead to gum disease. The mild form of gum disease is calledgingivitis;如果gingivitisis not treated, it can advance toperiodontitis.
• Health problems:Sinus infections,pneumonia,sore throat(pharyngitis) and otherthroatinfections, thecommon cold,influenza(flu),tonsil stones(tonsilloliths),thrush,bronchitis, postnasaldrip,diabetes,acid reflux(gastroesophageal reflux diseaseorGERD),lactose intolerance, otherstomachordigestionproblems, and someliverdiseases orkidneydiseases may be associated with bad breath.
• Dry mouth:Also calledxerostomia, dry mouth can also cause bad breath.Salivahelps moisten and cleanse the mouth, and when the body does not product enough saliva, bad breath may result. Dry mouth may be caused bysalivary glandproblems,connective tissuedisorders (Sjögren'ssyndrome), medications, orbreathingthrough the mouth.
• Allergies: Many medications used to treatallergiescan cause dry mouth, another cause of halitosis. In addition,post-nasal dripis a commonallergysymptomthat can result in bad breath.Sinuscongestiondue toallergiescan also cause people to breathe from their mouths, causing dry mouth.
• Mouth infections:Cavities, gum disease, or impacted teeth may cause bad breath.
• Denturesorbraces: Food particles not properly cleaned from appliances such asbracescan rot or cause bacteria and odor. Loose-fittingdenturesmay cause sores or infections in the mouth, which can cause bad breath.
• Medications:许多药物,包括antihistaminesto treat allergies anddiuretics, can cause dry mouth (see above), which can cause bad breath. Other medications that may lead to bad breath may includetriamterene(Dyrenium) and paraldehyde.
• "Morning breath": Bad breath in the morning is very common. Saliva production nearly stops duringsleep, allowing odor-causing bacteria to grow, causing bad breath.
• Pregnancy: Beingpregnantin itself does not cause bad breath, but thenauseaandmorning sicknesscommon during pregnancy may cause bad breath. In addition, hormonal changes,dehydration, and eating different foods due to cravings may also contribute to bad breath during pregnancy.
• Other causes of bad breath: Objects stuck in thenose(usually in children),alcoholism和大剂量的维生素supplementsmay also cause bad breath.

It is generally simple how to tell if you have bad breath. Others may notice someone has halitosis before the person does, so another person may tell him or her about their bad breath or give them a larger than normal personal space. The most obvious标志or symptom of bad breath is noticing an unpleasant smell coming from the mouth.

Other signs and symptoms of bad breath include

• unpleasant or sour taste or changes in taste,
• dry mouth, and
• a coating on the tongue.

The first stop when you have halitosis is usually your dentist. If your dentist determines you have a healthy mouth, you will likely be referred to aphysicianto look for an underlying health problem.

If you haveperiodontal disease, you may see a periodontist, a dentist who specializes in gum disease anddental implants.

If you have braces, it's like that your bad breath is caused by food getting stuck in them. You may see your orthodontist for an adjustment.

Bad breath inbabiesor young children may be a sign ofinfectionor undiagnosed medical problems. Consult a child's pediatrician or dentist if aninfantor young child has bad breath.

If proper oral hygiene does not get rid of bad breath, see a dentist ordoctorfor a diagnosis if bad breath is accompanied by

• persistent dry mouth,
• sores in the mouth,
• painor difficulty with chewing or swallowing,
• broken teeth or dentalpain,
• white spots on thetonsils, and/or
• feverorfatigue.

Also see a doctor or dentist if bad breath develops after taking a newmedication, after recentdental surgery, or any other symptoms develop that are of concern.

You have halitosis if you have bad breath, and a doctor is not needed to diagnose the condition. However, if your bad breath is chronic, if it does not go away with proper oral hygiene, or you have other symptoms, you will need to see a doctor or dentist to diagnose the underlying cause.

A doctor or dentist will examine your mouth to look for signs of gum disease, dry mouth, or infections that may be the cause of your bad breath.

Treatment of bad breath depends on the cause.

TheAmerican Dental Associationrecommends the following:

• Brush and floss teeth regularly. Remember to brush the tongue, too, to remove bacteria from its surface. Brushing the tongue can help with bad breath caused by foods a person has eaten.
• See a dentist regularly for checkups and to ensure dentures or braces are properly fitted and cleaned (and clean dentures thoroughly each night).
• Quit smokingor using chewing tobacco.
• Sugarless gum andsugar-free candy can also keep the mouth from drying out.
• Keep the mouth moist by drinkingwaterand chewing sugarless gum or sugar-free hard candy to stimulate the production of saliva. Eat adietof foods that need to be thoroughly chewed to keep saliva flowing. Foods that require a lot of chewing, such as apples or carrots, are good options.
• Over-the-countermouthwash can help kill bad breath-causing bacteria and may temporarily mask bad breath odors, but it may not treat the underlying cause.

Keep the mouth moist by drinking water and chewing sugarless gum or sugar-free hard candy to stimulate the production of saliva. Mouthwash may temporarily mask bad breath odors, but it may not treat the underlying cause.

Natural remedies used in the treatment of bad breath include chewing on mint orparsley.

If bad breath is due to a health problem such as asinus infection,diabetes, acidreflux(gastroesophageal reflux disease, orGERD), etc., then the underlying medical issue needs to be treated.

If bad breath is a side effect of taking a medication, discuss with a health care professional whether there are other options for medication that can be taken. Never stop taking a medication without first consulting your health care professional.

For patients who suffer from dry mouth (xerostomia),artificial salivamay be prescribed by a dentist.

Bad breath that is due to simple causes such as foods may be more easily masked or eliminated than bad breath due to medical conditions, infections, or medicationside effects.

There are some things a person can do to eliminate or at least temporarily mask bad breath.

• Good oral hygiene: Brushing the teeth and tongue, and flossing, keeps the mouth healthy and can often get rid of bad breath, at least in the short term.
• Mouthwash may temporarily mask bad breath and can help with oral hygiene.
• Chewing sugarless gum or sucking on sugar-free mints may temporarily mask bad breath odor.
• For more serious cases of bad breath, dentists can prescribe specialtoothpasteand mouthwash that can improve the symptoms of bad breath.

Most of the time, bad breath can be cured and prevented with proper oral hygiene. It is rarely life-threatening, and theprognosisis good. However, bad breath may be acomplicationof a medical disorder that needs to be treated.