Category: dental condition

Bruxism and TMD on the rise during COVID-19 Pandemic

Pandemics are stressful. Health scientists report an increase of people experiencing teeth grinding and oral pain during the coronavirus-19 outbreak because they feel increased stress due to health worries, the loss or work, and the close proximity of family members in lockdown.

Anyone who feels stressed-out is likely to experience jaw clenching and teeth grinding which can happen at night during sleep without the sufferer being aware of the exercise. This activity can rapidly wear down teeth, but there are dental remedies to help mitigate the damage and self-help measures like stress reduction and mindfulness that can effectively cure the problem. Either way, the path to wellness begins with your dentist.

Effects of teeth grinding Bruxism

Stress and anxiety are unhealthy, and dentists are eye-witnesses to the damage it causes the body. Not only does the friction rapidly deteriorate teeth, but such tensions are frequently associated with other more serious illnesses. Oral health professionals at Archer Dental can spot patients who are suffering bruxism (teeth grinding) and temporomandibular disorders (TMD) by the worn condition of their teeth.

How do temporomandibular disorders (TMD) affect sufferers?

The most common signs of TMD are soreness around the patient’s ear, jaw joint, and jaw-muscles. Other symptoms relate to soreness and noises when opening or closing the mouth. Jaw bones make clicking or crunching noises when the patient chews, or yawns or opens their mouth for any reason. TMDs may be linked with neck pains and headaches and sometimes people feel discomfort in their temples or in their teeth. If you have any of these symptoms, report your condition to your dentist or physiotherapist.

Dental maladies such as teeth grinding, jaw clenching, and jaw pain during the COVID-19 pandemic can be mitigated.

Temporomandibular joint (TMJ) graphic showing muscles and bones in skull.

The temporomandibular joint (TMJ) is the name of the joint located on either side of your head, just in front of your ears. These joints connect your mandible (jawbone) to your temporal bone (skull).

The temporomandibular joint can rotate backwards, forwards, and from side to side; it’s considered one of the most complex joints in the human body. This flesh to bone intersection, a tangle of muscles and ligaments, facilitates chewing, speaking and swallowing. When we have a problem with either the muscle, or bone or other tissue in the area of the TMJ, it’s considered a temporomandibular disorder or TMD.

How does Archer Dental treat TMD?

If you struggle with headaches, jaw or face pain, or the effects of jaw-clenching and teeth grinding, and you believe you may have a TMD, then professionals at Archer Dental can provide treatment options. Oral health care providers will examine your teeth and jaw and perform tests including x-rays to determine the exact nature of your ailment. If we diagnose a TMD, then we can help with treatment plans that may include:

Night guards reduce damage to teeth because they prevent TMD sufferers from grinding their teeth while they sleep and further aggravating their sore jaws at night.

Night guards are specially formed plastic oral health dental devices to protect teeth during sleep.
A clear plastic night guard is specially formed to fit perfectly in patients’ mouths.

The clear plastic device prevents those afflicted with TMD’s from doing further damage to their dental work, but it doesn’t cure the problem.

plastic mouth guard or sports mouth guard for athletes

A sport mouth appliance can be made for patients who grit their teeth while playing sports or doing physical work.

Pain medications can help ease the symptoms and give temporary relief.

Dentists can also refer patients to specialists like certified physiotherapists or chiropractors to help ease muscle pain and correct misalignment.

A behavioral therapist may be recommended to help find ways to deal with stress and help calm the tension that is causing the TMDs.

BOTOX® for Bruxism at Archer Dental

BOTOX® is used as an alternative treatment for TMD and associated jaw tension and pain.  Botox, otherwise known as Botulinum toxin type A, is a form of Clostridium botulinum (a bacterium) that has been purified for medical use. When this material is injected into TMJ region muscles it can help them relax, which relieves headaches, migraines, and jaw joint issues that stem from TMD, bruxism, and stress related clenching or teeth grinding.

Botox usually takes effect between one to three days after injection, but in some cases it can take up to two weeks to feel the benefits. The positive effects can last between three to six months.

