Halitosis is the technical term for what is commonly called bad breath. It affects roughly 25% of the U.S. population and it has several causes. Rarely, problems in your nose, throat or lungs will cause halitosis and stomach problems are almost never the cause. The vast majority of bad breath originates from the mouth.

           Certain types of bacteria (germs) in your mouth (everyone who has teeth has bacteria in their mouths) called anaerobic bacteria cannot live in the presence of oxygen. Because of this, these bacteria live in your mouth where oxygen is absent - underneath your gums and especially in the furrows of your tongue. They also digest proteins in your mouth from food and body fluids to produce what are called volatile sulfur compounds (VSCs). VSCs emit a foul odor often compared with rotten eggs or sulfur. When anaerobic bacteria are allowed to multiply unchecked, halitosis becomes a problem.

           Situations that allow these germs to proliferate in your mouth include: poor oral hygiene, decayed teeth, periodontal (gum)disease, dry mouth, spicy foods and canker sores. For example, anaerobic bacteria like to hide in decayed teeth where food can become caught. They are more active in a dry mouth and they live in canker sores. The deeppockets under your gums caused by periodontal disease are ideal places for these germs to thrive and reproduce as are the furrows at the very back of your tongue. Spicy foods add to your bad breath. Of course, if you are not cleaning your mouth nightly with thorough flossing, brushing and  tongue cleansing, bacterial overgrowth is inevitable. There are factors that can predispose you to these situations as well. Alcohol based mouthwashes and many prescription or even over-the-counter medications can cause dry mouth as may consumption of alcoholic beverages.  Tobacco use is the #1 risk factor for periodontal disease. Defective fillings can give halitosis causing germs an oxygen free place to hide under. All these circumstances must be addressed so that your halitosis can be brought under control.

Patients with advance periodontal disease almost always suffer from halitosis.

 
           First and foremost, oral hygiene must be established. After we give your mouth a thorough cleaning here in the office that may take more than one visit, it is essential that you maintain this state of cleanliness at home with strict nightly tooth brushing, flossing and tongue cleansing. If you have never cleaned your tongue regularly before, this step alone can significantly reduce bad breath. Tongue cleansing should be performed twice a day. Special tongue cleaners available at any drug store do this job better than toothbrushes. Any decay or defective fillings in your mouth must be eliminated. You should immediately discontinue using any alcohol based mouthwash and reduce alcoholic beverage consumption. You should use an alcohol-free, oxygenating mouthwash three times a day. Tobacco use should be eliminated. Any medications you are taking that may be causing you to have dry mouth should be discontinued or changed if at all possible. Minimizing consumption of spicy foods can have the added benefit of reducing the frequency with which you experience canker sores. As stated previously, the germs that cause bad breath cannot stand oxygen. If you use special mouthwashes and toothpastes that liberate oxygen in your mouth, these germs will be further limited. Below, you will find a list of some of the OTC (over-the-counter) mouthwashes and toothpastes that release oxygen.

Tongue scraping is
essential in controlling halitosis.

           In stubborn cases of halitosis, it may be necessary to make special trays for your mouth to hold oxygen releasing gels. These trays saturate your gums with the gel further reducing the bacterial count. Side effects of this treatment include a subtle lightening of your teeth (bleaching your teeth lightens them more dramatically) that may make your older bonded fillings more obvious and slight gum sensitivity that will resolve spontaneously when the treatment is ended. If your breath is most noticeable on waking in the morning, you should wear the trays overnight, especially if you breathe through your mouth. If it is worst in the evening, you should wear the trays for an hour in the afternoon. If your breath is objectionable over the entire day, you should wear the trays for half an hour in the morning and half an hour in the evening. This treatment is effective after two weeks in most cases. Brush with an oxygenating toothpaste on tray removal. In some cases a stronger gel is needed or office-dispensed mouthwash may be prescribed.

OTC OXYGENATING MOUTHWASHES AND TOOTHPASTES:

Mouthwashes
Rembrandt Age Defying
mouthwash

Toothpastes

Rembrandt Dazzling White
toothpaste
Rembrandt Daily Whitening Gel toothpaste
Rembrandt Age Defying
toothpaste

           Dr. McArdle has no financial interest whatsoever in Rembrandt products, but these are the only ones he is aware of that are specifically promoted to be oxygenating through peroxide compounds. Peroxides discharge oxygen in the mouth and have the side effect of lightening tooth enamel to some degree as the brand names above suggest.

IF YOU HAVE CONCERNS ABOUT YOUR BREATH, DON'T HESITATE TO TELL DR. MCARDLE.

HE CAN HELP YOU WITH THIS PROBLEM!