Breath Alert by Elvira Maricic If friends and family cringe when you open your mouth, it may be time for a halitosis checkup print article      send to a friend

" I was mortified," the 38-year-old editor says. "I had no idea I was walking around with bad breath--I couldn't smell it, and nobody told me. I thought back to all the times I had face-to-face conversations with people at work and wondered if they noticed my breath."

Leonard made an appointment with a dentist and found out she had periodontal (gum) disease, for which she then underwent treatment. "Now I'm not paranoid about up-close conversations with people, and I'm certainly more diligent about seeing the dentist when I'm supposed to," she says.

The Malodorous Mouth

Leonard's experience isn't that unusual, both in that people were too embarrassed to tell her that her breath smelled bad, and in that halitosis can be a symptom of a more serious condition.

"The number one cause of bad breath is something that patients don't know they  have--gum disease," says Steven E. Marek, DDS, a Joliet, Illinois, dentist. Other contributing factors are poor oral hygiene, smoking, and tartar build up. "A lot of patients say they can't get rid of their bad breath, and then we take X-rays and see that they have tartar built up below their gumline, which is impossible for them to remove," says Dr. Marek. "The bacteria that is in the pockets caused by tartar build up produce toxins that cause bad breath. We have ultrasonic instruments that go below the gumline and break up the tartar," he adds.

Other causes of bad breath include certain foods, such as onions and garlic, tooth decay, dry mouth, sinus or respiratory infections, and infrequent eating. Bad breath may also be caused by some medical conditions, including acid reflux, chronic bronchitis, diabetes, and liver and kidney problems.

To Treat and Prevent...

"The best way to prevent halitosis  is to keep your teeth really clean and keep your tongue clean," notes Sheldon Seidman, DDS,  of Sheldon Seidman and Associates in Chicago. "If you notice any halitosis at all, you need to use a tongue scraper, which is like a rake, on the back of your tongue,"  he says. Tongue scrapers are available in most drugstores or through your dentist.

Dr. Seidman also recommends using a mouth rinse that contains zinc chloride or chlorine dioxide. Most of these are available through your dentist, although one over-the counter mouthwash containing zinc is now available. Most mouth rinses work by neutralizing the volatile sulfuric compounds, which, according to Dr. Seidman, are the gases that you smell as bad breath. However, he notes, if the problem is caused by periodontal disease, no amount of rinsing will wash it away. "Even if you treat the sulfuric compounds and you have gum problems, you're still going to have bad breath," he says.

Beyond Bad Breath

Aside from being a major source of bad-breath embarrassment, periodontal disease, if left untreated, can produce serious side effects. In addition to causing tooth loss, notes Dr. Marek, the bacteria can exacerbate heart disease.

"Having gum disease is like having high cholesterol," says Dr. Marek, adding that there are no symptoms unless you're already in an advanced stage of the disease. Warning signs to look for, he says, include "gums that bleed spontaneously or when you brush or floss, halitosis, shifting teeth or teeth that seem a little bit loose, and pus oozing from the gums." But having periodontal disease doesn't mean you'll be sentenced to having a denture glass at your bedside for the rest of your life. "Ninety-five percent of the time, we can treat it and head it off at the pass," he says.

Ten Tips to Tend To

The American Dental Association (ADA) recommends the following tips to lead you to good oral health and a sweeter-smelling mouth:

• Brush your teeth twice daily with an ADA-accepted fluoride toothpaste, and floss daily.
  
  
• Brush your tongue daily.
  
  
• Rinse with an ADA-accepted fluoride mouth rinse or an ADA-accepted antimicrobial mouth rinse.
  
  
• Schedule regular dental checkups and professional cleanings.
  
  
• If you think you have constant bad breath, keep a log of the foods you eat.
  
  
• Keep your mouth moist.
  
  
• Ask your dentist if any of the medications you take dry your mouth, which can lead to bad breath.
  
  
• Use a humidifier.
  
  
• Use a moisturizing nasal spray to control post-nasal drip, which can be a factor in bad breath.
  
  
• If you use tobacco, which causes bad breath, ask your dentist or physician for tips to kick the habit.