The Sweet Smell of Success: How to Banish Bad Breath
Nov. 21, 2001 -- Jessica brushes her teeth after every meal, gargles with mouthwash, flosses religiously, and pops Altoids, the "curiously strong breath mint," in between.
But much to her and her husband's chagrin, Jessica still has terrible breath. Bad breath, or halitosis, affects an estimated 60 million people in the U.S., and Americans spend approximately $10 billion a year trying to banish bad breath.
Don't despair, says Louis Malcmacher, DDS, a general dentist in Cleveland. Research on the causes of bad breath has paved the way toward more effective treatments.
"There is new help for bad breath because we have finally been able to identify the source of the problem and the treatments are based on research," he tells WebMD. But effective treatment starts with a trip to the dentist, he says.
The cause of some cases of bad breath is bacteria that live in the deepest pockets of the tongue and gums, so mouthwash and toothbrushing does not always get to them, he says. The bacteria produce volatile sulfur compounds, and if there is enough buildup of these sulfur compounds, the result can be bad breath.
"Everyone has these bacteria," Malcmacher tells WebMD. "But with most people, it's more or less in check. However, the people with bad breath have a higher number of these bacteria in their mouths."
Enter new treatments, including special mouthwashes available through your dentist, tongue brushes to get at plaque lurking in the crevices of the tongue, and sonic toothbrushes that zap away the plaque and bacteria hiding in the gums.
"Your dentist has many new treatments including a specially form-fitted plastic mouth tray that will hold some peroxide right next to bacteria -- getting rid of bad breath," Malcmacher says. "Most patients see a huge improvement after two weeks, but for some, it can take anywhere up to three months. A lot of people are cured for good, but you can always get a recurrence, and then you just use the trays again."
None of this is to say that good oral hygiene isn't essential. If you don't brush and floss daily, particles of food remain in the mouth, collecting bacteria that can cause bad breath. Many of these bacteria also can live on your tongue and further back in your mouth, so make sure you brush your tongue, he says.
As for mints like Altoids, "they are mainly perfumes and they will mask the problem, but the mouth really needs a bath, not perfume," Malcmacher tells WebMD.
Jay Golub, DDS, a dentist in Sunnyside Queens, NY, says that oftentimes bacteria and plaque lurk behind ill-fitting crowns and bridges where they can cause bad breath. "If they are changed to fit better, fewer bacteria will hide there," he says. "We flush the bacteria out, and the problem reverses itself."
People who wear dentures that are not cleaned properly also can harbor food and bacteria, and cigarettes, cigars, pipes, and chewing tobacco also can be major cause of breath problems, he tells WebMD.
Sometimes bad breath stems from the stomach. Acid from foods may travel up the esophagus, resulting in a bad taste and bad breath. Usually, over-the-counter acid neutralizers can help, he says.
As for persistent bad breath or a bad taste in the mouth, that should not be ignored, Golub stresses, because it is one of the warning signs of gum disease.