I wanna have control..

December 5, 2008 5:34 AM

Why is my breath so bad? I seem to be doing all of the right things, and yet I have repulsive breath that sometimes even gum won't cover.

I think that two permanent retainers are at least partially to blame.

I eat right, exercise, drink more water than suggested, don't smoke, brush well twice daily (with a Sonicare, to boot), floss 1-2x daily, use the best toothpaste, use a tongue scraper, have tried all of the common mouthwashes from Biotene to Listerine, and yet, within minutes of spitting a piece of gum out my mouth tastes terrible.

I haven't always had this problem, but only in the past year or so has it arisen.

Things were fine for a time, but it's beginning to interfere with my day-to-day life, so I need to do something about it.

Note: Male, no medications, healthy weight/build, noticeably white/bright smile

I chew about a pack-a-day of sugarfree gum to cover up the smell, but sometimes it still comes through.

What should I do?

Thanks!

Anon. because my family and friends are really good at following me online ;)

throwaway email at breakthegumaddiction at gmail dot com

posted by anonymous to health & fitness (30 comments total)

It's total guesswork but I guess there's some underlying medical possibilities to consider, at least. My wife has hypoglycemia, for example, and her breath smelling bad (acetone-ish) can be a sign that her blood sugar is off. I'm sure there's many more possibilities, just throwing out the one I have experience with.
posted by empyrean at 5:47 AM on December 5, 2008

Not sure how a permanent retainer affects this, but you haven't mentioned flossing. Current research indicates it's even more important than brushing, and I know when I forget to do it for a coupla days, the foulest-smelling stuff is dislodged. Lately, I've taken to flossing at work after lunch (in the restroom), so I'm taking this advice very seriously now.
posted by IAmBroom at 5:51 AM on December 5, 2008

Um, he has mentioned flossing.
posted by kev23f at 5:57 AM on December 5, 2008

Get a healthcheck.
Otherwise, do you eat a lot of red meat of other things that slow down the digestive tract? Try eating lots more fibre & lots less meat for 2 weeks and see if that helps.
posted by Wilder at 6:00 AM on December 5, 2008

Are you or have you been losing weight? Ketones are excreted in the breath as a side effect of burning fat, and it can be unpleasant.
posted by Nattie at 6:01 AM on December 5, 2008

Tonsilloliths are a possibility. They can smell like all kinds of bad.
posted by cardboard at 6:02 AM on December 5, 2008 [1 favorite has favorites]

Acid-reflux causes seriously nasty breath and mint exacerbates acid reflux. So, if that's your problem, the tooth brushing and gum chewing are counterproductive. Reflux does not always manifest as heartburn, either, sometimes it can cause a little dry cough, or a oddly rumbling tummy or any number of non-heartburn-like symptoms.

Or, what empyrean said, but with a different underlying medical possibility. Get a check-up. It's probably medical, not hygenic.
posted by crush-onastick at 6:05 AM on December 5, 2008

Nthing time to see the doc -- there could be any number of medical conditions unrelated to oral hygiene that are causing this.
posted by desuetude at 6:11 AM on December 5, 2008

Lactose Intolerance is another possibility. The gasses created when you don't digest milk fats properly can cause bad breath for a day or more after the meal. So nthing go see a doctor to figure out what the problem really is.
posted by COD at 6:14 AM on December 5, 2008 [1 favorite has favorites]

Has anyone else actually told you that your breath smells bad? Because my mouth always tastes nasty to me after I spit out a piece of gum, presumably because of the sudden change from sweet-minty-goodness to normal-empty-mouth taste.
posted by lucidium at 6:25 AM on December 5, 2008

Have you tried rinsing with diluted hydrogen peroxide?
posted by electroboy at 6:35 AM on December 5, 2008

Strongly agree with above crush-onastick - acid reflux is your most likely candidate and you may think "nah, my stomach feels fine, I never have heartburn or anything" - you still might have a GI tract problem as-yet-undiscovered.
posted by arimathea at 6:46 AM on December 5, 2008

Here's a whole list of systemic and local things that could be causing chronic halitosis. Like everybody else said, see your doctor.
posted by vytae at 6:47 AM on December 5, 2008

As cardboard mentioned, tonsilloliths are really disasterous to your breath, and spring out of nowhere. They also tend to just disappear after a while but gargling warm salt water and the like helps.