Archer Dental has BOTOX Injection Professionals

Dr Janna Lee, Botox

Dr. Janna Lee has lots of real-world experience dispensing therapeutic BOTOX® injections to the face and neck. She is a Certified BOTOX Injector who has completed continuing education programs relating to the therapeutic and esthetic use of Botox. That means she’s well versed in the therapeutic effects and she also knows how to leverage its esthetic benefits. 

Botox works on a neuromuscular level to relax the muscles predisposed to clenching and grinding and reduces the contraction of those muscles so patients feel less pain in the area. 

Botox also relieves painful headaches or migraines that are often caused by bruxism, and it can protect your teeth from fractures and the wear and reduction from grinding.

In our experience, TMDs will usually resolve themselves over time as life conditions change. But while suffering, our dental professionals can help stop the damage being done and bring some relief to sufferers.

Dentist supervised self-care for TMD

Treatments for TMD can include self-help. Archer Dental recommends patients do exercises at home and they offer these practical suggestions.

  1. Create either cold or warm compresses (whichever feels better) to help ease sore jaw muscles. Carefully apply the compress to the affected area to ease the pain and gain movement in your jaw area.
  2. Try to minimize the movement of your jaw and this may require only eating soft foods for some time. Explore protein shakes or nutrient rich meal replacements; this is a temporary approach for acute pain.
  3. Avoid yelling or singing carols while your TMJ region is healing.
  4. Stop chewing gum, nuts or beef jerky, as these actions require repetitive motions that may aggravate the muscles in the region.
  5. When sleeping, avoid putting pressure on your jaw, remember to lie with head up instead of resting chin on hand, pillow, or partner.
  6. Learn to use your tongue to keep your teeth slightly apart; this will minimize clenching and grinding, especially during exercise.
  7. Breathe properly and take warm baths, walks, and try to remain calm.

Physiotherapists can remedy orofacial pain

certified physiotherapist massages the temporomandibular joint (TMJ) bones and muscles, manual therapy.
A certified physiotherapist massages a patient’s temporomandibular joint muscles.

Many sufferers use physiotherapy to eliminate TMJ pain. A trained physiotherapist can perform more detailed assessments of a patient’s TMJ problem and more accurately match the treatment plan to the root cause. 

Some patients have a TMJ joint that moves too easily, and too much or in a poor pattern. Experienced physiotherapist can recognize this problem and design treatments with exercises that strengthen weak muscles and improve mouth and jaw movement patterns.

POSTURAL TRAINING or simply changing a patient’s forward head posture can help some people who suffer from TMJ dysfunction. Physiotherapists teach patients how to strengthen postural muscles and lengthen shortened tissues so that they can improve their head position.

PAIN RELIEF for TMJ DYSFUNCTION? When patients are in a lot of pain and just need some relief so that they can begin to make the changes outlined above, a physiotherapist can help relieve the pain with thermal modalities, acupuncture and gentle manual therapy. 

Bleeding Gums When Flossing, Brushing Teeth

Bleeding gums, causes and treatments for bloody gums

Blood on the toothbrush? Blood on the tooth floss? Blood on apples that you eat? Whatever the reason, it’s hard to ignore such an obvious red-alert signal.  Below is a long list of common causes and treatments for bleeding gums, a minor dental emergency.

Bleeding Gums Causes

Readers of the Archer Dental blog know that itchy discomfort, chronic pain and even bad breath can be signs of severe dental problems. Bleeding gums is yet another indication that something is terribly wrong with your teeth; bleeding gums is a genuine oral health emergency, but there’s almost always more to the story. If you’re a meticulous tooth-brusher and dental-flosser then you should know there are other medical scenarios and factors that can result in bleeding gums besides inadequate oral hygiene, which is the leading cause of the condition. Of course, if you’re a regular brusher who suffers from bleeding gums then perhaps you may want to re-investigate how you brush your teeth. Improper brushing technique is another commonly encountered cause for sore and bloody gums.  More on this below but suffice to say that circular motions to clean the teeth are recommended. While many people use a back-and-forth motion, this motion can irritate and damage your gums, making them sore and more likely to bleed or recede.

bleeding gums after eating

From a probability standpoint, bleeding gums are the most common symptom of gum disease.  That’s a rather scary statement in bold font, so let’s break that down; it all starts with plaque buildup along the gumline. When you’re too busy to brush properly, and when you don’t schedule routine visits to see dental hygienists to remove plaque in a timely manner, it hardens into tartar which is a calcified material to which more plaque adheres. The build-up continues until it begins to irritate the gums which causes them to bleed. This is the nightmare scenario that can progress into more advanced forms of gum disease if not corrected in time.

