Bad breath         Introduction    Store
shelves are overflowing with mints, mouthwashes and other products
designed to help people control bad breath. Yet these products help
control bad breath (halitosis) only temporarily. And, they actually may
be less effective in controlling bad breath than simply rinsing your
mouth with water after brushing and flossing your teeth.  Certain foods, health 
conditions and habits are among the causes of bad breath. In many cases, you 
can improve bad breath with
 proper dental hygiene.  If
simple self-care techniques don't solve the problem, you may want to
see your dentist or doctor to rule out a more serious condition that
may be causing your bad breath.      Causes    The causes of bad breath are 
numerous. They include:    Food.
The breakdown of food particles in and around your teeth can cause a
foul odor. Eating foods containing volatile oils is another source of
bad breath. Onions and garlic are the best known examples, but other
vegetables and spices also can cause bad breath. After these foods are
digested and the pungent oils are absorbed into your bloodstream,
they're carried to your lungs and are given off in your breath until
the food is eliminated from your body.  Alcohol behaves in
the same fashion, allowing the measurement of alcohol levels by breath
tests. Alcohol itself has almost no odor, however. The characteristic
smell on your breath is mainly the odor of other components of the
beverage.    Dental problems.
Poor dental hygiene and periodontal disease can be a source of bad
breath. If you don't brush and floss daily, food particles remain in
your mouth, collecting bacteria and emitting hydrogen sulfur vapors. A
colorless, sticky film of bacteria (plaque) forms on your teeth.  If
not brushed away, plaque can irritate your gums (gingivitis) and cause
tooth decay. Eventually, plaque-filled pockets can form between your
teeth and gums (periodontitis), worsening this problem — and your
breath. Dentures that aren't cleaned regularly or don't fit properly
also can harbor odor-causing bacteria and food particles.  Dry mouth.
Saliva helps cleanse and moisten your mouth. A dry mouth enables dead
cells to accumulate on your tongue, gums and cheeks. These cells then
decompose and cause odor. Dry mouth naturally occurs during sleep. It's
what causes "morning breath." Dry mouth is even more of a problem if
you sleep with your mouth open. Some medications as well as smoking can
lead to a chronic dry mouth, as can a problem with your salivary
glands. Diseases.
Chronic lung infections and lung abscesses can produce very
foul-smelling breath. Several other illnesses can cause a distinctive
breath odor. Kidney failure can cause a urine-like odor, and liver
failure may cause an odor described as "fishy." People with
uncontrolled diabetes often have a fruity breath odor. Chronic reflux
of stomach acids from your stomach (gastroesophageal reflux disease, or
GERD) and a slight protrusion of the stomach into the chest cavity
(hiatal hernia) also can produce bad breath. Mouth, nose and throat
 conditions.
Bad breath is also associated with sinus infections because nasal
discharge from your sinuses into the back of your throat can cause
mouth odor. A child with bad breath may have a foreign object lodged in
his or her nose. A bean or small item stuck in the nose can cause
persistent nasal discharge and a foul odor. Strep throat, tonsillitis
and mononucleosis can cause bad breath until the throat infection
clears. Bronchitis and other upper respiratory infections in which you
cough up odorous sputum are other sources of bad breath. Canker sores
may be related to bad breath, especially if they accompany periodontal
disease. Tobacco products. Smoking dries out
your mouth and causes its own unpleasant mouth odor. Tobacco users are
also more likely to have periodontal disease, an additional source of
bad breath. Severe dieting. Dieters may develop unpleasant "fruity" 
breath from
 ketoacidosis, the breakdown of chemicals during fasting.      Bad breath can 
usually be eliminated with good dental hygiene.    When to seek medical advice  
  Most
people can prevent or improve bad breath by practicing proper dental
hygiene. If bad breath persists despite self-care, see your dentist. If
the cause isn't dental, see your doctor to determine a possible medical
cause. You may need a physical examination and testing to pinpoint the
underlying cause.     
 Self-care    Try the following steps to improve or prevent bad breath:  Brush 
your teeth after you eat. Keep a toothbrush at work to brush after eating.   
Floss at least once a day. Proper flossing removes food particles and plaque 
from between your teeth.   Brush your tongue.
Giving your tongue a good brushing removes dead cells, bacteria and
food debris. Use a soft-bristled toothbrush and brush your tongue with
at least five to 15 strokes. Pay particular attention to the middle
third of the tongue, where most of the bacteria tend to collect. Clean your 
dentures well.
If you wear a bridge or a partial or complete denture, clean it
thoroughly at least once a day or as directed by your dentist. Drink plenty of 
water.
To keep your mouth moist, be sure to consume plenty of water — not
coffee, soft drinks or alcohol. Chewing gum (preferably sugarless) or
sucking on candy (preferably sugarless) also stimulates saliva, washing
away food particles and bacteria. If you have chronic dry mouth, your
dentist or doctor may additionally prescribe an artificial saliva
preparation or an oral medication that stimulates the flow of saliva. Use a 
fairly new toothbrush. Change your toothbrush every three to four months, and 
choose a soft-bristled toothbrush.   Schedule regular dental checkups. At least 
twice a year, see your dentist to have your teeth or dentures examined and 
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