But definitely see a doctor, as many of the issues that cause bad breath are really easy to pick out straight away.
posted by shownomercy at 6:53 AM on December 5, 2008

Another vote for tonsil stones. Get a flash light and see if you have any white things back there.
posted by kimdog at 6:54 AM on December 5, 2008

Acid reflux or tonsil stones. If you have any other acid reflux symptoms, get to a doctor--acid reflux left untreated can have serious consequences.
posted by PhoBWanKenobi at 7:00 AM on December 5, 2008

you mentioned permanent retainers. are they the metal kind that are anchored to two teeth and then there's a space between the "bar" and all the other teeth? i had one of those on my lower teeth for years. never had one on my upper teeth.

anyway, barring medical issue that everyone else is scaring you about, it could certainly be because of the retainers. it is very easy for gunk to get trapped between your teeth and the retainer, and it is VERY hard to floss with those things.

does your bad breath exist even immediately after you've had a thorough cleaning from the dentist?
posted by misanthropicsarah at 7:19 AM on December 5, 2008

within minutes of spitting a piece of gum out my mouth tastes terrible.

This isn't your only data point, right?
posted by Solon and Thanks at 7:22 AM on December 5, 2008

Read this, "The War on Stink" : http://query.nytimes.com/gst/fullpage.html?res=9A05E0DD1E3DF936A25753C1A9669C8B63&sec=&spon=&pagewanted=all

So what does Preti actually do for people who smell? For those with TMAU, he recommends not eating beans or boiled fish, two foods that contain the compound that those with TMAU can't break down. Patients afflicted with genuine halitosis get lectures in diligent tongue scraping, raking the plaque right back at the threshold of the gag reflex. ''Nobody is taught from early age to clean the back of their tongue,'' he says. ''It's the best long-term solution.'' Preti adds that some cultures, like India's, do teach tongue scraping, and they have relatively lower incidence of halitosis.

He also recommends a mouth rinse developed by Dr. Jon L. Richter, a practicing Philadelphia dentist who runs a breath clinic. Richter worked with Preti and spent more than $1 million to develop products that remove plaque on the tongue. To improve on Listerine, which Richter claims ''basically just irritates the mouth'' and doesn't get rid of tongue plaque, Richter created a chlorine-dioxide solution -- the same compound that sanitizes drinking water -- to kill bacteria and remove odors. The rinse is basically pool water, but it took ''hundreds of thousands of dollars,'' Richter says, to come up with the right proportions. They also developed a plastic tongue cleaner for raking off plaque. ''That first tongue scraper cost us about $20,000 just to get a mold,'' Richter says. ''Now it costs about 8 cents to produce.''
posted by xammerboy at 8:16 AM on December 5, 2008

Uh oh. I know what you're talking about. It's not the normal kind of bad breath that anyone gets from not brushing teeth, eating garlic, or morning breath or whatever. It's persistent and really bad, sometimes smelling like nasty chemicals, a fetid swamp, or maybe like it ought to be coming out the other end. And it never goes away, day to day, month to month. You may have encountered someone else with the problem and I bet you avoided them thereafter and referred to him as "that guy with the breath". And now you're that guy. Mouthwash may make it go away for a few minutes, but then it's right back. Gum may not even cover it over while chewing it. It makes you very self conscious and you try to keep your distance from people or angle your head away sometimes or cover your mouth, right? Never without your gum? Anxious about kissing? It can be socially crippling. I say this just to let you know I understand.

I can't tell you what causes it or how to solve it at the root level, but I can tell you one of the only things that will help you until you can solve it. You want this stuff. The enemy is apparently volatile sulfur compounds emitted by the beasties living in your mouth and the answer is apparently chlorine dioxide, which mainstream products don't contain (I've heard Oxyfresh does but haven't tried it). Ironically the alcohol in regular mouthwash is an enemy according to this company's doctor founder, because it dries out the tissues, which exacerbates things somehow. Anyway, this stuff works when nothing else does, though I'm sure that if there are various causes such as gum disease, reflux, or whatever, then this may or may not do the trick for a given person. I bet it will help though. For me it was like night and day. It doesn't work permanently or cure anything, but you can get hours of relief. And if you follow the regimen, you might even be able to get all day relief (gotta use mid-day too).

The product line includes mouthwashes, toothpastes, sprays, breath strips, gum, mints, floss, and some other stuff that may be dubious (crazy expensive probiotic stuff). I can vouch that the main product line is not a gimmick. I haven't gotten as good results from the strips, gum, or mints, but they're better than nothing. If you are desperate, consider ordering one of their starter kits. The $45 one looks like an even spread of the basic stuff without going overboard, but even the $12 mini one would probably be enough to convince you. Also there's a lot of educational material on the site, which can help you understand things that may aggravate or help with the condition. These days you can even find the mouthwash in many drug stores, and sometimes the toothpaste. I'd encourage you to get at least those two things and follow the regimen on the site, with flossing, scraping, rinsing, and gargling. Good luck!

