What Causes Bad Breath?

Bad breath may be caused by not paying enough attention to oral health, or it may be caused by different systemic problems. There are many reasons for this, but most bad breath begins in the mouth.

What Causes Bad Breath?

Bad breath basically occurs due to the effect of foul-smelling gases released as a result of the exposure of various biochemical substances in the mouth and gastrointestinal system to some chemical reactions under the influence of microorganisms. These biochemical substances may be food residues, or they may be different biological substances accumulated throughout the mouth, stomach or intestinal tissues due to the effects of different diseases.

Bad breath may occur for a short time depending on the food consumed, or it may be permanent due to some health problems. Health problems that may cause persistent bad breath must be investigated.

We can list the most common causes of bad breath as follows:

• Food residues in the mouth: If oral hygiene is not taken into consideration, food residues may fill the spaces between the teeth, anatomical areas in the mouth or tonsil grooves after eating. When they are not cleaned, microorganisms in the mouth grow in these residues and cause bad breath. Likewise, if residues remain in these areas for a long time, they may harden and lead to stone formation (dental stone, tonsil stone, etc.). Strong-smelling foods such as garlic, onions and some spices affect the breath and cause bad breath as they are digested and circulate through your body.

• Lack of oral hygiene and gum disease: If brushing the teeth, flossing, and cleaning the tongue are neglected, food particles are allowed to remain in the mouth. Bacterial breakdown of these food residues causes the odor. However, bacterial growth also increases the risk of gum disease.

• Tooth decay: Tooth decay may occur if oral health habits such as regular tooth brushing are not followed. In this case, bad breath occurs due to the effect of microorganisms found in caries.

• Plaques on the teeth: Again, due to poor oral hygiene, microorganisms cause plaque formation on the surface of the teeth. Plaques may contain microscopic food residues and cause bad breath.

• Gingivitis: Inflammation of the soft tissues and gums around the teeth, also called periodontitis, can cause bad breath as a result of infection with microorganisms.

• Tonsil and throat infections: Bad breath occurs when there are respiratory infections and inflammation of the sinuses, lungs or throat, especially mucus discharge in the mouth and nose area.

• Smoking or alcohol use: Substances in cigarettes, tobacco products and alcohol accumulate in the tissues of the mouth and cause bad odor. Moreover, consuming tobacco products increases the risks of oral and other cancers.

• Reinforcement appliance or denture (prosthesis): If any dental appliance (device) is not cleaned regularly during use, it causes bad breath. Therefore, it is very important to clean the equipment regularly.

• Dry mouth: Saliva helps clean your mouth by removing food particles. If there is not enough saliva production, food particles remain in your mouth, which can cause bad odor. Side effects of some medications, including dry mouth, can indirectly cause bad breath.

• Long-lasting hunger: In order to nourish the tissues against the falling blood sugar in case of hunger, our body increases the destruction of fatty tissues and sends temporary nutrients called ketone bodies into the blood. Ketone bodies, on the other hand, turn into foul-smelling chemicals called acetone after various chemical processes and are eliminated from the body through respiration. For this reason, persistent bad breath may occur during long periods of hunger or fasting.

• Gastroesophageal reflux: In reflux disease, which is defined as the reflux of stomach contents and food residues from the stomach to the esophagus, the bad odor of the stomach contents and food residues reaches the mouth and can cause bad breath.

• Gastrointestinal diseases: In gastrointestinal disorders that cause complaints such as indigestion and bloating in the abdomen, gastrointestinal contents may leak back and bad odor may come to the mouth through belching. In addition, gases accumulated in the digestive system during the night cause bad breath in the morning.

• Bad breath coming from the stomach: It is usually due to the digestive system not working properly. Raw vegetables, which regulate digestion, also prevent gas formation. In addition, they enable the formation of more saliva and cleanse the bacteria that cause bad odor in the teeth and tongue.

• Diabetes: In diabetes, which occurs due to uncontrolled increase in blood sugar in the body, sugar accumulates in the veins and tissues in the mouth. Bad odor may occur due to the use of this accumulated sugar by microorganisms.

• Kidney disorders: Kidneys are the organs responsible for excreting harmful substances from the body. Defects in this function of the kidneys may cause harmful substances to accumulate in the oral tissues and emit bad odor.

