Ask Dr. Mark Kraver and Dr. Phillip Kraver!
Below are some common questions we receive on a regular basis. Feel free to browse our Dental FAQ. If you would like you can also ask a question on the right side of the page. Remember, we cannot diagnose any dental conditions from this website. This page is only meant to give background information on how we form our diagnoses.
Why does my breath smell even though I brush 3-4 times a day and use mouthwash 2-3 times per day?
Bad breath, or halitosis, is a very common problem for many people. Halitosis can adversely affect interpersonal relationships and it can even be borderline offensive to some. Conventional wisdom would say that the #1 solution to bad breath is to simply clean your mouth more often, with more firepower, ie. brushing more, mouth rinses, tongue scrapers and flossing. It is true that having a dirty mouth can cause halitosis, but what do you do when your mouth is ultra clean and odor remains?
Here are several other well known causes of bad breath.
Periodontal disease has a VERY characteristic bad odor that dentists and other members of the dental team can identify in a crowd of people pretty easily. The classic odor is caused by an overload of bacteria and their waste products around and under the gum line. The combination of bacteria and bacterial waste is called dental plaque. The gum line is by far the most difficult area to keep clean in the mouth because there is a small, shallow “pocket” that encircles every tooth in the mouth. Most people do an excellent job cleaning the tops of the teeth, but very few people effectively clean these tough-to-reach pockets on a daily basis. Within 24 hours of smelly plaque accumulating around the gum line, the mineral content in the saliva begins to mineralize the soft dental plaque. The hardened material is called tartar, or calculus.
Over time this tartar continues to grow and grow and eventually the gums and bone begin to shrink away from the teeth, causing periodontal disease, or gum disease. Teeth with periodontal disease have deep and odor-filled pockets teaming with stinky bacteria. Effectively managing gum disease is not easy. Frequent professional cleanings by a dental hygienist must be a high priority for periodontal patients in order to limit disease progression. Referral to a periodontist (gum specialist) may also be warranted to help manage gum disease.
It is a well known fact that certain foods (such as onions and garlic) can cause bad breath. The exact mechanism for the food causing bad breath is not that easy to explain. It is a combination of bacterial breakdown of certain foods into volatile sulfur compounds or VSC’s and the metabolism of the smelly food, usually in the blood stream. Avoiding these foods can really help alleviate bad breath altogether.
Tonsilloliths are also known as tonsil stones. They are small, white calcified bacterial colonies that form on the wavy surface of the tonsils. Sometimes those waves invaginate to form a pouch that forms the environment where these putrid smelling stones develop. Tonsil stones do not usually require any treatment. The stones typically dislodge themselves while eating and are swallowed along with the meal unnoticed. In cases where the tonsilloliths are suspected to cause bad breath, removing the tonsils may be an option.
Liver failure, kidney failure, lung infections, chronic sinusitis, diabetes, and other metabolic diseases of the blood have all been linked in some way or another to odor causing agents that find their way into our breath through various mechanisms. Regular wellness checkups are crucial to ensuring your body is functioning as well as it can.