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What Causes Bad Breath?

From The Perio Group  

Are There Links Between Gum Disease and Cardiovascular Disease?

Dr. Stephen Brown, DDS.
Professor of Periodontics, University of Pennsylvania School of Dental Medicine
Professor of Periodontology and Oral Implantology, Temple University School of Dentistry
Director, Dental Implant Division, Albert Einstein Medical Center

What Causes Bad Breath?

Bad breath is a condition affecting over 80 million Americans. Temporary malodor, or the more persistent condition known as halitosis, can be caused by certain foods or systemic disease, but more often, it is due to a combination of poor oral hygiene and gum (Periodontal) disease.

The warm, dark, moist environment of the mouth, with many hidden spaces, is populated with more than 500 different types of bacteria. These germs are often found in gum pockets and on the surface of the tongue. 

Microorganisms feed on leftover food particles and naturally occurring sulfur containing proteins. Bacteria digest these proteins then produce the familiar rotten egg smelling gases known as Volatile Sulfur Compounds (VSCs).


Mouthwashes, Breath Mints, Toothpaste, Chewing Gum and other commonly used “remedies” represent a billion-dollar industry of products that are largely ineffective in eliminating bad breath. 

At best, they provide momentary “perfuming” of the breath. Such attempts are doomed to failure. They represent nothing more than an unsatisfactory attempt to minimize the results, without eliminating cause.

How Can This Condition Be Improved?

Bad breath can usually be avoided by proper dental care and prevention of gum disease.

Gum Disease is caused by bacteria which result in the buildup of plaque, often called Gingivitis in its early stages then periodontal disease as it progresses. 

Periodontal disease affects an estimated 80% of adults and left untreated, may lead to gum recession, tooth loss and other, potentially life-threatening health problems.

Gum Disease, Bad Breath and Other Health Problems

Gum disease may also be connected to damage elsewhere in the body. People who have gum disease are at a much higher risk for heart attack and other systemic diseases. Recent studies suggest a link between oral infections with diabetes, heart disease, stroke, and premature, low-weight births. Your teeth and gums can hold important clues to overall health.

One of the mechanisms for this is bacteria hidden within the infected gums and tongue surface, which can dislodge and attach to plaque in the arteries.1

For the elderly, “an association between oral conditions such as periodontal disease and Respiratory Diseases has been noted. Recent evidence has suggested a central role for the oral cavity in respiratory infection. The teeth may serve as a reservoir for respiratory pathogens, and oral bacteria can be aspirated into the lungs to cause pneumonia.”2

Effective Methods of Treating Bad Breath

Bad breath is treated by minimizing or eliminating the bacteria associated with periodontal disease by treating active gum disease, thoroughly removing bacteria, and eliminating foreign material and dead tissue from the surface of the tongue.

Best treatment methods:

  • An oxidizing agent (Activated Chlorine Dioxide) to eliminate existing odors (VSC’s)
    • Kills the odor-producing germs
    • Neutralizes sulfur proteins used by the bacteria

  • Combining this three-pronged attack:
    • Treating the gum disease
    • Removing the bacteria from the tongue
    • Neutralizing the gases with an oxidizing agent

  • Periodontal Maintenance
    • The most comprehensive and effective means for eliminating chronic bad breath.
    • Routine preventive periodontal maintenance, no less than four times a year, will insure ongoing freedom from breath malodor.

Cited Sources:

  1. AcademyofGeneralDentistry, Oral Health Resources, March 2007
  2. J. of Periodontology, July 99, vol. 70, No. 7, 793-802

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