Zenker's Diverticulum

This is not a “common” cause, but does exist and can be very serious if not treated. It involves the perforation of the esophageal mucous membrane and does cause bad breath.

Tobacco Smoking

Tobacco smoking encourages growth of bacteria by drying the mouth. As we discussed previously, dry mouth is one of the leading causes of bad breath.

Sinusitis

This is an inflammation of the sinuses, with or without pus and can carry along with it not only bad breath but a terrible taste in the mouth.

Poor Dental Hygiene.

We have discussed some of the leading causes of bad breath, but nothing matches poor dental hygiene as a leading cause of bad breath.

Lack of brushing, flossing and regular checkups are the most important weapon for ridding oneself of bad breath and preventing more serious conditions from developing.

Pharyngitis

This is an inflammation in the area at the back of the mouth known as the Pharynx as usually occurs because of a virus.

This is the same area where you begin to feel a slight “scratchiness” at the onset of a cold or flu. The bacteria involved can lead to more serious streptococcus, commonly known as “strep throat.” If it progresses it can be highly contagious and because it is bacterial it will produce bad breath.

Periodontal Disease

It’s hard to believe that in a 2002 poll of 1,000 Americans over the age of 35, it was determined that 60% of adults polled knew little or nothing about gum disease! A tragedy when you consider that gum disease is the leading factor in tooth loss, even healthy teeth.

Your teeth can appear to be healthy and disease free, when under the surface gum disease can stalwartly march on creating a condition that will ultimately lead to serious tooth loss. Bad breath is a “red flag” to help determine if this problem is prevalent in your mouth.

Healthy gum tissue forms a shallow groove at the point where the tooth meets the gum line. This disease occurs when the anaerobic, sulfur producing bacteria we discussed earlier, become trapped beneath the gum line.

This is a perfect breeding ground for the bacteria and they will settle in and take residence.

Not recognizing and dealing with the problem will result in serious dental problems up to and including loss of teeth and even underlying bone disease.

If you are diagnosed with serious periodontal disease, work to save your teeth needs to begin as soon as possible.

The first step that your dentist will take is probably what is called “scaling and root planing.” This is a non-surgical procedure to remove the deposits of plaque on the surface of the tooth including the root. Since periodontal disease rarely occurs in just one tooth, this will probably need to be done to all your teeth.

The dentist will scrap the surfaces of the tooth below the gum line to remove all traces of plaque clear down to the bottom of the pocket. He will then smooth the surface of the root to encourage healthy gum tissue to heal. This process also discourages plaque from reforming.

Depending on how involved your case might be, the dentist may prescribe medication to assist in healing or control pain and potential infection.

More diagnostics are required before a prognosis of your case of periodontal disease can be given. Each deposit of plaque creates its own “pocket” and the dentist needs to measure the depth of the pockets that were scaled during your first visit.

Often, the scaling procedure works well to eliminate the problem and you are free from further treatment other than normal examinations. At this point you would be well served by employing a daily regimen of preventative maintenance to insure the disease does not return.

However, if the diseased pockets are deep and extending into actual bone, you may need to have surgery in order to keep the teeth. If this is the case, your dentist will refer you to a periodontist, a doctor who specializes in periodontal disease.

The periodontist will use a surgical process to aggressively penetrate the diseased areas and ferret out the plaque and bacteria. The pockets where plaque resides must be sealed off so the environment does not invite a return of the disease.

In some cases bone surgery or bone grafts may be necessary to rebuild bone that was destroyed by the periodontal disease. If there was substantial tissue damage grafts may need to be used to replace the soft tissue. This procedure involves removing gum tissue from your palate to cover the areas where severe gingivitis has penetrated too far into the gum line.

Impacted Tooth

An impacted tooth is one that rebelliously will not erupt into its proper position and most often results in infection, which we know is another cause of bad breath.

Hepatic encephalopathy

This is a rare but possible cause as a result of liver disease.