That being said, it is possible that a patient’s bleeding gums could be caused by other underlying conditions related to other causes of inflamed gums.

Occasional blood on your gums could be caused by the subject brushing too vigorously, as mentioned above, or wearing dentures that don’t fit quite right. We’ve all eaten foods that irritate our gums and popped kernel corn, spicy meats, and nuts can also irritate gums by becoming lodged between the gums and the teeth. Candy is essentially pure sugar, so of course it is bad for your teeth and gums. Especially harmful, however, are sticky candies because the candy grips onto your teeth and encourages bacterial growth. These tactile substance love the crevices between teeth and when they become lodged there, they break down slowly which gives bacteria plenty of time to go wild.

Stress can cause bleeding gums

High levels of stress at home and at work can lead to widespread inflammation in the body and can weaken the immune system. This inflammation can lead to the swelling of the gums which, in turn, can cause bleeding.  What can be done to prevent the effects of stress on your gums? Practicing good oral hygiene helps. Get into the habit of using floss and mouthwash.  Making lifestyle changes to reduce the effects of stress on your gums will also help to significantly improve your quality of life.  Try and get more physical exercise everyday, and plan a few extra hours of sleep. Eat a balanced diet with lots of fruits and vegetables. Try meditation and deep-breathing exercises. Life is too short to allow yourself to bleed in pain from excess stress.

Scurvy can cause bleeding gums

vitamin C collagen synthesis - image by Allison CalabreseFive hundred years after the Age of Exploration, scurvy is still known as a ‘sailor’s disease’, a condition that results from a complete depletion of ascorbic acid.  Sailors couldn’t bring fruit as it would spoil so they ate dried meat and twice-baked bread for months on long ocean crossings and then wondered why their teeth fell out. Vitamin C is essential for the production of collagen and other connective tissue components in the body. It is a fatal disease characterized by a slow dissolution of connective tissue, including the walls of the blood vessels. Today fully developed scurvy is rare; however, sub clinical scurvy is very common among the elderly, infants, children on special diets, and people with poor dietary habits. Scorbutic gums, a symptom of such scurvy often manifests in a painful triangle-shaped area between the teeth.

It takes at least a month with no vitamin C in the diet before symptoms occur. In modern times, scurvy occurs most commonly in people with mental disorders, unusual eating habits, alcoholism, and older people who live alone. Other risk factors include intestinal malabsorption and dialysis. While many animals produce their own vitamin C, humans are among the few animals that cannot simply make their own Vitamin C. Stupid body.

Vitamin K deficiency causes bleeding gums

Another factor which may cause bleeding from your gums when you brush or floss is Vitamin K or lack thereof. This vitamin helps your blood clot properly. It’s also good for your bones. If you don’t get enough through your diet or your body doesn’t absorb it well, it can cause bleeding problems.  Think of this vitamin as a shield – it helps block substances that break down bone. It also helps your body produce osteocalcin, a protein that supports bone strength. A vitamin K deficiency can slow down your body’s healing process and make you more likely to bleed.

Foods rich in vitamin K include watercress, kale, spinach, Swiss chard, lettuce, mustard greens, soybeans, canola oil, olive oil.

A close look at healthy gums inside the mouth

Human gums are part of the soft tissue lining of the mouth. They surround the teeth and provide a tight seal around them. But the lips and cheeks and softer gums are harder and more tightly bound to the underlying bone which helps this protective layer handle the friction of all types of food. Thus when healthy, it presents an effective barrier to the barrage of periodontal insults to deeper tissue.

cross section of tooth showing gums

Healthy gums are usually coral pink in light skinned people, but may be naturally darker with melanin pigmentation. Other colours like red, white, and blue can signify inflammation (gingivitis) or a serious disease. Although healthy gum tissue is commonly described as being ‘coral pink’ as stated above, but variations in colour do occur.  This doesn’t necessarily mean that someone’s gums are unhealthy. Uncommonly coloured gums could be the result of other factors including blood thinning or thickening medications, or the thickness and degree of keratinization of the epithelium (epithelial tissues line the outer surfaces of organs and blood vessels throughout the body) and how it affects blood flow to the gums, and natural skin pigmentation, and disease.