• Sinusitis: The nasal cavity is connected to the oral cavity through the nasal passages. For this reason, bad odors caused by the accumulation of inflammatory substances in the nasal cavity and sinuses due to infection such as sinusitis can also be felt in the mouth.

• Nose and adenoid diseases: People tend to breathe through the mouth when they cannot breathe through the nose due to reasons such as curvatures in the nose and the size of the nasal flesh or adenoids that narrow the respiratory tract. In this case, dryness may occur in the mouth, providing a suitable environment for microorganisms to multiply and spread. This can cause bad breath.

• Sleep apnea: When snoring or apnea occurs during sleep, a tendency to breathe through the mouth may occur, resulting in dry mouth. This can cause bad breath in the morning.

• Dehydration: In case of dehydration, which is known as the loss of fluid in the body, dry mouth will occur, making it easier for microorganisms to grow in the mouth, and bad breath may develop.

• Some vitamin deficiencies: In case of deficiency of some nutrients such as vitamin A, the structure of the tissues in the mouth deteriorates, creating suitable conditions for microorganisms and bad breath may occur.

• Respiratory system diseases: In cases such as bronchiectasis or lung infections, air rich in microorganisms in the lungs may come into the mouth and cause bad breath.

• Medications: Bad breath may occur as a side effect of some drug treatments.

How to Prevent Bad Breath?

The most common cause of bad breath is poor oral hygiene. For this reason, in order to treat bad breath, the person’s oral health habits are questioned and faults and wrong practices are tried to be corrected. It is very important to give the person training on how to perform correct oral hygiene and to acquire oral health habits in order to prevent bad breath from occurring or recurring.

The following recommendations should be followed in order to eliminate bad breath and protect oral health.

• Brushing your teeth at least twice a day for at least two minutes: Brushing your teeth after meals prevents conditions that cause bad breath, such as the development of cavities, tartar and plaque formation.

• Brushing the tissues in the mouth, such as the tongue and cheeks, is also very important to get rid of microorganisms there. To prevent residue accumulation and microorganism formation in oral tissues such as the tongue and cheeks, these areas should also be brushed.

• Cleaning the food accumulated in the teeth and oral tissues must also be done to eliminate bad breath. For this, dental floss can be used at least once a day. It is recommended to use dental floss to clean food residues in the mouth.

• It is beneficial to remove denture teeth at night and clean them before using them during the day to eliminate bad breath. When it comes to using prosthetic teeth, it is desirable to remove the prosthesis and clean it at night and pay attention to its cleaning before use.

• It is important to use antibacterial mouthwash after cleaning the mouth.

• Since dry mouth can directly cause bad breath, it is also very important to eliminate dryness by drinking enough fluids during the day. It is recommended to consume plenty of fluids. For dry mouth, healthy foods that require a lot of chewing and have their own juice, such as carrots or apples, can be recommended. Food will move in your mouth, helping to increase saliva. Chewing sugar-free gum or sucking on sugar-free candies may also be recommended.

• Removing or reducing foods that may cause bad breath, such as garlic, dairy products, and high-sugar foods, from consumption habits can contribute to the prevention of bad breath.

• Aromatic foods such as mint candy can be used to eliminate bad breath.

• It is also important to change the toothbrushes used every three to four months to protect against microorganisms that can grow on toothbrushes and therefore prevent bad breath.

• It is recommended to have an oral and dental examination twice a year. Regular checkups allow your dentist to detect problems such as gum disease or dry mouth and stop them before they become more serious.

• In addition, if there are oral and dental health problems such as tooth decay or gingivitis that cause bad breath, they must be evaluated by a dentist and appropriate treatment must be planned.

• Apart from these, if dental problems are eliminated by the dentist as a possible cause of bad breath and it is determined that the mouth is healthy, the patient is referred to a specialist doctor. Only a specialist doctor can determine whether you have a different health problem.

Although bad breath can be annoying, don’t let it become a social obstacle. If you are concerned about bad breath, see your dentist. Even if bad breath isn’t a problem for you, following the advice above will help you stay healthy and feel more confident about your breath.

I wish you healthy days.