What Causes That Stink Gross Breath?

If you've ever encountered bad breath in someone close to you, or perhaps even yourself, you know that it's one thing you want to get rid of fast! Getting rid of bad breath is sometimes easier said than done!  To effectively treat or manage bad breath, you need to know what's causing it. 

Bad breath isn't anything new. Records from the 1500's BC show that some people used a mixture of wine and spices to cure bad breath!  That's not a bad approach. The alcohol in wine can kill bacteria that cause bad breath, but since bacteria regrow readily in the mouth, this is – like mouthwashes from today – a temporary remedy.

Every dental hygienist program teaches that the primary cause of bad breath is, in fact, bacterial growth in the mouth.  The best way to manage oral bacteria is to practice good dental hygiene.  That involves regular brushing, flossing and the use of mouthwash. But there's a catch.  Simply brushing your teeth won't remove enough bacteria to make an effective dent in their numbers.  In addition to brushing your teeth, you also need to pay a little extra attention to your tongue. 

Bacteria set up shop on your teeth and their growth and byproducts are very easily seen, but the truth is that 80%-90% of the bacteria in your mouth lives in, on or around your tongue. These bacteria thrive in the moist environment of your mouth. Despite the fact that your mouth, gums and teeth are constantly bathed in saliva, your tongue is actually relatively dry.  Small food particles, dead skin cells from your tongue, gums and cheeks, and sinus drainage make the ideal soup for certain kinds of bacteria.

Not surprisingly, your tongue – much moreso than your teeth – is the source of most cases of bad breath. Changing the environment in your mouth is key to reducing the size of the bacterial colonies that live there. You can reduce bacterial growth on your tongue and in the other soft structures in your mouth by brushing your tongue (just like you'd brush your teeth) and by using mouthwash for at least 30 seconds two times per day.

Bacteria will always grow in your mouth, so you'll need to make these steps part of your oral care routine.  Alcohol-based mouthwashes are effective at killing bacteria, but non-alcohol based mouthwashes are just as effective and may be easier to tolerate, especially for children.

Your tongue isn't the only source of bad breath. Other soft structures in your mouth can cause bad breath, too.  Gum disease is a source of bad breath, as are dental infections.  Your tonsils have crypts (little empty spaces) that can harbor food particles and other materials. As these decay, they can produce some pretty foul breath. 

Gum disease is best treated by dental professionals, who can prescribe a regimen that can help decrease swelling, bleeding and bacterial growth. Mouthwash is also effective at reducing foreign matter that becomes lodged in the tonsillar crypts, provided that you can get the mouthwash far enough into your mouth to reach them.

Bad breath can also be symptomatic of other problems outside of your mouth.  Your esophagus is the structure that runs between your mouth and your stomach. Food particles that are lodged in your esophagus can cause bad breath. The muscular valve at the base of your esophagus can also weaken or fail to close properly. This can produce a range of problems, including acid reflux and gastroesophageal reflux disease (a chronic condition). A hiatal hernia can also prevent this valve from closing properly, leading to the escape of acid and unpleasant odors from your stomach. 
Rarely, other serious conditions like cancer, diabetes, and serious respiratory infections can also cause bad breath. These conditions must all be treated by medical professionals.