Bad Breath and Why People Get It

 Bad Breath, otherwise known as halitosis, is experienced by millions of people every day. Halitosis can be a minor transitory embarrassment or it can be a constant severe problem that never goes away and consumes one’s life and is a constant source of embarrassment.  There are numerous reasons a person might experience bad breath, but at the same time there are a lot of myths surrounding the causes and treatments for halitosis. I will touch on some of the more common causes and also some common myths surrounding this condition. Let’s address some common causes of bad breath first.

Probably the most common cause of halitosis is simply poor oral hygiene. This is usually the main cause of minor transitory bad breath issues and is easily resolved with proper oral hygiene. Gum disease, also known as periodontal disease, can produce mild to severe chronic halitosis. The gram (-) anaerobic bacteria that are responsible for causing gum disease produce volatile sulfur compounds (VSC), and these are what people notice when they are near someone with bad breath. Once the gum disease is treated the bad breath usually resolves rather quickly. The most common reason people suffer from long term chronic halitosis is due to an imbalance in the oral bacteria in their mouth. This does not mean they have poor oral hygiene. It merely means they have more anaerobic bacteria in the mouth than they normally should. There are numerous reason why this imbalance may occur but some common causes are due to dryness of the mouth (xerostomia), excessively long taste buds that allows excessive anaerobic bacteria and mucous to accumulate in and on the tongue, and post-nasal drainage which results in the buildup of a biofilm or mucous on the tongue. I have been treating patients with the chronic forms of halitosis for over 18 years and many of our patients travel great distances to seek a resolution to their condition. In fact the majority of our patients travel from outside of the state or even the country to seek our help. It may be hard to understand why someone would travel such distances for help with this problem but unless you have experienced such a condition is it hard to relate to it, or understand how much it can affect a person’s life. Over the years I have studied the causes or etiologies of chronic halitosis and this has provided me an insight as to how to help patients suffering from this problem.

Unfortunately there are a lot of myths related to halitosis, it’s causes, and how to resolve it.  Some common myths that we see related to halitosis are:


1.     Halitosis comes from the stomach.
        Only in extremely rare cases does this occur. Cleansing the intestines offers no benefits in
        treating halitosis.

2.     Halitosis comes from the lungs.
        Only rarely does this occur and it can be a manifestation of a serious disease.

3.     Halitosis is a hereditary problem.
        This is absolutely not true. Certain conditions that can contribute to a bad breath condition can
        be hereditary, but there is no halitosis gene that can be passed on to an offspring.

4.     Mouth washes and breath mints can help a breath problem.
        This is not true. They only mask the problem for a few short minutes at best. Alcohol based
        mouthwashes in fact will worsen the problem because they dry out the mouth thus increasing
        the volatilization of breath odors.

5.     Internal breath fresheners can eliminate a chronic halitosis condition.
        Products taken for food-induced odors will have little effect on a chronic halitosis condition.
        There are, however, many food induced odors that can be offensive to others and there are ways
        to resolve those types of problems. The only product we have tested that has been shown to be
        effective against food induced odors such as garlic breath or onion breath is a product called
        Breath Gemz™. This product has the ability to eliminate the odors during or even well after a
        person consumes the foods that will produce strong or offensive breath odors.

6.     Brushing my teeth more will help eliminate my breath condition.
        This is also not true. Excessive brushing can dry one's mouth, thus increasing the halitosis
        problem. Excessive brushing can also damage the teeth and gums over time. It is very difficult
        to remove the specific odor causing bacteria with brushing and flossing alone, and most patients
        we see at our center tend to have very good oral hygiene.

7.     Halitosis is caused by foods.
        Foods such as onions, garlic, or cauliflower can induce certain odors but these are only
        transitory, and can be easily eliminated by avoiding that particular food. The odors they produce
        also are not of the "sulfur" type commonly seen in true halitosis conditions, and generally are
        not as offensive.

8.     There is no treatment for halitosis.
        There is a highly effective treatment for this problem, at the Center For Breath Treatment.

9.     Probiotics can help in eliminating my bad breath.
        There is no scientific evidence to support the benefits of probiotics in the treatment of halitosis.
        The use and benefits of probiotics for treating a bad breath condition is very overstated and over
        simplified. For that reason we do not recommend the use of these products.

10.   I have heard that the bacteria H. Pylori causes halitosis. Is this true?
        This is absolutely false. H. Pylori is a common cause of peptic ulcers and when patients have
        been placed on antibiotics to eliminate the H. Pylori they sometimes find that their chronic
        halitosis condition improves. The reason for the improvement has nothing to do with the
        elimination or reduction of the H. Pylori. I may occur because the antibiotics temporarily reduce
        the amount of the anaerobic bacteria that are contributing to the halitosis condition. Once the
        antibiotic regimen is completed the bad breath always returns.

11.   Rinsing with hydrogen peroxide will help cure my bad breath.
        Hydrogen peroxide has never been shown to be helpful in treating halitosis. It is considered a
        cytotoxic product (toxic to cells) that will damage the tissues in the mouth. An occasional use of
        the product will not cause any significant damage to the oral tissues but any prolonged or regular
        use of hydrogen peroxide will breakdown the tissues and cause ulcerations of the tissues. We
        recommend patients do not use it for oral purposes.

When patients seek help from us in resolving a chronic halitosis condition we take them through a diagnostic process in which we determine what the causes of their halitosis condition are. There are always multiple causes and therefore the treatment usually requires a combination approach to resolving it. Treatment typically is focused on addressing the conditions that are resulting in the bacterial imbalance. For more information on treating this problem please visit the section on halitosis treatment on our web site.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

New Clinical Recommendations: Maintain Oral Health During Pregnancy

New clinical recommendations from the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) are urging expectant mothers to be diligent about maintaining their periodontal health as research has indicated that women with periodontal disease may be at increased risk of adverse pregnancy outcomes such as giving birth to a preterm or low weight baby.

