Halitosis: Breath Behaving Badly

The following information sheets have been designed to be copied and distributed to your patients. Anyone who has purchased this course may use the following sheets. You may use them as they are or retype on office letterhead for personalization.

DO I HAVE BAD BREATH?
Just about everyone has a bout of bad breath every now and then. It is very common to wake up with bad breath or have bad breath after eating certain foods.

WHERE DOES THE ODOR COME FROM?
In the most common forms of bad breath, the odor comes from the activity of bacteria in the mouth, usually from the back part of the tongue. Microorganisms in the mouth break down proteins and produce putrid gasses.

Bad breath can come from gum disease, especially if you notice the odor particularly when flossing the areas between the teeth and gums yields a foul odor. Your dentist can provide treatment for gum diseases in various ways, depending on the type and extent of the problem.

BAD BREATH ODOR USUALLY COMES FROM THE ACTIVITY OF BACTERIA IN THE MOUTH
The most common cause of bad breath is bacteria on the back part of the tongue. This bacteria lives deep in the tiny grooves of the tongue and digests proteins to produce putrid gasses.

IS THERE A CURE FOR BAD BREATH?
Bad breath is usually treatable once a proper diagnosis is made.

WHAT SHOULD I DO IF I HAVE BAD BREATH?
Practice thorough oral hygiene including flossing and gentle tongue cleaning. Use an antibacterial mouth wash approved by the ADA. If you still have bad breath, you should make an appointment to see your dentist.

When you make the appointment, tell the receptionist that you want to discuss bad breath. Try to notice when the bad breath is most noticeable. Ask a family member or a friend to help you understand the intensity and odor of your breath.

On the day of the appointment, try not to eat, drink, smoke, chew gum, eat candy, or use mouthwashes for at least 2 hours before the appointment so that a normal sampling can be taken. Try not to wear heavy perfumes or cosmetics that might mask the odor of the breath.

WHAT WILL HAPPEN AT MY APPOINTMENT?
The dentist will ask you questions about your medical history and medications you may be taking now. He or she will also perform a complete examination of your teeth and gums to look for cavities or infections. Some dentists have special machines to test the breath for gasses.

If you have no medical problems and have healthy teeth and gums, the odor probably comes from the back part of your tongue. The dentist can scrape off a plaque from this area using a plastic spoon. The odor coming from this sample can be compared to the general odor.

WHAT TYPE OF TREATMENT IS AVAILABLE FOR BAD BREATH?
If the odor is coming from a dental or gum problem your dentist will recommend dental treatment. The dentist may also suggest regular rinsing with a mouthwash that is scientifically shown to reduce bad breath. If the tongue is the source of the problem, then the dentist can recommend a method of cleaning the tongue, either with a toothbrush, or a special tongue scraper. This method may be difficult at first because it may trigger your gag reflex, but time and practice will help you overcome this.

Your dentist may also refer you to a clinic that specializes in bad breath, or to another medical expert.

WHAT ELSE CAN I DO?
Normally, the treatment and regular home care your dentist recommends will take care of bad breath. It is important to practice home care daily to prevent the bacteria from colonizing on your tongue.

Listed below are some of the Do's and Don'ts regarding bad breath.xxv Remember, bad breath is a problem that needs professional attention. Don't mask it - deal with it.

Do's

Visit your dentist regularly.
Have your teeth cleaned periodically by a dental professional.
Floss or otherwise clean between your teeth, as recommended by your dentist. Choose unscented floss so that you can detect those areas between your teeth that give off odors, and clean them more carefully.
Brush your teeth and gums properly.
Ask your dentist to recommend a toothbrush or scraper for your tongue. Clean your tongue all the way back gently, but thoroughly.
Drink plenty of liquids.
Chew sugar-free gum for a minute or two at a time, especially if your mouth feels dry. Chewing parsley, mint, cloves or fennel seeds may also help.
Clean your mouth after eating or drinking milk products, fish and meat.
Unless your dentist advises otherwise, soak dentures overnight in antiseptic solution.
Get control over the problem. Ask a family member to tell you whenever you have bad breath.
If someone in your family or a close friend has bad breath, find a kind way to let them know. If you can't tell them directly, leave this fact file lying around. They may get the message.
Ask your dentist to recommend a mouthwash which has been shown to be clinically effective in fighting bad breath. Use it right before bed time for the best effect.
Eat fresh, fibrous vegetables such as carrots.

