Been smelling your own breath lately with all the mask-wearing? The harsh realities of the odors coming from our mouths have come front and center these days. Tic Tacs, mints and chewing gum… can’t fix a true breath problem.
While bad breath (also known as halitosis) isn’t often a symptom of disease per se, it can affect our overall well-being as well as our psychology, work life and relationships. So let’s look into why you (or someone you know) may be dealing with halitosis — and how to fix it!
There are several potential causes of bad breath. Commonly, it’s very simply down to a lack of oral hygiene which may be easy enough to fix. But sometimes there are deeper issues at play. We’ll start by exploring the more benign reasons for bad breath, then cover how and when it may be a red flag for more serious issues.
This will not come as a surprise, but certain foods are linked to transient oral malodor (or temporary bad breath). Garlic, onions and spicy food are common culprits. Sulphur compounds in these foods are particularly high, and when chewing, the bacteria in your saliva release these sulphur compounds from your food. In fact, if you do have issues with these foods such as bloating and gas then you might want to look at getting tested for SIBO, Small Intestinal Bacterial Overgrowth!
Released by the mechanics of chewing and chemically by digestive enzymes, and no longer bound up in the food you ate, these volatile sulphur compounds quickly turn gaseous. Once able to mix with the air, volatile sulphur compounds (VSC) can exit your mouth via the breath.
Tobacco, coffee and alcohol may also perform this foul-smelling trick. It varies, but you may notice a change in breath odour for several hours. (And likely so will your family members, friends and co-workers…)
Food sensitivities can also contribute to halitosis - and lactose intolerance is a perfect example of this. When the body can’t digest the sugars in milk, the microbes that feast on those particular undigested sugars put off a sulfurous pungent odor that can be smelled on the breath.
Further down the system, improperly broken down food can make its way into your bloodstream. Normally, the gut lining works to prevent this. But in situations of chronic food sensitivity and ongoing inflammation, the protective mucosal lining of the digestive system becomes permeable.
Escaped food particles act as toxins in our blood. As the accumulation of toxins builds, we may start to notice symptoms that include bad breath. Your functional medicine doctor can help you identify any existing food sensitivities, work with you to restore your gut lining, and (as a welcome side effect) get rid of chronic bad breath.
The mouth is an area rife with microbes and bacteria. Many of them play important roles in the first step of the digestive process. Others, such as gram-negative bacteria (like Enterobacteriaceae) take up residence under the tongue, in plaque and in the deep creases between our teeth and gums where they interact with each other, giving rise to halitosis.
No single bacterial species is to blame for bad breath, but together these bacteria cause Volatile Sulphur Compounds to be released. Some of the bacteria that thrive in the depths of the gum line can cause gum diseases such as pericoronitis or periodontal abscess, which can increase the volume of Volatile Sulphur Compounds released even more.
As we dive deeper under the gums, we see less oxygen and a lower (i.e. more acidic) pH. This acidic pH creates those smelly diamines. When food-trapping gum pockets arise due to gum disease, regular amino acids from the trapped food are converted into diamines.
When that happens, we (and those close to us) smell the difference.
Having a dry mouth, no matter the cause, is a serious issue. It’s not only uncomfortable but if the condition is ongoing it prevents the important cleansing function whereby saliva flushes bacteria out of the mouth.
Oral dryness can cause discomfort for a number of reasons beyond the obvious (and easy to rectify) dehydration. Mouth breathing is a common culprit, often arising from an obstruction of the sinuses and nasal cavity, and causing increased airflow and subsequent dryness in the mouth. Salivary glands may be infected, blocked or malfunctioning. And many medications also have a dry mouth listed among their side effects.
Saliva is your mouth’s best friend. It helps wash out the mouth, reducing bacteria and preventing tooth decay, gum disease and plaque formation in the mouth. As oral bacteria have been found to have made their way to the arterial plaque of heart disease patients as well as causing issues in the mouth, we know that avoiding a chronically dry mouth is a whole-body problem - with bad breath acting as a red flag.
