From the ADA – Critical Information for Our Diabetic Patients!
Study: Poorly Managed Diabetes Changes Mouth Microbiome To Favor Disease-Causing Bacteria.
Philly (PA) (9/1, Rush) reported that patients with poorly managed diabetes “are more likely to lose their teeth because of severe periodontitis, an irreversible gum disease that attacks the tissues and bone around the teeth.” A new mouse study “by University of Pennsylvania researchers that was supported by the National Institute of Dental and Craniofacial Research,” may have found the mechanism behind this. Researchers discovered “that unmanaged diabetes changes bacteria in the mouth so that microbes are more capable of causing disease.”
The Oral Health Topics on ADA.org and MouthHealthy.org provide additional information on diabetes for dental professionals and patients.
What is halitosis?
Halitosis, a.k.a. chronic bad breath, is a condition in which a person emanates an unattractive odor from their mouth. The everyday “morning breath” most people wake up with is not halitosis. Neither is the five minutes of bad breath you’ll experience after eating the occasional spice-heavy exotic meal. True halitosis is a persistent smell that does not go away after brushing, flossing and rinsing. It can be demoralizing and embarrassing, so much so that many people are reluctant to even mention it to their dentist. But it’s also fairly common, and thus, quite treatable.
What are the causes of halitosis?
Halitosis has a number of possible causes, 80% of which are oral: cavities, gum disease, cracked fillings and less-than-clean dentures are all likely suspects. Then there are the dietary factors. High-protein/low-carbohydrate diets, acidic foods, sweets and, of course, a steady fare of onions and garlic will definitely curdle your breath like sour milk. So will excessive coffee and alcohol consumption. Tobacco users run an even higher risk.
Though rare, lung disease, certain cancers and tonsil infections have been known to cause halitosis. So have blood disorders and lung and kidney diseases. A more common medical cause is likely to be diabetes, because of fluctuating blood-sugar levels, acid reflux and postnasal drip. Even a common sinus infection can affect your breath with the buildup of mucus. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems.
Are there treatments for halitosis?
Since most cases of halitosis originate from inside the mouth, your first step should be a re-evaluation of your basic brushing and rinsing technique. While cleaning the teeth is necessary, it is of paramount importance that you give extra focus to the tongue—this is where a large amount of the bacteria lives that’s causing your bad breath. Scrape the tongue, then floss and rinse. Remember that brushing alone cleans only 25% of your mouth. Add rinsing to get your whole mouth clean.
Persistent bad breath or a bad taste in the mouth may be a warning sign of gum (periodontal) disease. Gum disease is caused by the buildup of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums. If gum disease continues untreated, it can damage the gums and jawbone.
Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and dental caries (cavities).
The medical condition dry mouth (also called xerostomia) also can cause bad breath. Saliva is necessary to moisten the mouth, neutralize acids produced by plaque, and wash away dead cells that accumulate on the tongue, gums, and cheeks. If not removed, these cells decompose and can cause bad breath. Dry mouth may be a side effect of various medications, salivary gland problems, or continuous breathing through the mouth.
Practice good oral hygiene. Brush twice a day with fluoride toothpaste to remove food debris and plaque. Brush teeth after you eat (keep a toothbrush at work or school to brush after lunch). Don’t forget to brush the tongue, too. Replace your toothbrush every 2 to 3 months or after an illness. Use floss or an interdental cleaner to remove food particles and plaque between teeth once a day. Rinse with an antibacterial mouthwash twice a day.
Stop smoking and chewing tobacco-based products.
Drink lots of water. This will keep your mouth moist.
Chewing gum (preferably sugarless) or sucking on candy (preferably sugarless) also stimulates the production of saliva, which helps wash away food particles and bacteria. Gums and mints containing xylitol are best.
Keep a log of the foods you eat. If you think they may be causing bad breath, bring the log to your dentist to review. Similarly, make a list of the medications you take. Some drugs may play a role in creating mouth odors.
An antiseptic mouthwash can help eliminate bacteria that cause bad breath. Ask your dentist about which product is best for you.