Since the colour of the gums can vary, uniformity of colour is more important than the underlying color itself. Excess deposits of melanin can cause dark spots or patches on the gums (melanin gingival hyperpigmentation), especially at the base of the inter dental papillae. There are cosmetic surgeons that offer gum depigmentation (aka gum bleaching) to remove these discolorations, however that service is not offered at Archer Dental presently.

The most obvious answer is poor dental hygiene, but let’s outline all the possible causes before hunkering down on the details.

Gums Bleed When Flossing, Blood on Toothbrush

The gingival cavity micro ecosystem is fueled by food residues and saliva which come together to offer life- support for thousands of different microorganisms, of which some can be injurious to the teeth and even to overall health. Improper or insufficient oral hygiene can thus lead to many gum and periodontal disorders, including gingivitis or periodontitis which are major causes for tooth failure. But this is old news to Archer Dental Blog Readers who are of course familiar with How Everyday Acids and Bases Affect Oral Health and Human Homeostasis.

Gums are made of delicate tissue, so brushing the wrong way could damage them. A study published in 2015 by the Journal of Clinical Periodontology looks at what happens to the gums when people brush their teeth. The goal of the study was to see the effect “traumatic tooth brushing” had on the development of gum recession and lesions on the gums. A number of factors influenced whether the subjects in the study were likely to have wear and tear on their gums: how they brushed, how often they brushed and how forgiving their toothbrush’s bristles were. Even though you can still buy toothbrushes with medium or hard bristles, using them may damage the enamel on your teeth or cause red and swollen gums.

Consider changing your toothbrush. Is there ever a reason to choose a hard toothbrush? Archer Dental does not recommend using stiff bristled toothbrushes and certainly not if you have sensitive teeth or bleeding gums. Although some people claim they prefer using firm bristles, studies show they do wear away tooth enamel and increase harm to gums. The well-known benefit of harder bristles is that they remove slightly more plaque than soft-bristled brushes. But in light of the damage that can and likely will occur over long periods of time, this slight advantage is usually not enough to justify their use.  If your gums are really bothering you, consider switching to an electric toothbrush; this may do a better job cleaning your teeth when brushing, and without the risk of destroying your enamel or gums.

Pregnancy Can Cause Bleeding Gums

bleeding gums, blood drips from open mouth

Hormonal changes during pregnancy can make expecting moms’ especially vulnerable to plaque build-up, which can lead to inflammation and gums bleeding. This is also called pregnancy gingivitis or gum disease. There is no magic remedy to this condition beyond increased personal oral health care, and that simply means more and better brushing and flossing and using antiseptic mouthwash rinses more frequently.

If you have morning sickness (nausea and vomiting), rinse your mouth with plain water after each time you are sick. This will help prevent the acid in your vomit from damaging your teeth. Also important: do not brush your teeth straight away as they will be softened by the acid from your stomach. Wait about an hour before brushing.

Periodontal disease, Gingivitis or Periodontitis

Gingivitis is a common type of periodontal disease. Signs of gingivitis include swollen gums that are not healthy pink in colour, but red and puffy. Sore gums bleed easily when the person brushes their teeth. Gingivitis often resolves itself with improved oral hygiene, such as longer and more frequent brushing and flossing. In addition, an antiseptic mouthwash may help control bacteria.  Chlorhexidine mouthwashes (0.2 per cent) is one of the most commonly prescribed antiseptics in oral healthcare. Rinses that employ this compound have long been considered to be a gold standard among oral antiseptic mouthwashes, acting on bacteria, spores and fungi.

Blood on your toothbrush or tooth floss could also be a sign of gingivostomatitis, a common infection of the mouth and gums. The main symptoms are a swelling of the gums which is uncomfortable. There may also be lesions in the mouth that resemble canker sores. This infection may be the result of a viral or bacterial infection and is often associated with improper care of your teeth and mouth.  Children with gingivostomatitis, the ultimate fate of the lazy child that never brushes, may drool and refuse to eat or drink because of the pain and ‘unease’ caused by the mouth sores.

