Tulsa dentist Kevin Winters is often featured on KJRH’s “2 Works for You” segment. Recently, he was asked a question about bad breath and had to give a brief answer because of the time constraints for the segment. Here is a more comprehensive rundown on causes of bad breath.

Gum Disease

Right off, Dr. Winters focused on gum disease because it is not only one of the most common causes of bad breath, it’s one of the most serious. Gum disease can not only lead to tooth loss, but can contribute to heart disease, diabetes, pregnancy complications, and has even been linked to several types of cancer, including oral cancer, lung cancer, and breast cancer.

If you have chronic bad breath, this is the first thing you should check out.

Tongue Bacteria

Another common cause of bad breath is bacteria that accumulate on your tongue. These bacteria will recur regularly, but you can help keep them under control by brushing or scraping your tongue every time you brush your teeth. This will help keep bacteria under control.

Acid Reflux

Acid reflux, also known as gastroesophageal reflux disease (GERD) can contribute to your bad breath. If you have GERD, you might have undigested stomach contents rotting in your stomach. You might also be regurgitating small bits of food into your mouth and throat, leading to a bad smell.

Talk to your doctor about acid reflux if you’re also experiencing indigestion, heartburn, and other GERD symptoms. Your doctor may also point out other illnesses that may be responsible for your bad breath, such as diabetes or, in rare cases, cancer.

Infected Teeth

Another place where bacteria can accumulate is actually inside your teeth. Bacteria not only form cavities in your teeth, they use these cavities for shelter, and when cavities get large enough, anaerobic bacteria--the ones that “breathe” sulfur instead of oxygen, so they give off lots of smelly compounds--can shelter inside your teeth. Depending on the position and size of the cavity, you might also notice a foul taste in your mouth regularly.

An infected tooth will usually require root canal therapy because the bacteria is beginning to attack the nerves in the tooth, and can spread from the tooth to your bones, other teeth, and even your sinuses and brain.

Tonsil Stones

Tonsils are actually supposed to catch bacteria. They’re located on either side of your throat at the back of your mouth, and they have many folds and pockets to collect things that aren’t supposed to go down your throat. But when they accumulate too much bacteria, they can develop deposits that are called tonsil stones, which contain bacterial plaque, dead immune cells, food, and other debris. They can smell very strongly.

Usually, tonsil stones aren’t the only cause of bad breath, because all the bacteria come from someplace else. Normally, the tonsils can process and eliminate bacteria, but when bacterial levels get high in the mouth, the tonsils can’t keep up and they develop stones. So if you develop tonsil stones regularly, we will want to investigate other possible sources of bacteria.

Dry Mouth

Another potential cause of high bacteria levels in your mouth is a dry mouth. Saliva is your body’s natural antibiotic, and when you’re not producing enough of it, bacteria can flourish. You may also have a harder time clearing food from your mouth, which gives more fuel for bad breath. You can brush and floss to help control bad breath, but avoid alcohol-based mouthwashes, which can actually dry your mouth out more.

Treating dry mouth involves identifying the cause and treating it or supplementing saliva with artificial alternatives.

Retained Food

Ever get food stuck between your teeth? If you don’t know that you have food stuck in your teeth or don’t remove it quickly, it can spoil, giving you very bad breath. Food can get stuck in your teeth if you have a large cavity or it can get stuck between teeth if your teeth have gaps. Large deposits of tartar--hardened plaque--can also create shelves where food gets trapped and oral bacteria can shelter.

A cleaning can remove the tartar. Reconstructive dentistry can be used to close holes in your teeth, and orthodontics can close tooth gaps.

Diet and Medications

Your diet can also contribute to your breath, beyond the short term “garlic breath.” If you are on a low-carb diet you can change the way your body metabolizes food. You enter a state called ketosis, which can increase the concentration of ketones in your breath, creating a distinct odor.

Dry mouth is one of the most common side effects of medications, which is how they normally cause bad breath, but sometimes they break down into chemicals with a particular odor.

Sleep Apnea, Snoring, and Chronic Morning Breath

Morning breath is a side effect of increased bacterial levels overnight. Your saliva production decreases overnight, and bacteria take advantage of the opportunity. Everyone experiences morning breath sometimes.

But if you have very bad breath every morning with a dry mouth, headaches, and you’ve been told about your snoring, it’s very likely you have sleep apnea. Unfortunately, the most common treatment for sleep apnea, CPAP, can actually make your morning breath worse, although it does a good job of treating other sleep apnea symptoms.

We can also treat sleep apnea with an oral appliance, which is not only more comfortable and convenient than CPAP, it isn’t going to make your bad breath worse.

We Can Track Down the Cause of Your Bad Breath

No matter what is causing your bad breath, we can track it down and recommend the proper treatment so that you can enjoy fresh-smelling breath again.

To learn what’s behind your bad breath in Tulsa, please call (918) 528-3330 today for an appointment at Winters Dental Excellence.