While many dental patients are ashamed to complain about bad breath, what are some of the conditions and circumstances which can cause or aggravate this totally preventable situation? Regular readers of this column should know that the most common fundamental source of bad breath is related to the presence of oral bacteria. The smell comes from volatile sulfur compounds There are, however, other factors which also influence the odour of one’s breath. In fact, the quality of a person’s breath is multifactorial.

Let’s look at some details of specific issues and conditions related to the presence of bad breath. Take notice of the fact that many of them directly correlate to:
Oral bacteria
Conditions which promote the growth of oral bacteria such as not cleaning, or not being able to clean, those areas where oral bacteria reside.

Later on, we will discuss the specifics of why bacteria cause odours, and specifically how to clean these bacteria away, for right now at this point in our discussion, just realise that anything which promotes oral bacterial growth will most likely promote bad breath too.
How do foods cause bad breath?

Everyone knows that certain foods have a reputation for causing bad breath, possibly the two most notorious ones are garlic and onions. Incidentally, alcohol is included here. When foods are digested their component molecules are absorbed by our bodies and subsequently carried off in our bloodstream. Some of these molecules, which can have very unique and unpleasant odours, will be released into our lungs as our blood flows through them. As we exhale our breath will carry these offending molecules out of our bodies.
While this type of bad breath can be annoying or embarrassing this is not the type of breath problem I consider to be clinically critical. Bad breath related to the consumption of certain foods will resolve on its own in a day or so as your body completes the process of breaking down and utilising or else excreting the offending molecules. You can control this type of bad breath simply by avoiding or avoiding or minimising your consumption of these foods.

You are probably familiar with people who have “ smoker’s breath”. While the odour associated with smoking is multifactorial, a great part of it is related to the tar, nicotine, and other foul-smelling substances derived from tobacco smoke which accumulate on a person’s teeth and the soft tissues of the mouth (tongue, cheeks, gums).

Once again, this is not the precise type of bad breath we address on this site’s pages. Short of quitting smoking there is no effective way to totally eliminate smoker’s breath, although immaculate oral hygiene can help reduce it.

As a contributing factor, the act of smoking does have a drying effect on oral tissues. Decreased moisture in the mouth limits the washing and buffering effect of saliva on oral bacteria and their waste products. Mouth dryness is addressed as a topic just below.
It’s a known fact that persons who smoke have a tendency to have problems with periodontal disease (“ gum disease”) than those who don’t. The causative agent of periodontal disease is bacteria. Gum disease, as it relates to bad breath, is discussed in more detail below.

Even if you don’t have significant problems with bad breath you probably have noticed that your breath is least pleasant when you first wake from a night of sleep. This is because while we rest our mouth dries out, due to our body’s natural tendency to reduce saliva flow when we sleep. The result of this mouth dryness is “morning breath”.

This same souring effect is often noticed by teachers and lawyers whose mouths have become dry after speaking for prolonged periods of time. Along these lines, persons with chronically dry mouth, a condition term “xerostomia”, tend to have more difficulty keep there breath pleasant.

Moisture in our mouth helps to cleanse it. The presence of moisture encourages us to swallow. Each swallow we take washes away millions of bacteria, as well as the debris and food particles on which they feed. Moisture also dilutes and washes away the waste products created by the bacteria which live in our mouths.

Saliva is a special form of mouth moisture, It’s the body’s natural mouth rinse. Beyond the washing and diluting effect that any moistness will produce saliva, saliva also contains special compounds which kill oral bacteria and other ones which buffer the effects of bacterial waste products.

When our mouths dry out, all of the benefits which moisture can produce are lessened. The net result is that conditions for bacterial growth are enhanced while the neutralisation of bacterial waste products is reduced.

Some persons have chronically dry mouth, this condition is termed “ xerostomia”. Xerostomia can be a side effect of the medication a person is taking. Antihistamines ( allergy and cold medications), antidepressants, blood pressure agents, diuretics, or anti-anxiety medications are each known to produce xerostomia. As a person ages, they may find mouth dryness to become more of a problem. It seems that with age, our salivary glands tend to work less effectively, and the composition of our saliva changes also. Both of these factors result in less effective salivary cleansing and buffering.

Compounding the problems associated with mouth dryness, long term sufferers of xerostomia are known to have an increased susceptibility to periodontal disease ( gum disease). Periodontal disease is a causative factor of bad breath.