Bad Breath and What Causes it

Clinical studies have demonstrated that odor-causing bacteria build-up on the tongue is a prime cause of bad breath and a potential contributor to other oral health problems such as gum disease.  Especially during sleep, the tongue is coated with a plaque film of bacteria and other odour causing compounds. The texture of the tongue is very conducive to housing this unwanted bacteria, which is why, fresh breath is difficult to maintain, even after brushing your teeth. Brushing your tongue with a toothbrush only stirs up this plaque film, without effectively removing it.

The American Dental Association News recently reported that halitosis experts agree that the dominant cause of bad breath is the bacteria on the tongue.

"When saliva collects in the mouth - particularly in depressions at the back of the tongue - and is digested by oral bacteria, powerful odors can result".-- Time Life, The Medical Advisor, Bad Breath, Causes 

The bacteria release odorous byproducts (known as Volatile Sulfur Compounds, or VSCs similar to the gasses released by a rotten egg) as they thrive on the tongue. These "stinkers" also arise from active gum disease. In fact, according to recent research, VSCs may even be the first factor in initiating gum disease.

While volatile sulphur compounds are the principle causative agents of bad breath, the bacteria that live in our mouths also produce other waste products, and some of these have their own unpleasant odors too. A few of these wastes are:

• Cadaverine - the smell we associate with corpses
• Putrescine - the compound responsible for much of the foul odor produced by decaying meat
• Skatole - the characteristic smell of human fecal matter
• Isovaleric acid - the smell of sweaty feet

Most people are surprised to discover that this wonderful mix of compounds emanates from the mouths of humans, and noone is an exception. Everyone has some level of these unpleasant compounds in their breath. Fortunately, however, low levels of these odorous compounds cannot be detected by the human nose. It's only when the levels of these compounds become elevated, and others' noses can detect them, that we have "bad breath".

The diagram below illustrates how the harmful bacteria hiding under the coating of the tongue lead to bad breath and plaque:

The tongue is a rough surface that provides the bacteria with plenty of hiding places. When we eat, debris left over from food and normal mucus production build the "coating" on our tongues. This coating provides the bacteria with a "safe" hiding place. Why is it safe? Because the bacteria are anaerobic oxygen is lethal to them. So the bacteria, hidden in the safety of the tongues coating, do their "dirty work" releasing odourous gasses in the process.

This is the primary cause of halitosis. It also leads to increased risk of decay (especially root surface decay), and a decreased sense of taste.

A study done by Anne Bosy, co-founder of the Fresh Breath Clinic in Toronto, found that most people with bad breath do not have gum disease. Instead, she found that sulphur-producing bacteria live at the back of the tongue, bedding down under plaque and mucous. These bacteria are a source of halitosis.

A white film on the top of the tongue means there are millions of bacteria living there.

It is estimated that approximately 85% of all halitosis cases have their origin within the mouth; of these, 90% are caused by tongue residues. Previous studies have established that hydrogen sulfide and mercaptans are the primary components of halitosis.

Do you smoke, drink alcohol, take heart, sinus, birth control, or antidepressant medicines, or are over 55 years old? A positive answer to any one of these conditions means you have diminished salivary flow and are prone to bad breath. If you are dieting successfully, or your gum disease is active (bleeding gums) - you're going to have bad breath!

Behavioral studies reveal that no one informs those with bad breath, often not even their spouse for fear of embarrassing them.

The latest shocking research associates the bacteria in our mouths to heart disease and other ailments:

"It is impossible to remove all the bacteria from the mouth because it is constantly under attack by the gram negative anaerobic bacteria which thrives in the anaerobic environment of the posterior dorsal villa of the tongue  These anaerobic type bacteria include the likes of A. actinomycetemcomitans, B. forsythus, T. denticola, P. intermedia and P.gingivalis and are readily associated with periodontal disease"

The plaque settled on the tongue can result in various tooth problems such as gingivitis, periodontitis, and other gum diseases besides offensive mouth odour or bad breath. 

• One of the chief causes of periodontal disease is a bacterium that hides under the food and mucous layer settled on the tongue. This bacterium present in periodontal disease invades the bloodstream through damaged, bleeding gums, and may cause damage throughout the body, including the heart.

• Many recent studies have shown that several of the bacteria in the mouth can enter the bloodstream and promote blood clots and damage heart muscle tissue. The bacteria Clostridium perfingens, which is commonly found in the oral cavity, is suspected of being one of the major culprits . 

Other research suggests that newborns with low birth weight may be associated with the toxic byproducts released by the bacteria from gum infections in pregnant women. There are also ongoing studies that link the worsening symptoms of both diabetes and periodontal disease. 

As well, bacteria found in the mouth can end up in the airways and increase the risk of complications associated with chronic lung conditions and respiratory disease.

Many people are aware of the fact that metabolic byproducts and toxins are removed from the body through the coating of the tongue. Unfortunately, we are re-injesting most of this with our breakfast.