If a candida yeast overgrowth appears in the mouth, deeper factors are often at play in the body. A healthy immune system prevents this fungus from taking root and growing. The candida species is commonly found in and on your body, but it seizes the opportunity to grow when the immunity is vulnerable.
In the case of bad breath, this underlying immune dysfunction alters the balance between your immune system and oral microbes. Candida and other microbes proliferate. Volatile Sulphur Compounds and methyl mercaptan (another player in the malodour scene) are then produced and released.
While 90% of halitosis cases arise from the mouth alone, other systems can also be involved: Calcium deposits in the tonsils can cause a 10-fold increase in Volatile Sulphur Compound levels if they are overloaded; foreign bodies in the nose (often seen in children) are slowly dismantled by bacteria, resulting in breath odour; and infected sinuses can leak pus on the back of the tongue.
While bad breath is typically transient (think: morning breath) it can linger. For those dealing with chronic halitosis, you know just how impactful it can be.
But don’t worry. Your functional medicine doctor can help you battle your bad breath.
Oral hygiene is paramount when treating halitosis. Brushing, flossing, and regular dental check-ups are the foundation of good oral health. Unchecked cavities, gum disease and other dental pathologies must be addressed if you want to achieve better-smelling breath and the health benefits that come with it.
But it is important to remember that the mouth is a delicate area, it is the starting point of a carefully balanced digestive system which requires a fine balance of moisture and bacteria to work optimally.
Gurgling with mouthwash is a powerful tool in your halitosis arsenal. Anti-bacterial agents flush unwanted microbes from the crevices of your teeth, tongue and gums. However, conventional products typically include an array of irritating ingredients as well.
Artificial food dyes make mouthwash look good on a shelf, but these components can be detrimental to your mouth (and body). All nine FDA- approved artificial food dyes are linked to various health concerns. These range from sensitivities all the way to cancer.
Meanwhile, acidic stabilizing agents and alcohol can strip your teeth of and temporarily soften the enamel (make sure to brush before using mouthwash and not after for this reason).
Herbal mouthwash is a safer (yet effective) approach. The right combination of botanicals can deliver multiple beneficial medicinal actions. Peppermint, for instance, is antimicrobial, anti-inflammatory and helps to increase salvation. A handful of herbs and essential oils can combat bad breath on multiple fronts.
Additionally, unlike the antibacterial agents found in conventional mouthwash, these herbal ingredients don’t kill as many of the good bacteria, preserving a balance.
Oil pulling - a traditional remedy originating in India - has many therapeutic benefits. An organic oil, such as coconut or sesame, is swished around in the mouth for about 20 minutes. During this period, antioxidants in the oil break down the cell walls of harmful bacteria, effectively killing them. These bacteria stick to the oil and are “pulled” out of your mouth.
There are many benefits to oil pulling. By reducing the formation of plaque, this technique can help prevent dental cavities, gingivitis, periodontitis and, of course, bad breath. One of my favorite products is an Ozonated coconut oil pulling solution. If you would like to find out more about that you can call Health Habit Health Foods at 602-252-6000.
While odorous bacteria are often in the gums, poor tongue hygiene also poses a problem.
The back of the tongue in particular is a source of concern. Large papillae (bumps on the tongue often containing multiple taste buds) trap particles and microorganisms that lead to bad breath. A backlog of white blood cells, saliva constituents and flakes of dead cells may all be found here - even in those with otherwise good oral hygiene.
While tongue scraping gives some short term relief, recent studies show the benefit over time is minor. Cleansing your tongue (gently and regularly) won’t cause any harm. If you’re struggling with bad breath, it may be worth a shot. But remember: there are other options.
For many cases of chronic bad breath, sticking to a few simple lifestyle habits can achieve great benefits:
In some cases, further investigation may be warranted. Underlying medical conditions — like sinus infections, acid reflux and diabetes — may be contributing factors to halitosis, so it is important to check in with your functional medicine doctor for the right testing and to tailor a health plan specifically for you.
Let’s face it. Chronic bad breath can put a damper on social life without you even knowing it!
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