Does Your Breath Stink?

So you are at a party, a funeral, or a wedding where you are in close personal contact with folks you may or may not know. Introductions are made, conversations are started. What's the one thing that can stick more in the minds of people who meet you? Well, if your breath is bad then that's the one undesirable thing people seem to remember most...trust me. And what's worse, because of social etiquette, no one will tell you.

Bad breath can have many factors. And, no, I'm not talking about "onion breath" or "garlic breath" from the spaghetti dinner you had last night. In fact, in my business, I would rather smell onions or garlic than what we in the dental field call "Perio Breath". Perio Breath is a term to describe the odor that results from the breakdown of tissues (including bone) in your periodontal pockets or small space between the edge of your gums and down inside where the gums attach to your teeth. When we converse with others, this offensive odor can be projected toward an unsuspecting victim. These periodontal spaces normally are 1-3 mm, and are pretty easily cleaned out with good brushing, flossing, and routine dental cleanings. But, especially as we age, have an underlying disease like diabetes, or if we have a genetic predication (our parents had the same problem), these pockets can get deeper. The deeper these "periodontal pockets" are, the more area for food debris, plaque, and bacteria to accumulate out of our reach. The result can be a stream of infection produced fluid that constantly seeps from around the teeth, and it does not smell very pleasant on your breath, nor is it masked for long by mouthwashes, chewing gum, or peppermints. (Sorry, I know this is a graphic description).

The bacteria and debris that collect in these deeper pockets cannot easily be reached. So, that's why we recommend 6 months cleanings for most people to clean these pockets out and remove deposits from the teeth. Like I said, "normal" pocket depths usually range from about 1-3mm, and, in conjunction with your twice a year cleanings, good home care will keep these spaces clean and healthy.

One of the most important services your dentist or Registered Dental Hygienist can provide during your routine cleanings is the measuring of your periodontal depths. I have seen folks who haven't seen the dentist for years, and who have never had a cavity, show up complaining their teeth are loose unknowingly because gum disease has destroyed the surrounding bone over the years down around the teeth in these pockets. Anything 5mm or greater needs to be taken seriously. Periodontal disease sort of feeds on itself. It can literally have a "domino effect" on your teeth (not good!). The deeper the pocket, the faster the progression (including bone loss around the teeth) can be. Deeper pockets may need more advanced treatment or a referral to a Periodontist who specializes in treating these deeper pockets. I have seen Periodontists do amazing things to stop gum disease in it's tracks, and keep people from losing their teeth in advanced cases!

Other less insidious causes of bad breath can be stomach, sinus, or tongue. Have you ever gotten your eye lashes curled in the morning by your children's or significant other's breath during allergy season? When we sleep, our sinuses can drain and coat the tongue resulting in "morning breath". Remember to brush your tongue to remove that yucky coating that can contribute to bad breath.

So try to brush at least morning and night, and floss at least once a day, especially before bed to remove plaque and debris from under your gums and around your teeth. And please see your dentist/hygienist at least every 6 months to help keep your gums healthy by removing the stuff you can't reach or that needs to be scraped off, and to allow your dentist/hygienist to monitor your probing depths. You'll be glad you did.

-Dr Culver