A: More than 90 million people suffer from chronic halitosis or bad breath. In most cases it originates from the gums and tongue.

2. What causes bad breath?

A: Although there may be a number of causes, most of the time, halitosis originates in the mouth. It is caused by oral bacteria breaking down stubborn food debris and their decay. This process creates byproducts called volatile sulfur compounds, which emit a smell similar to rotten eggs. The type of bacteria that initiates this process needs an environment that is free of oxygen, so they usually inhabit areas that are difficult to reach, such as the pockets around teeth and the fissures of the tongue. In some circumstances, the odor may be caused by a systemic condition such as diabetes or a problem in the sinuses, pharynx, lungs, or stomach. Other debris in your mouth and poor oral hygiene can also cause odor. Therefore, the first step in solving bad breath problems is to undergo a medical examination to ensure that there are not any systemic problems contributing to the condition. Other factors can also cause halitosis: tobacco, alcohol, mouth rinses containing alcohol, garlic, onions, spicy food, hunger and dry mouth. These are all secondary to the main culprit - oral bacteria. If you have concerns about bad breath, please discuss this with us.

3. Can bad breath also come from other causes?

A: Bad breath also may occur in people who have a medical infection, gum disease, diabetes, kidney failure, or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to this problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath. An odor that comes from the back of your tongue may indicate post-nasal drip. This is where the mucus secretion, which comes from the nose and moves down your throat, gets stuck on the tongue and causes an odor. Bad breath originating in the stomach, however, is considered to be extremely rare.

4. What can be done to combat bad breath?

A: If it is clear that bacteria are the culprits, methods to reduce them are the first line of defense. That's why if you have bad breath, you should make sure to obtain a complete dental examination that includes a periodontal examination. Keeping your mouth as clean as possible helps eliminate bacteria. In fact, it's valuable to consider this cleaning process as "full-mouth disinfection," focusing on all areas where bacteria may reside. This "disinfection" includes thorough brushing, proper use of dental floss, mouth rinse and cleaning the tongue. At the Atlanta Center for Cosmetic Dentistry, we have a full line of breath control products from companies like BreathRx, which are designed to control or eliminate bad breath. Remember, you're not alone. We are here to help.

It is also important to practice good oral hygiene, such as brushing and flossing your teeth at least twice a day. To alleviate the odor, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue. Chewing sugar-free gum also may help control the odor. If you have dentures or a removable appliance, such as a retainer or mouthguard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouth rinses, deodorizing sprays or tablets, talk with our dentist because these products only mask the odor temporarily, and some products work better than others.

5. Why is saliva important in the fight against bad breath?

A: Saliva is the key ingredient in your mouth that helps keep the odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva allowing the bacteria to grow inside the mouth. To alleviate "morning mouth," brush your teeth and eat a morning meal. Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware because the odor may reappear even if you've brushed your teeth.

6. Do certain food cause bad breath?

A: Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach and the odor is then excreted through the lungs. Studies have even shown that garlic rubbed on the soles of the feet can show up on the breath.

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