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Gum Diseases

Bad breath

01/11/2007

Question:

Who will save me from this shame.My mouth smell even if i brush and use mouth wash three times a day, that is after every meal as recomended but unfortunately it does not even take two minutes before it start smelling a gaing. I have tried and even went for a very expensive mouth cleaning to no a vail. My gum used to bleed but after the mouth cleaning process it no longer bleed but the smell has worsen. Please help me have a fresh breath

Answer:

Usually, there are two common sources for bad breath to occur: the nasal cavity and/or the mouth. The first step to find a solution would be to determine where the smell is coming from, the nasal cavity or the mouth.

Common causes: The nasal cavity could present infections or an anatomy that prevents normal drain of mucus. If an infection is present, this should be treated in order for the bad breath to go away. If there is an anatomical defect, mucus accumulation serves as a reservoir for bacteria to accumulate and degrade protein that causes bad odor. The same happens with an infection. These conditions should be treated by a physician specializing in ENT.

If the mouth is the source of bad odor, several factors could be involved. If you suffer from allergies, the post-nasal dripping of mucus will provide a constant source for bacteria that are present in the posterior (back) of the tongue to degrade protein from the mucus and cause a bad smell. Infection of the gums (gingivitis) and/or support of the teeth (periodontitis) could be another source. Accumulation of bacterial plaque in between the teeth, severe decay, tooth infections, and diet. The most posterior (back) of the tongue accumulates bacteria that degrade protein from mucus, blood, and food. Certain foods that have high protein contents, like dairy products, would contribute to bacteria producing a bad smell.

Often times it could be a combination of the nasal cavity and the mouth. Since you have had your cleaning already, that is an excellent start for the treatment of it, even if you have not had any resolution at this moment. You should consult with your dentist if this cleaning has been definitive treatment for the elimination of infection of your gums. If not, further treatment might be necessary by a specialist in the field of periodontics.

Also, to make sure there are no cavities or dental infections, you might need to work with your dentist for the treatment of bad breath.

In the meantime, measures that you could adopt at home would be part of the cure.  Use dental floss every day and make sure to use it in between all the teeth. This is a significant source as well of bad smell.

The last recommendation would be to brush very well the back of your tongue as far back as you can at least twice a day. When cleaned it should look pink/gray in color, similar to the gums. You could also use a tongue scraper for sale at the local stores, dental section.

You might need to use special prescription rinses to aid in the cure, but that will come from your dentist. Since bad breath is a multi-factorial problem, every source must be evaluated and corrected if necessary. Over-the-counter rinses, as well as candy and chewing gum, might be a very short term solution. The majority of the rinses contain alcohol that would dry your mouth and worsen the problem.

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Response by:

Jose I Arauz-Dutari, DMD Jose I Arauz-Dutari, DMD
Formerly, Assistant Professor of Periodontics
School of Dental Medicine
Case Western Reserve University