June 1, 2020
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How to prevent bad breath

By: George Malkemus
October 12, 2018

Pulp and paper mills produce nasty gases that smell like rotten eggs or even the smell of rotting meat. Did you know your mouth is like a pulp and paper mill?

In your mouth, these gases are called VSCs, volatile sulfur compounds. The bacteria, which live in your mouth, feeds on food particles. As bacteria die and decay, they release paper mill gases during the decay process. 

When you talk to a co-worker after you eat lunch, you might notice the person steps back from you while you talk. That is because she or he is reacting to the VSCs from your mouth, not the garlic you just ate. You have halitosis, or commonly called bad breath.  

You are not alone. Over 40 million people in the U.S. have halitosis.  And over 85 percent of these cases are caused by bacteria living in the mouth.  Oral bacteria are also related to the status of your overall health, causing gingivitis and periodontal disease and even contributing to heart disease and diabetes.

You can have bad breath and be totally unaware.  Humans are programed not to smell themselves.  It comes from an adaptive trait in animals to shut down their own smell, so they can smell other animals, be it prey or predators.  A deer can smell the approach of a hunter by not smelling itself.  Since bad breath can be an embarrassing issue, I am often the first person to point out the problem to a patient on their initial comprehensive dental examination.

Causes of Halitosis

Over 85 percent of all cases of bad breath originate in the mouth from periodontal disease. Morning breath happens to nearly everyone to some degree.  But over 40 million people in the U.S. have a bad case of morning breath that continues throughout the day.  Because the mouth is dry and inactive during sleep, the odor is usually worse upon awakening.   Bacteria living in the mouth causes halitosis.  Saliva helps wash away bacterial growth.  Saliva flow stops during sleep. If the flow did not stop during sleep, we would awaken with drooling spit on our pillow.  Therefore, at night during sleep, there is more bacterial growth, leading to morning breath. So the most important time to brush and floss is after the last food is eaten at night. 

Smoking and drinking can cause reduced saliva flow and dry mouth, which can lead to bad breath.  Also 75 percent of the medications taken cause dry mouth, which can lead to periodontal disease and halitosis.  Most over-the-counter mouthwashes are alcohol based and add to the problem of mouth drying and bad breath, even though just for a short-term they mask the smell of halitosis.

Usually bad breath indicates gum infection problems, with sulfur producing bacteria living in the spaces around the gums.  But halitosis can also be caused by deep tooth decay.  Having dental treatment for decay problems and a professional deep cleaning to improve gum health are necessary for stopping bad breath. A less obvious reason for halitosis is the VSCs produced by the bacteria living and dying on the tongue. 

Occasionally digestive problems cause bad breath.  Acid reflux disease, as well as bulimia, can compromise tooth health as well as cause halitosis.  Stomach acid moving up into mouth will corrode teeth, leading to decay and sensitivity along with bad breath.   Though rarely, halitosis can be sign of diabetes, liver or kidney disease.

Tongue scrapers

Tongue scrapers have been shown to reduce bad breath.  In the past, I recommended that my patients brush their tongues as part of their daily oral care routine. Though tongue brushing is good, recent studies show that tongue scraping is even more effective in reducing halitosis.

Your tongue is not a smooth surface. It is covered with deep crevices called “papillae” that are created by the taste buds. The papillae at the back of your tongue are longer than those in the front. They are perfect hiding places for bacteria. Picture your tongue as a chessboard, with all the pieces elevated like the papillae.  There are more nooks and crannies that can fill up with food debris which the bacteria will decay producing a foul odor.   Without regular tongue cleaning, they continue to thrive and create that awful sulfur, rotten egg smell. 

Besides contributing to good oral and overall health, cleaning your tongue will enhance the taste of your food! The soft plaque coating on your tongue interferes with your taste buds’ ability to sense food flavors.

Tongue scrapers are inexpensive.  Experiment until you find one that is easiest for you to use. If the tongue scraper is easy to use, you are more likely to use it regularly.  Tongue brushing works, but it is difficult to brush far back on the tongue without gagging.  Tongue scrapers are thinner and much easier to wipe the back of the tongue.

Mints, gum and mouthwashes

Many people use breath refreshing mints, gum and mouthwashes, which has spawned a $3 billion a year, breath freshening industry.  Most of these solutions are only temporary, masking the odor for only a short time while actually adding to the underlining problem.  Refreshing mints and gums that contain sugar increase sulfur-producing bacterial growth and cause tooth decay.  Alcohol-based mouthwashes dry the mouth and reduce salivary flow making it a better environment for the odor-producing bacteria.  

So use sugar-free mints and gum.  Chewing sugar-free gum is beneficial by increasing saliva.  Look for chewing gum that contains xylitol, which actually inhibits the bacteria that cause decay.  

To prevent bad breath, look for a mouthwash that is alcohol-free and contains chlorine dioxide, which neutralizes ‘rotten egg’ sulfur-smelling gases.   Ordinary mouthwashes and toothpastes only cover up the sulfur smell temporarily by adding flavors and scents.  Chlorine dioxide actually breaks the molecular bonds and completely destroys odorous gases.  Available in my office are different types of tongue scrapers and the ClosysII system, which

‘Breath’ see page 13 


‘Breath’ from page 7

contains chlorine dioxide in a mouthwash, toothpaste and an oral spray.  

By maintaining a regular checkup schedule, your dentist and dental hygienist can assist you with your oral hygiene care, avoid bad breath and keep a health mouth.

Enjoy Life and Keep Smiling!

George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at