Data point: I have a bit of a hiatal hernia and have had acid reflux for a long time. I don't know if that's the cause of the problem, though. Fair warning, your dentist will likely be more than useless on this matter. Ironic, huh? Most likely your GP too. Be persistent and keep trying other people. Maybe try an ear nose and throat doctor. If that works, email me! Haven't tried that but was thinking about it.
posted by kookoobirdz at 8:16 AM on December 5, 2008 [2 favorites has favorites]

When was your last dental cleaning?
posted by ikkyu2 at 9:35 AM on December 5, 2008

A large percentage of bad breath cases is due to bacteria buildup on the posterior aspect of the tongue. These anaerobic bacteria produce malodorous volatile sulfur compounds (VSC's) that cause bad breath. Try brushing your tongue to see if your symptoms remedy.
posted by terranova at 10:05 AM on December 5, 2008

It's probably gum disease.

When the gum separates from the tooth, bacteria get trapped in there and causes bad breath.

Regular dental cleanings are fine, but I see a periodontist twice a year. He scales your teeth and scraped them. He looks at your gums and trims them away from your tooth (with a scalpel or a laser) if you have any problems.

And all toothpastes are the same. They all have fluoride. Some have peroxide, but it's not enough to really be effective.
posted by Zambrano at 10:19 AM on December 5, 2008

scrapes
posted by Zambrano at 10:22 AM on December 5, 2008

Have you gone to the dentist? You could definitely have a cavity or gum issues. I'd go there first - don't be embarrassed, they've seen it all.
posted by barnone at 10:45 AM on December 5, 2008

The gum you're chewing could be the problem. Some people get terrible breath from aspartame. This was covered recently in Dr. Gott's health column.
posted by tomboko at 3:06 PM on December 5, 2008 [1 favorite has favorites]

Oh, please note it's the second letter in the column that addresses this.
posted by tomboko at 3:21 PM on December 5, 2008

A tongue sweeper might help...

"Despite its recent exposure in the U.S., tongue cleaning is not a new practice. Long before we had terms like “plaque and halitosis”, people in ancient Egypt, China and India were cleaning their tongues. The idea behind tongue cleaning is simple: The bulk of oral bacteria and debris, including the volatile sulfur compounds that cause bad breath, reside on the tongue. Removing the debris on the back of the tongue is critical for reducing malodor according to the American Dental Association. It has also been suggested that pathogenic organisms on the tongue contribute to tooth decay and periodontal disease. Some of the most recent studies that may relate to tongue cleaning are the studies that link the health of the mouth to the health of one’s entire body. Oral bacteria are being related to heart disease, respiratory disease, pneumonia, stomach ulcers, and diabetes. Many people also report an enhanced sense of taste after using a tongue cleaner. A December 1991 article in the JADA recommends tongue cleaning for geriatric patients that have a low desire to eat due to depressed taste sensation. Since the plaque coatings on the tongue dull the taste receptors, this makes perfect sense.

Dentists have long encouraged their patients to brush their tongues and use a mouthwash. However, attempting to brush the hard-to-reach, back of the tongue readily triggers a gag reflex and does little more than press the bacterial debris and plaque down into the tongue. Mouthwash cannot penetrate the tongue plaque. They usually contain mouth drying alcohols, can be expensive, and may have long-term safety issues. Brushing and flossing are not enough. The Tongue Sweeper instruments have been specifically designed to safely and effectively lift bacteria and debris from the tongue. A few quick sweeps, once or twice a day is all it takes for fresher breath and a cleaner mouth."
posted by bkeene12 at 8:07 PM on December 5, 2008

I have the same complaint since I had a crown put on a back tooth. The smell is accompanied by a taste. I first noticed the same breath smell when my father had crowns put on several of his teeth. I mortifies me to think my breath is anything like his. But here we are.... Here is what my dental hygenist told me:
Keep up the good dental hygene routine. Try to brush 2 to 3 times a day. (I keep a toothbrush and toothpaste at work now for after lunch.) Use a mouthwash and/or toothpaste with hydrogen peroxide in it. Pop in gum or a mint and drink plenty of water. Most bad breath starts with dehydration.
This part is just MY 2 cents: Try to focus on your more positive qualities. It may not really be as bad as you think it is.
posted by MonaLisaV at 5:07 AM on December 6, 2008 [1 favorite has favorites]

A couple of things...

You didn't mention whether or not you are a coffee drinker? Coffee can cause rancid breath
depending on the conditions of your mouth.

Also, try TheraBreath (kookoobirdz mentioned it above), if you haven't already. They have a whole arsenal of products, including a spray you can carry around. That stuff is basically failsafe if the problem is in your mouth. If the problem is in your gut, they will not be as effective.

Also, consider finding substitutes for gum to freshen your breath. Go to a health food store for alternatives. You may be in a vicious cycle related to all the chemicals found in common gums.
posted by OlivesAndTurkishCoffee at 10:46 AM on December 6, 2008 [1 favorite has favorites]