Don'ts

Don't let your concern about having bad breath run your life. Don't be passive.
Don't be depressed. Get help. Don't ignore your gums - you can lose your teeth as well as smell bad.
Don't drink too much coffee - it may make the situation worse.
Don't forget to clean behind the back teeth in each row.
Don't brush your tongue with regular toothpaste - it's better to dip your toothbrush in mouthwash for tongue cleaning.
Don't run to the gastroenterologist for concerns of having bad breath - it usually comes from the mouth and almost never from the stomach.
Don't give mouthwash to very young children, as they can swallow it.
Don't clean your tongue so hard that it hurts.
Don't rely on mouthwash alone - practice complete oral hygiene.

Proper home care will give you fresh breath and will keep your teeth and gums healthy.

What is Plaque?
Bacteria lives in your mouth. The foods you eat can be turned into acids by this bacteria. The acids can cause decay in the teeth.

Bacteria colonizes and forms a sticky substrate called plaque. Plaque produces irritation to the gums, making them red, tender or bleed easily. If they are irritated for long enough they pull away from the teeth and form pockets where bacteria thrives and infections form. If the gums are not treated, the bone around the teeth can be destroyed. If the supporting bone of the teeth is destroyed, the tooth will be lost.

Regular Daily Home Care of the Teeth and Gums xxvi
Plaque forms every day, so you should brush your teeth every day. The American Dental Association recommends the following:

Use a soft-bristled tooth brush to clean your teeth at least twice a day. Use a brush appropriate to the size of your teeth and mouth. Choose a fluoride toothpaste that displays the American Dental Association Seal of Acceptance because it shows the product meets the stringent quality guidelines of the ADA.

Use dental floss every day to remove plaque and debris where the brush doesn't reach.

Clean your teeth regularly, eat a balanced diet and visit your dentist regularly to protect your valuable teeth and gums.

You probably already know the basics of brushing and flossing, but here are a few pointers to improve your technique.

Brushing Tips

Place the toothbrush bristles against the gums at a 45-degree angle.
Move the brush back and forth gently in short (one tooth wide) strokes.
All surfaces of the teeth need to be cleaned: the inner areas (by the tongue), the outside areas (by the cheeks and lips), and the grooved biting surfaces.
Turn the brush to use the whole length of it to clean the insides of the upper and lower front teeth.

Flossing

Break off about 15 inches of a strong floss and wind most of it around one of your middle fingers. Or you can tie the two ends of the floss together to form a circle.
Wind some of the floss around a finger of the other hand.
Hold the floss taunt between your thumbs and forefingers. Guide the floss between your teeth using a gentle back and forth motion. Don't snap the floss between the teeth.
After the floss is through the tight area between the two teeth, curve it into a C shape against one tooth. Gently slide it up and down the tooth and under the gum line.
Do the same thing for the side of the other tooth.
Advance the floss so you use a clean area between each tooth.

Tongue Cleaning

Gently brush the tongue with a regular toothbrush dipped in an antibacterial mouth wash. Reach back as far as you can without hurting yourself. At first, you may gag, but practice will decrease this natural urge. Rinse the toothbrush well and repeat a few times until the white coating on the surface of the tongue is removed. Be gentle so the delicate tissues are not damaged.
Special tongue cleaning devices may be used. Gently scrape the surface of the tongue according to the manufacturer's directions.