Tenderness, redness, or swollen gums are a few of the indications of periodontal disease. Other symptoms include gums that bleed from toothbrushing, flossing, or eating, or even loose teeth. It is not uncommon for pregnant women to experience what is called “pregnancy gingivitis” during their pregnancy. These symptoms should not be ignored and it is important to see one’s dentist regularly during pregnancy. See Different Types of Gum Disease on our web site and see information about the different types of gum problems and how they differ.

The clinical recommendations released by the AAP and EFP state that nonsurgical periodontal therapy is safe for pregnant women. Routine brushing and flossing accompanied by regular trips to the dentist for prophylaxis and a comprehensive periodontal evaluation during pregnancy may decrease the chance of adverse pregnancy complications. By maintaining your periodontal health you are not only supporting your overall health, but also helping ensure a safe pregnancy and a healthy baby.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

The Link Between Oral Bacteria and Joint Failure

Joint Failures Potentially Linked to Oral Bacteria

 ScienceDaily (Apr. 18, 2012) — The culprit behind a failed hip or knee replacements might be found in the mouth. DNA testing of bacteria from the fluid that lubricates hip and knee joints had bacteria with the same DNA as the plaque from patients with gum disease and in need of a joint replacement.
This study is one of many that came from the Case Western Reserve University School of Dental Medicine that have linked oral bacteria to health problems when they escape from the mouth and enter the blood. Working with University Hospitals Case Medical Center researchers, the dental, orthopedic and arthritis researchers suggest it might be the reason why aseptic loosening or prosthetic wear of the artificial joints fail within 10 years when no infection appears to be present. The pilot study's findings were reported in the April issue of the Journal of Clinical Rheumatology.
Dr. Nabil Bissada, chair of the Department of Periodontics at the dental school, said the objective of the study, "Identification of Oral Bacterial DNA in Synovial Fluid of Patients with Arthritis with Native and Failed Prosthetic Joints," was to see if bacteria like Fusobacterium nucleatum and Serratia proteamaculans found in patients with gum disease were present in the fluid. "For a long time, we've suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," Bissada says.

The researchers recruited and studied patients seeking care at the University Hospitals Case Medical Center for osteoarthritis (the wearing of the joints) and rheumatoid arthritis (an autoimmune disease). These study participants had both natural and artificial joints. Researcher extracted samples of their synovial fluid, which is much like oil that keeps a door from squeaking. These patients also had signs of periodontitis or gum disease and undergone exams where dental plaque was obtained for the study.

Plaque build-up from the bacteria, associated with gum disease, breaks down the walls of the pockets around the teeth. The inflammation process from the bacteria acts like a gate that gives bacteria access to the blood stream. Once in the blood, the oral bacteria can induce inflammation in remote sites. These oral bacteria have been linked to heart and kidney diseases, and premature births and fetal deaths. Because these bacteria cannot be found with routine lab tests, DNA sequencing analysis of the oral bacteria and the joint fluids are performed. 

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Periodontal Disease and Your General Health

Welcome to the first article of our new blog. Our dental office, Anthony Dailley DDS www.dailleydds.com regularly sends out similar electronic newsletters to our patients to keep them abreast of the lastest developments in dental health. We hope our blog will provide readers with additional knowledge about their dental health and what modern dentistry has to offer. Below is an article about how gum disease can effect much more than just one's oral health.

Anthony Dailley DDS

The relationship of periodontal disease to disorders elsewhere in the body has attracted a great deal of attention from the dental and medical professions, as well as from the public.  Numerous studies have emphasized that the oral cavity, and the periodontal tissues specifically, can affect other tissues and organs.  In essence, these studies have connected the mouth to the rest of the body and have resulted in physicians and nurses becoming more aware of diseases of the teeth, gums, and other structures in the oral cavity. Many studies recently published in medical and dental literature suggest that the mouth truly is a window to the body.  In fact many systemic diseases can manifest themselves orally well before any other signs or symptoms have become apparent medically.  The oral cavity is affected by inflammation (in particular periodontal disease).  The toxins produced by the oral bacteria that are responsible for periodontal disease can harm wherever they travel to in the body. Scientist have observed a connection between oral health and heart conditions.  In a study published in the International Journal of Cardiology found that patients who had suffered recent heart attacks had noticeably worse oral health compared to those patients with healthy hearts.  Multiple studies, including a recent report in the Journal of Clinical Periodontology show a startling correlation between patients with periodontal disease and those with heart disease.  The more severe the gum disease, the thicker and harder the walls of the arteries.  This is even true for young adults with no symptoms of heart problems.  There are increasing links between oral health and conditions such as diabetes, kidney disease, preterm labor, osteoporosis, and even Alzheimer's disease.  A 2007 report in the New England Journal of Medicine noted that patients who had their periodontal disease treated emerged not only with healthier gums but with healthier endothelial function which is a measure of health or the lining of the blood vessels.  The alarming fact is that more than 80% of adults aged 20-64 in the U.S. have some form of periodontal disease.  Maintaining good oral hygiene habits and regular visits to the dentist to prevent and manage periodontal disease are becoming more important as it relates to one's general health. “We all think that cholesterol is important to heart disease. The health of your gums is a more  important predictor of whether you will have a heart attack or not.” Mehmet C. Oz, M.D. F.A.C.S Director,Cardiovascular Institute Columbia University Medical Center, New York, NY   About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.