Gum disease/Gingivitus

This is inflammation of soft tissue surrounding the teeth. This condition is much more serious than a single abscess. Gingivitis is the precursor to periodontitis which is the final step of gum disease that can ultimately lead to toot loss. This will be discussed in depth a bit further on.

Foreign body in the nose

Do you have small children? This is a situation that requires immediate treatment to prevent serious consequences.

Dry Mouth

Sounds like such an innocuous little phrase, doesn’t it? Thought to be a leading cause of bad breath, dry mouth occurs when saliva production is reduced and carries its own nasty little package of problems.

The medical term for dry mouth is “xerostomia” (pronounced ZEER-oh-STOH-mee-ah). Saliva performs vital work in your body. It aids in digestion by using the enzymes to help break up different foods and also makes it easier to talk.

You may not realize that it can also help to prevent tooth decay by rinsing away food particles from between the teeth as well as the gums. Saliva also helps you taste the food you eat and makes it easier for you to swallow that food. It is also known for neutralizing any damaging acids.

It is believed to be caused primarily by certain medications which we listed in the previous paragraph. The symptoms of dry mouth can include:

• Dry, rough tongue
• Poor sense of taste
• Burning sensation in your mouth
• Increased plaque
• Reduced saliva production

Alzheimer’s disease, AIDS and stroke are also attributed to causing dry mouth as well as pregnancy and/or hormonal changes due to menopause.

Increasing fluid intake can help to re-hydrate the mouth. It’s important to keep it moist so you don’t lose all the benefits provided by saliva production.

Drugs

Certain drugs such as antihistamines, antidepressants, blood pressure meds, steroids, cancer therapy drugs, diuretics and oral contraceptives are all known to increase the propensity for bad breath as well as an increased risk for gum disease.

Diabetes

People who have diabetes may also have bad breath. This occurs because of poor control of blood sugar, the problem with most diabetics. Gum disease is a problem for diabetics. And, diabetes is a problem for people with gum disease.

It can be difficult to determine which comes first, the diabetes or the gum disease, but the underlying problem is clear. High blood sugar contributes to gum disease. Diabetics have trouble controlling the high blood sugar. Gum disease is a leading cause of bad breath, hence the correlation.

The American Dental Association reports that people with type 1 diabetes 5 are at greater risk for gingivitis.

Dentures are prosthetic replacements for natural teeth and are just as susceptible to the build up of plaque which causes bad breath. Denture wearers also have a tendency toward dry mouth which also increases the risk of bad breath.

Cavities

These holes in the outer two layers of a tooth contain decay which in turn produces bad breath.

Oral Candida

This is a fungal infection of the mouth cavity. Also known as thrush, it is fairly common among infants, diabetics, chemotherapy patients and people with HIV or AIDS.

Cancers

Cancers such as esophageal, pharyngeal, oral tumors, leukemia, pulmonary and stomach cancer all present severe bad breath due to the decay that is taking place. Additionally, the medical treatments for these cancers can exacerbate the bad breath.

Atrophic Rhinitis

This is an inflammation of the nasal mucous membrane usually a result of nasal drip due to colds or sinusitis.

Alcoholism

Immoderate use of alcohol causes decreased production of saliva causing dryness of the mouth. Dry mouth is a leading cause of bad breath.

Abscessed Tooth

Infection of the tissue surrounding a tooth that usually fills with pus which has a very smelly odor.

What Is Bad Breath?

Bad breath is the side effect of the action taken by certain bacteria that live in the mouth, the tongue and the tonsils. The fact is that we all have these bacteria in our mouth. These bacteria pretty much remain dormant until some action in their environment causes them to change.

Because they are anaerobic and sulfur producing, when they react to these changes they produce chemicals compounds. Some of these compounds smell and taste terrible like hydrogen sulfide which smells like rotten eggs and other compounds. We will discuss some of these odors and possible relative odors further on.