What are the medical causes of bad breath?

What are the medical causes of bad breath?

Most reasons for halitosis are sited in the mouth.

Gum disease is the most common reason for bad breath and is caused by plaque.

Plaque is a mixture of food residues, dead gum cells and bacteria that forms between the gum and the tooth. The bacteria create an unpleasant odour and contribute to bleeding gums and loosening of teeth.

The cause of gum disease is often bad oral hygiene. If you do not regularly brush your teeth you will experience bad breath.

A coated, furry tongue is often a sign of indigestion, smoking or dehydration - all of which can make breath smell.

Any infections around the mouth and throat might be significant. Nasal congestion, sinus infections, tonsillitis and swollen adenoids could all contribute. So could indigestion caused by acid reflux from a hiatus hernia.

Even lung disorders such as chronic bronchitis and bronchiectasis (where infected sputum is present) may play a part.

Consider too, any medications you might be taking. Anything that dries up saliva as a side-effect, such as amitriptyline (an antidepressant), may add to the problem.

How do you know if you have bad breath?

Here are some useful pointers, so you don't have to rely on others telling you.

* Lick the inner surface of your wrist. Wait a few seconds and sniff the licked area. Is there an odour?

* Do you smoke at times other than mealtimes when the odour is diluted by food, drink and saliva?

* Do your gums look swollen or puffy and do they bleed when you brush them?

* Does your dentist or hygienist comment on your gum disease (gingivitis) and suggest more efficient brushing and flossing?

Remedies

Start with the dentist and hygienist, because the root of the problem is usually dental.

Proper brushing techniques and regular flossing can work wonders. Brushing a furry tongue with a tongue cleaner is helpful.

* Avoid smoking, alcohol and spicy foods.

* Clean your mouth after eating milk products, fish and meat.

* Chewing sugar-free gum helps because it encourages the flow of saliva without contributing to tooth decay.

* Use a mouthwash to get rid of bacteria and bits of food that you may have missed when brushing.

* Deodorising mouth sprays can mask halitosis in the short term, but you need antibacterial and antiseptic preparations with a longer duration of action to make any lasting difference. Your dentist can advise you on what will be most appropriate.