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Halitosis May Suggest Serious Systemic Problems

Patients are often concerned about bad breath, or halitosis.  Most often, the patients themselves are unaware of a problem, but they have been told by someone who cares about them that their breathe “can peel paint off the walls.”  The good news is that “morning breathe” is normal and is usually cleared up by brushing soon after waking in the morning.  However, chronic halitosis usually has an underlying cause.

The normal bacteria in the mouth that are necessary for proper digestion proliferate during sleep when saliva flow is reduced.  Incidentally, these same germs are also the ones that cause tooth decay.  They produce secretions that build up on the tongue, which is why the tongue usually looks coated when waking.  One excellent hygiene practice to do regularly is to brush the top of the tongue thoroughly whenever the teeth are brushed, as far back in the mouth as possible.  This helps to clean the grooves in the tongue where odiferous bacteria accumulate.

Untreated periodontal disease and tooth decay cause chronic halitosis.  Again, the culprit is an abundance of odor-producing germs.  When pus and bleeding is produced, such as in a mouth with gum disease, bad breathe is a common symptom.  Sometimes prescription-strength antibiotic mouth rinses can help with this type of halitosis, but definitive treatment of the disease process is essential to treat the breathe thoroughly.

Digestive problems such as ulcers, gastric reflux disease, stomach or esophogeal cancer, etc., can also cause chronic halitosis.  Since these are outside the scope of treatment by a dentist, it is always a good idea to discuss any concerns about halitosis with both a dentist and a physician.  Often halitosis can be a significant early warning sign to something much more concerning.

Lastly, people are taking many medications today.  This is a phenomenon called polypharmacy.  One of the side effects of many of these medications is dry-mouth, or xerostomia.  Essentially, the medications shut down or reduce the amount of saliva that the saliva glands produce.  Therefore, it seems that those suffering from medication-induced xerostomia suffer from “chronic morning breathe.”  (Remember that salivary flow reduction is normal during sleep.)  There is a medication that dentists and physicians can prescribe, called pilocarpine, that stimulates the flow of saliva in these cases with reasonable success.  Besides the discomfort caused by chronic dry mouth and halitosis, medication induced xerostomia also increases the risk of tooth decay because saliva is the body’s protective mechanism against decay.

We welcome the opportunity to provide you with comprehensive oral health care and invite you to schedule a visit to meet Dr. Huff and our team.

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