Struggling with Bad Breath? Effective Solutions for Oral Health - Dentistry

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Help me!


I have severe halitosis, and I wake up with a bitter taste in my mouth.
I've seen numerous dentists, and they mostly say the same thing: there's nothing wrong, just brush your teeth diligently.
The doctors recommend brushing twice a day and using dental floss, which I do diligently, but there has been no improvement.
I also don't have sinusitis or anything like that.
Please help me, doctor!

Xiao Xin, 10~19 year old female. Ask Date: 2005/09/19

Dr. Wu Jinjun reply Dentistry


Hello: There are many causes of bad breath, primarily due to the production of foul odors by bacteria in the oral cavity, nasal cavity, or even the respiratory and gastrointestinal tracts.
Some patients with systemic diseases, such as liver disease or lung disease, may produce a distinctive odor.
You may have heard many doctors suggest that you brush your teeth diligently; however, if there is no improvement and none of the aforementioned causes are present, it may be due to ineffective removal of bacteria in the mouth despite your efforts.
Generally, it takes about 15 to 20 minutes of thorough oral hygiene to eliminate 90% of the bacteria in the mouth, and the tongue should also be brushed, as the tongue coating is a breeding ground for many bacteria.
Keep up the effort, and best wishes to you!

Reply Date: 2005/09/19

More Info


Bad breath, or halitosis, can be a frustrating and embarrassing issue, especially when standard oral hygiene practices like brushing and flossing don't seem to help. It's important to understand that bad breath can stem from various causes, and addressing it effectively requires a comprehensive approach.

First, let's consider the common causes of bad breath. The most prevalent reason is poor oral hygiene, which can lead to the buildup of bacteria in the mouth. These bacteria produce sulfur compounds that contribute to unpleasant odors. However, since you mentioned that you are already diligent about brushing twice a day and using dental floss, we need to explore other potential factors.

1. Dry Mouth (Xerostomia): Saliva plays a crucial role in maintaining oral health by washing away food particles and bacteria. If you experience dry mouth, it can lead to an increase in bacteria and, consequently, bad breath. Factors that can contribute to dry mouth include certain medications, smoking, or even sleeping with your mouth open. If you suspect dry mouth, consider discussing it with your healthcare provider, as they may recommend saliva substitutes or other treatments.

2. Diet: Certain foods, particularly those high in sugar or strong-smelling foods like garlic and onions, can contribute to bad breath. Additionally, a diet low in carbohydrates can lead to ketosis, which can also cause a distinct odor. Keeping a food diary to track what you eat and how it affects your breath may be helpful.

3. Gum Disease: Even if your dentist has not identified any issues, it's worth considering that gum disease can develop without obvious symptoms. Gingivitis and periodontitis can harbor bacteria that produce foul odors. Regular dental check-ups and cleanings are essential for maintaining gum health.

4. Tonsil Stones: If you have your tonsils, they can sometimes harbor food particles and bacteria, leading to the formation of tonsil stones, which can cause bad breath. If you suspect this might be an issue, consult an ENT specialist for evaluation.

5. Underlying Health Conditions: Certain medical conditions, such as diabetes, gastroesophageal reflux disease (GERD), or sinus infections, can contribute to bad breath. If your bad breath persists despite good oral hygiene, it may be worth discussing with your healthcare provider to rule out any underlying health issues.

6. Oral Care Products: While brushing and flossing are essential, the type of toothpaste and mouthwash you use can also make a difference. Look for products that contain antibacterial agents or are specifically designed to combat bad breath. Additionally, consider using a tongue scraper, as the surface of the tongue can harbor bacteria that contribute to bad breath.

7. Regular Dental Visits: Since you've seen multiple dentists without improvement, it may be beneficial to seek a second opinion from a specialist, such as a periodontist or an oral medicine expert. They can provide a more in-depth evaluation and may identify issues that a general dentist might overlook.

In conclusion, while maintaining good oral hygiene is crucial, bad breath can be multifactorial. If you've already implemented standard practices without success, it may be time to explore other potential causes, including dry mouth, dietary factors, gum disease, tonsil stones, or underlying health conditions. Consulting with a healthcare professional who can provide a comprehensive evaluation and tailored recommendations will be key to finding an effective solution for your bad breath. Remember, you are not alone in this struggle, and with the right approach, you can improve your oral health and confidence.

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