Bad Breath: The Culprits

I've been holding onto an email a reader sent me a few months ago (sorry!). In it, she asked a question that frankly, I couldn't answer: How to tell someone that they just plain stink. She wrote to me asking this, "I have a co-worker who is a great guy. And I might even date him, if he didn't have such bad breath. But I don't have a clue how to tell him. Any suggestions would be appreciated!"

I thought about it and thought about it, and couldn't come up with a great answer. (And I must admit that I'm curious whether or not they're a couple yet.)

So instead, I contacted dentist Nancy Rosen, a NYC dentist who is a frequent contributor to NBC's Today Show, among others. The easy part was tapping into her knowledge to shed some light onto this all-too-familiar condition. The harder part? Figuring out how to break the news, gently.

If you're curious too, here's her take. And, of equal importance is this: if you have a solution for my beleaguered reader, please make her happy and share below!

Q. What is the major cause/causes of bad breath?

A. If you don't brush, floss and brush your tongue daily, particles of food remain in your mouth. There is bacteria that lives in our mouth and will feed off these particles. The bacteria release "volatile sulfur compounds" which cause the odor in your mouth.

Q. Is it true that certain foods, like onions and garlic, are notorious for causing bad breath? Conversely, are there any foods or liquids that are actually helpful in keeping our breath fresh?

A. Sure certain foods like garlic and onions can contribute to bad breath. Once the food is in the bloodstream, it is transferred to the lungs and we expel that air that contains the foul smells. The stomach can also be a cause- if the stomach is not properly digesting foods, it can cause gases and the air you expel can give off the foul smell as well. Some foods known to help are crunchy, hard fruits and vegetables, yogurt, chewing on some parsley, spearmint or tarragon, berries high in vitamin c.

Q. What foods or liquids should someone concerned about their breath avoid like the plague?

A. Onions, garlic, acidic foods or drinks like coffee, alcohol, candy - bacteria have a feast on these types of foods.

Q. Why is it that some people don't even realize their breath stinks while everyone around them can smell it easily?

A. Sometimes people can and can't tell if their breath smells. It could be that their sense of smell isn't as good as others; smokers usually don't smell smoke on themselves because they are used to the smell. And then, there are those people who just don't care if they offend anyone.

Q. Are there underlying illnesses or health conditions that can be responsible for chronic bad breath?

A. Sure, if your dentist says your mouth is healthy he or she may tell you to see a physician. Some illnesses that may cause bad breath include respiratory tract infections, post nasal drip, chronic sinusitis, bronchitis, G.I. disorders, liver or kidney aliments, reflux, ulcers, or hypoglycemia.

Q. What about tongue scrapers - are these an effective tool and what are the proper ways to use them?

A. Tongue scrapers are great, but you can use a toothbrush as well. Whichever one you use, start at the back of your tongue and scrape (or move the brush) forward towards the tip of your tongue. Do this 3-4 times.

Q. What about chewing gum or eating mints to combat bad breath?

A. Gum, mints and mouthwashes usually mask the odors. But you need to manually remove the bacteria (plaque) from your mouth. If you are doing this and you still have bad breath, you may need to use a special antimicrobial rinse (you can get this from your dentist), or see your gastroenterologist.

Q. Can old fillings or cavities be responsible for bad breath?

A. Cavities and old fillings with cavities (decay) underneath them can certainly cause bad breath. But remember: just because you have fillings in your mouth doesn't mean that they will cause bad breath.

Q. Finally, if there is someone with chronic bad breath, what's a nice way (or is there a nice way) of telling them?

A. Tough...if it's a loved one- just be honest and say it- they'll appreciate it. If it's a friend or a co-worker- offer them a piece of gum (hopefully you have a pack of gum handy!).