Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.
There are various causes that attribute to bad breath, but in healthy people, the major source is microbial deposits on the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

WHAT CAUSES BAD BREATH?
Morning time – Saliva flow almost stops during sleep, reducing its cleaning power and allowing bacteria to grow, which results in bad breath.

Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.

Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.

Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.

Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.

Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
Tobacco products – Dry the mouth, causing bad breath.

Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.

Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.

Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.
Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist.

What can I do to prevent bad breath?
Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.

See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits.

Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.

Drink water frequently – Water will help keep your mouth moist and wash away bacteria.

Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath.  If it is determined that your mouth is healthy and bad breath remains persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

Smoking or chewing tobacco – Tobacco users are more likely than non-users to form plaque and tartar on their teeth.

Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

SIGNS AND SYMPTOMS OF PERIODONTAL DISEASE
Red and puffy gums – Gums should never be red or swollen.

Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

Persistent bad breath – Caused by bacteria in the mouth.

New spacing between teeth – Caused by bone loss.

Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

Pus around the teeth and gums – Sign that there is an infection present.

Receding gums – Loss of gum around a tooth.

Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.