Article reposted from bristlehealth.com Written by Brian Maurer
Halitosis, or bad breath, is a common condition in oral health care that affects people of all ages and can decrease self-confidence and social interactions. Estimations state that 50% of people experience halitosis regularly.
“Most of my patients are timid when talking about bad breath. My approach is discussing the mouth and body as a whole versus separate entities and helping the patient maximize their overall health. This is because bad breath is usually associated with sub-optimal health in some form. It’s important for me to understand the underlying issue to devise treatment solutions for their bad breath.” – Dr. Chris Strandburg, DDS
Since bad breath can be not only annoying but also hazardous to our health, it is vital to introduce new oral hygiene recommendations and proper oral health care rituals.
Let’s take a closer look at what causes bad breath and what we can do to keep our breath fresh.
Most common causes of halitosis
The sources of halitosis fit two categories: intraoral (in the mouth) and extraoral (from outside the mouth).
Below we will explore the most common causes of intraoral and extraoral halitosis.
Intraoral halitosis
Intraoral halitosis is responsible for approximately 90% of halitosis cases. It’s caused mainly by a buildup of molecules called volatile sulfur compounds (VSCs), which have an unpleasant odor.
VSCs include hydrogen sulfide (which has a rotten egg smell) and methyl mercaptan (producing a bad cabbage smell). When VSCs build up in our mouths, their unpleasant odor diffuses as we breathe and speak.
Factors that influence the levels of VSCs in our mouth include oral bacteria, oral disease, tongue coating, and dry mouth.
Oral bacteria
Our mouths are filled with bacteria, fungi, and viruses – collectively called our oral microbiome. Most of these species are beneficial and help us extract vitamins from our food, fight off infection, and even reduce our blood pressure and increase our cognitive function. But some species are harmful and lead to conditions like bad breath, cavities, and gum disease if they grow too large in number. More and more dentists recommend frequent oral bacteria tests to prevent bacteria-related diseases.
Oral bacteria are the primary producers of VSCs in our mouths. Certain species, including S. moorei, P. gingivalis, and P. nigrescens, break down proteins in our diet and release VSCs as a byproduct – leading to bad breath. Studies have found direct associations between the levels of these species and the amount of VSCs they produce.
As these bacteria build up they arrange themselves into a community structure called a biofilm. This all starts with individual bacteria colonizing our teeth, which can take place minutes after a professional cleaning. Hours later, this turns into biofilm, and during the rapid growth stage, the bacteria (biofilm) starts to multiply throughout the mouth.
You can typically feel this biofilm as a slimy coating on your teeth or tongue. These bacteria are anaerobic, which means they cannot survive in oxygen. Forming this biofilm allows them to create a protective layer from oxygen and disturbances to continue multiplying. As this biofilm develops further, it will harden into dental plaque on our teeth and gums, a coating on our tongues, or “stones” on our tonsils, making it harder to remove.
