Upon awakening all of us have bad breath. Bad breath or halitosis is a foul odor that comes from an individual’s mouth or nose that is usually not noticeable to that individual. Morning bad breath occurs from the lack of salivation or moisture in the mouth during sleep. Because the mouth becomes drier during sleep, food particles and bacteria tend to stay in place on the tongue and gums rather than be washed away by the natural action of saliva. As a result of this static pattern, the mouth bacteria are able to feed on any food particles that remain in the mouth. The bacterial metabolism from this feeding frenzy causes the foul odor that is universal in all of us. Many adolescents are particularly fearful of bad breath especially in social situations or more intimate circumstances such as kissing.
Who is likely to develop bad breath?
Besides occurring in all of us after sleep, bad breath can occur in adolescents under other circumstances. These circumstances can be divided into lifestyle activities and disease.
Lifestyle activities:
- Inhaled substances including tobacco
- Ingested substances including onions, garlic, chewing tobacco and coffee
- Improper oral or dental hygiene
- Braces
- Belching
Diseases:
- Gingival or gum disease
- Streptococcal sore throat
- Dental infections
- Mononucleosis
- Tonsillitis
- Sinusitis
- Postnasal drip
What are the symptoms of bad breath?
Bad breath may manifest itself by a variety of different odors that are unpleasant to others. Researchers have been able to determine that there are different odors that can emanate from an individual. For example, there are odors from the nose, whole mouth, front of the tongue, teeth and back of the tongue. If the odor is due to an infection, it may have a smell of putrefaction as in tonsillitis, sinusitis or mononucleosis. If the odor is from ingested garlic that is on the tongue, it will have the odor that is familiar to all of us. And inhaled cigar smoke will expose the entire mouth and gums to that pungent smell. Adolescents who do not take in enough fluids, such as anorexic teens, may also have bad breath due to a dry mouth.
How is bad breath evaluated?
If an adolescent has bad breath due to a lifestyle activity, then the evaluation and cause is straightforward. If the adolescent’s bad breath is due to disease, then a clinician may be needed to find the cause. A primary care physician may be consulted for an examination to determine if there is infection in the mouth, nose, throat or sinuses. A dentist may be consulted for an oral examination to determine if there is dental or gum disease. The dentist may also review the adolescent’s oral hygiene.
How is bad breath treated?
The treatment for an adolescent’s bad breath will depend on the cause. If it is a matter of a food ingested or substance inhaled, then that activity could be changed.
Adolescents should floss and brush on a regular basis. Flossing removes trapped food and prevents the buildup of tartar. Bacteria will digest trapped food, and this may cause bad breath. Tartar can cause an inflammation of the gums called gingivitis and this also is a source of bad breath. Because some food may be trapped on the tongue, some individuals suggest that the tongue be brushed to remove trapped food particles. If certain foods cause you to belch, then be wary of eating those foods. Keep your mouth moist by drinking plenty of fluids including water. Ideally, brush your teeth after each meal and at bedtime and awakening. Rinsing and gargling with water or water with a bit of salt in it several times a day is helpful. Flavored antibacterial mouthwashes are probably no more effective than a simple solution of salt and water.
If the bad breath is due to a disease, then the underlying disease should be treated in order to dispel the bad breath. For example, streptococcal sore throat and sinusitis are usually treated with antibiotics. Gingivitis and dental infections need to be evaluated and treated by a dentist. Although mononucleosis has no specific remedy, frequent gargling is helpful in that condition. Postnasal drip, which could be due to infection or allergies, could be treated with medications to dry up the drip including pseudoephedrine or an antihistamine. In a paper published in 2003, tongue brushing performed by a dental professional on adolescents with halitosis was helpful in alleviating bad breath.
How is bad breath prevented?
Adolescents may prevent bad breath by having good oral hygiene including frequent brushing and flossing and regular dental examinations. Adolescents who wear braces must be particularly careful to brush out any trapped food. If the bad breath continues, then the teen should see a primary care clinician for an evaluation.
Related topics:
Allergies, anorexia nervosa, body odors, coffee, colds and flu, dental care, dental problems, gum disease, kissing, mononucleosis, orthodontics, smoking and tobacco, strep throat
