“10 Years
– And I Still Have Bad Breath” –

Alvin H. Danenberg, DDS • Nutritional Periodontist
September 26, 2016 [printfriendly]

many causes of bad-breathEmily scheduled a telephone consultation with me the other day. Her problem has distressed her for years, and she was clearly frustrated.

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She explained to me that she had been trying to prevent bad breath for over 10 years! She described how her coworkers would shy away from her. Only her closest friends would tell her that she had bad breath. She went to her medical doctor years ago to try to figure out what was going on – only to be rebuked. Her MD poo-pooed the whole idea and said her bad breath was not caused by a medical problem.

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Then Emily went to her dentist who examined her mouth and suggested more frequent cleaning appointments with the dental hygienist. That made sense to Emily, but after repeated cleanings, there was no difference. Confused, Emily began to research other solutions for her problem.

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During her unsuccessful efforts to find the answers, she did begin to eat a more nutritionally balanced diet. Emily felt better and had more energy, but she still had bad breath. She finally discovered me online and sought my opinions.

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First, I explained the obvious causes of bad breath, which she already knew and investigated. Then I explained some underlying medical issues, which could be the cause and which needed to be ruled out by a medical doctor. Her previous medical doctor never suggested these steps. I gave Emily some names of medical doctors who also practiced functional medicine in her local area and who could perform a thorough medical exam incorporating functional testing. Finally, I made some recommendations for her to try right away. Here is a summary of my discussion with Emily:

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Obvious Causes

First of all, look for the most obvious causes. In Emily’s case, she already did that. But, as a review, here they are.

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Most bad breath comes from gum infections, decaying food particles in the mouth, or from foods you have eaten that produce strong odors as they are digested. To take care of gum infection or decaying food particles, you must clean your mouth correctly and efficiently. HERE.

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There is very little you can do if you eat foods that create odors. As these foods are being digested, they produce gases, which can pass through the lungs and are exhaled as bad breath. You might be able to reduce these odors if the foods are cooked rather than eaten raw. Also, eating green leafy vegetables either during or after the offending foods may help neutralize some odoriferous foods like onions and garlic.

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Since Emily had addressed these causes with no change in her bad breath, I then delved into the causes that may not be so obvious.

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Not-So-Obvious Causes

  • Specific prescription medications and various nutritional supplements can create unique and unpleasant odors. To remove these odors, you would need to stop taking those medications or supplements.
  • Dry mouth or reduced saliva flow could cause bad breath. HERE. Dry mouth may be a result of taking certain medications or may be a result of a disease in, or damage to, the salivary glands. HERE. Bad breath also could be a result of psychological stress, which often could reduce salivary flow. HERE. A simple solution would be to have bottled water available to drink as frequently as necessary.
  • The tonsils that are located on the sides of the throat just past the tongue can lodge calcified bacteria, which are known as tonsil stones. They may look like small, white nodules that can harbor significant odor. If you gargled with warm salt water, you might be able to dislodge them. If not, a dentist or an “ear, nose, and throat specialist” could do that for you.
  • If bad breath is still a problem, definitely make a nutrient-dense, anti-inflammatory diet part of your lifestyle. HERE. Nutrient-dense foods and anti-inflammatory foods will help keep bad bacteria in check and will support a healthy immune system – all of which support pleasant breath.

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Many of the causes I have described up to this point are under your control. The following are trickier and will require a healthcare professional.

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Specific diseases need to be ruled out by a physician who may need to perform some medical tests. Infections and lesions in the sinuses, stomach, lungs, intestinal tract, pancreas, liver, and kidneys are potential problem areas. Also, if foods are not digested properly and completely, their remaining particles could become putrid and create strong odors.

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Functional medicine testing could shed some light on the source of bad breath. HERE. Your doctor may want to order a stool test. Also, testing for SIBO (small intestinal bacterial overgrowth) through breath analysis may be helpful. These tests could pinpoint overgrowth of bacteria, yeast, or parasites in the digestive tract. If unhealthy levels of these microbes are discovered, your doctor may suggest botanical or prescription medicines to eliminate them. If inadequate digestion were diagnosed, various supplements like digestive enzymes and Betaine HCl might be recommended. In addition, fiber (from vegetables and fruits) and good bacteria (from fermented foods) would be beneficial.

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Final Thoughts

Bad breath affects everyone at times. But, it is pathologic for bad breath to last for a long time. There is always a cause. Getting to the cause may be tricky. I have summarized my suggestions to understand and resolve this problem once and for all.

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Gut Problems Causing Mouth Problems?:
Lab Tests for the Not-So-Obvious

      Alvin H. Danenberg, DDS     February 21, 2016   [printfriendly]
 
 

Not-So-ObviousI recently wrote about gut problems that could cause gum problems and how functional medicine might shed some light on not-so-obvious triggers. In this article, I discuss some tests that could point to an underlying cause.

 

There are specific functional-medicine tests that may help put together the pieces to this puzzle. Unfortunately, no tests are 100% conclusive. Some are more accurate than others. However, many may give false positives as well as false negatives. Here are two examples of errors in testing:

  • A false positive: a test result that reported you had a specific unhealthy gut microbe possibly causing your gum problems, but in fact you did not have that unhealthy microbe.
  • A false negative: a test result that reported there were no out-of-whack gut microbes, when in fact there were some bad guys that could be the culprits.

 

While not 100% accurate, the tests below may help identify some not-so-obvious causes that could affect your mouth problems. Your doctor could order any of these for you if necessary:

  • Cyrex Labs has a number of blood tests that can suggest if you are sensitive to specific foods that you are eating, which could cause unhealthy immune responses in your body. Specifically, they are Array 3, 4, and 10. Combined, these tests can help narrow down specific foods that may be harmful to you. A blood lab draws your blood. Then, the blood technician sends the tubes to Cyrex for analysis.
  • Doctor’s Data provides a stool test that tries to identify specific bacteria, yeasts, or parasites, which might be the source of your mouth problems originating in your large intestine. The test consists of taking 3 stool samples on 3 consecutive days. You send the collection tubes to Doctor’s Data for analysis.
  • SIBO Center for Digestive Health offers a breath test that might suggest if there were bacteria out of control in your small intestine. This test uses a fermentable, non-absorbable sugar (lactulose) that you add to water and drink. Every 20 minutes you exhale into a collection device that collects your breath into a small vacuum tube. You do this for 3 hours collecting 10 separate samples of your exhaled breath. These are sent to the lab, which can determine the amount of methane and hydrogen gases that are in the collection tubes. These results may determine if there were unhealthy bacteria in your small intestine producing these gases.

 

This is important: These tests should not be the first thing to do to get to the bottom of your dental problems. The first thing to do is to rule out the obvious causes of gum disease such as unhealthy dental plaque, tartar under the gums, or excessive biting forces on your teeth. Most likely, addressing the obvious causes and then improving your oral hygiene as well as your overall diet will take care of all your gum problems.

 

However, the specialized tests I have described could detect some not-so-obvious causes starting in your gut that may be affecting the health of your mouth.

 

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