Bleeding Gums Murphy

Murphy’s bleeding gums were more likely due to poor oral hygiene and his passion for smoking cigars than his saxophone. Older musicians, especially saxophone and trumpet players sometime experience orthodontic problems, soft tissue trauma, focal dystonia, denture retention, dry mouth and temporomandibular joint (TMJ) disorders.  There is no correlation between passionate saxophone playing and increased gingivitis or periodontitis.

Bleeding Gums Murphy, saxophone Lisa

Bleeding Gums Murphy (Simpsons TV Show) was depicted in the hospital with pink teeth to signify sever dental issues related to his saxophone playing.

How to Stop Bleeding Gums

Whatever the cause of sore, painful gums, there are steps you can take to minimize gum damage and discomfort.

An antiseptic mouthwash containing 0.02% Chlorhexidine may help. Such rinses are one of the most commonly prescribed antiseptics in oral healthcare as it acts on bacteria, spores and fungi.

Rinse your mouth with hydrogen peroxide.

Stop smoking.

Reduce stress level.

Increase your intake of vitamin C.

Increase your intake of vitamin K.

Eat fewer carbohydrates and brush / floss after every meal. Use antiseptic mouthwashes more regularly.


Define Halitosis, and Describe Halitosis Causes, Treatments

infected mouth, halitosis in adult male

There’s a big difference between bad breath and halitosis.   Bad breath is easily overcome and can literally be wiped away.  While embarrassing, it’s often only temporary. Halitosis on the other hand is usually a symptom of something more sinister.  If you have halitosis for real, then it won’t just go away by itself.  The condition is trying to tell you something, and at Archer Dental we listen with our noses.

What is Halitosis?

Halitosis describes the regular occurrence of an unpleasant odor in the mouth. Fetor oris or ‘chronic bad breath’ is a medical condition, as opposed to occasional bad breath which could have more benign causes. Halitosis is the symptom of a more complex medical issue, and only in the best and more easily remedied scenarios is it caused by certain foods, and corresponding poor oral hygiene; more often it relates to excess alcohol or tobacco use, dry mouth, and underlying medical conditions and or related medications.

See below for a long list of medical scenarios your bad breath may be signalling.

What Causes Halitosis?

Similar to body odour, there are many causes of chronic bad breath and only one is easily treatable: poor oral hygiene.  That just takes elbow grease to eradicate the odoriferous circumstances, and learning better habits helps keep it clean.  Below are seven other more serious causes for chronic bad breath.  Poor oral hygiene can often be cured with brushing and by using antiseptic mouthwash and other toiletries over time.

Poor Oral Hygiene can cause Halitosis

Some people have terribly unhealthy mouths, and this is mostly because they don’t put much effort into cleaning them up. They don’t brush often enough, and when they do brush their teeth, they don’t do a proper job of it.  In the short term, this behaviour will likely result in some unpleasant after-dinner aromas and morning breath scenarios, but long term the daily neglect can cause more complex oral health issues.

Pungent foods such as onions and garlic and other strong-smelling flavourings can leave particles behind in your teeth and on your tongue. Fish oils and other greasy substances don’t rinse away easily, and this results in an unpleasant odor.  Large quantities of sugar can also boost the bacteria count in your mouth. As the tiny organisms that live on your teeth and tongue digest the sugars, your breath turns sour.  Anaerobic bacteria can produce various byproducts, including sulfur compounds which smell terrible. By and large however, this is NOT halitosis.  It’s just bad breath. When food remains anywhere in the mouth, bacteria will break down the material creating a sulfur-like compound that gives off a fermented, bad-breath smell. This is the reason why Dr. Archer recommends that patients floss their teeth before they brush for best results. But this scenario is easily treated with a toothbrush and toothpaste, tooth floss and antiseptic mouthwash, and as such, this is NOT halitosis which is a medical condition that is not so easily mitigated.

Halitosis is chronic bad breath, and this medical condition is always a symptom of a greater malaise than malodorous meal choices. Repeated indulgences in smelly food combined with poor oral hygiene can create halitosis yes, but at some point, we go beyond oral health and enter into a discussion about mental health.

