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May 21st, 2014

Halitosis, commonly called “bad breath”, is thought to affect as many as 50% of the adult population and can be a chronic, persistent problem in as much as 25% of the cases.  Dentist’s are often consulted in trying to identify and control the cause of the condition. Like many medical problems, every patient is an individual and the causes can be quite varied.  A plan must be formulated and tailored to the patient’s needs and conditions.
The word halitosis is derived from Latin (haliatus -breath) and Greek (osis – condition or pathologic process).  Combined in English this translates to “bad breath” and most patients would rather not have the problem.
Persistent, chronic halitosis can be caused by a single factor, or by a combination of factors including poor oral hygiene, deep tooth decay in one or more teeth, periodontal (gum) disease, oral infections, disease around dental implants, infected wisdom teeth, ulcerations in the mouth (such as canker sores), certain foods, food impacted in hard to clean areas, coatings on the tongue, poor flow of saliva, and improper cleaning of removable appliances (dentures, retainers, etc.).
Interactions of oral bacteria and many of these factors results in production of various chemical compounds, notably volatile sulfur compounds (VSC’s) having the odor of “rotten eggs” or “rotten cabbage”.  Additionally, some VSC’s are produced when foods such as garlic are ingested and metabolized.  Here the VSC’s are secreted in the lungs and come out when exhaling.  These won’t be treated with any amount of mouthwash or tooth brushing.
With so many factors involved, it is important to inform your dentist that the problem exists and allow the dental team to get all the information necessary to evaluate the condition and formulate a plan for treatment.
What medications are being taken can be an important factor as many will affect saliva production.  Blood pressure, heart and anxiety medications are just a few of those that can cause dry mouth.  Auto-immune diseases may also decrease salivary flow.
Other conditions such as sinus infection, lung disease, poorly controlled diabetes, and gastro-intestinal disorders (just to name a few) may demand referral to a medical specialist.
Of course, dental problems can be diagnoses and treated by your dental team.  Again, an individualized approach is key to solving the problem.

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