Natalie Archer n CBC Halitosis, bad breath

Dr Archer appeared on CBC The Goods to discuss Halitosis and bad breath prevention on Tuesday Jan 22nd 2018. Bad breath affects an estimated one in four people in North America. There are a number of possible causes of halitosis and the vast majority come down to inferior oral hygiene.

Dental Problems can cause Halitosis

Along with pain and discomfort, bad breath can be another way the body signals the presence of gum disease and tooth decay.  Dental issues can allow bacteria to hide in cavities, or inside pockets around the gums caused by conditions such as gingivitis and periodontal disease.  So chronic bad breath might be a signal its time to visit the dentist. Short-term breath freshening methods might mask the problem, but the smell always returns when core issues remain uncorrected.

Periodontitis, also generally called gum disease or periodontal disease, begins with bacterial growth in your mouth and may conclude with tooth loss due to destruction of the tissue that surrounds your teeth. Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). However, it is important to know that not all gingivitis progresses to periodontitis. Read more about the treatment of Periodontal disease at Archer Dental.

Other dental causes of bad breath include poorly fitting dental appliances.

Health Problems can cause Halitosis

Besides gum disease (periodontal disease) which was discussed above, there are other health conditions that can cause halitosis. People who suffer from diabetes, cancer, kidney disease, liver disease, lung disease and respiratory tract infections, or other lesser-well-known metabolic disorders often experience chronic bad breath because of a co-symptomatic dry mouth condition.  This document explores how dry mouth causes bad breath in detail below.

Diseases that affect the lungs and liver can cause halitosis in the mouth because of chemicals emitted by the body in each exhale.  Your liver regulates your body’s blood sugar. If your liver can’t function properly, toxins will build up in your bloodstream and give you foul-smelling breath that takes on a sweet, musty odor.  Lung cancer can (and usually will) result in bad breath.  Lung cancer causes a distinct breath odor that can be measured and used in early detection of the disease. Cystic fibrosis and asthma are two other lung disorders that have a distinct odor that is associated with them (both of them smell somewhat acidic). People suffering from sinusitis, pneumonia, postnasal drip, and polyps which affects the airways may also have foul breath. Chronic bronchitis is a long-term swelling and irritation in the air passages in your lungs.  The lung damage often gets worse over time, and it is usually permanent, but early signs and symptoms may include a morning cough that brings up mucus from the lungs and a bad taste or bad breath that is noticed by others.

Medications can cause Halitosis

Certain medications can cause chronic bad breath mostly because they cause dry mouth.  The term dry mouth is a medical condition called xerostomia which is dry mouth resulting from reduced or absent saliva flow. Xerostomia is not a disease by itself. This is a symptom of another related medical conditions, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications. Because saliva is necessary to moisten the mouth, neutralize acids produced by plaque, and remove dead cells that accumulate on the tongue, gums, and cheek, foul odours can be produced in this region of the body simply because there wasn’t any water there to wash them away.

Other medications and drugs such as nitrates which are used in treating angina, and chemotherapy chemicals and tranquilizers such as phenothiazines (which also reduces saliva production) can increase the occurrences of mouth odor because of the breakdown and release of chemicals from the body into the patient’s breath.

Crash Diets can cause Halitosis

low carb diet - ketones can cause halitosisLow-carb diets can cause halitosis when certain chemicals are released in the lung’s exhale as the body burns fat. This is called ketogenesis.  Ketogenesis is the biochemical process through which organisms produce ketone bodies through breakdown of fatty acids and ketogenic amino acids. During the process of ketogenesis, which is when ketone bodies are formed from the breakdown of fatty acids, acetoacetate is the first ketone that’s created. Beta-hydroxybutyrate is then formed from acetoacetate. Both acetoacetate and beta-hydroxybutyrate are responsible for transporting energy from the liver to other tissues in your body. Acetone, a biproduct of acetoacetate, smells like nail polish remover and this is the odour most commonly associated with this olfactory phenomenon.

Acetone, which is the simplest and least-used ketone body, is created spontaneously as a side product of acetoacetate.  Acetone, or propanone, is the organic compound with the formula (CH₃)₂CO. It is a colorless, volatile, flammable liquid and is the simplest and smallest ketone. Acetone is miscible with water and serves as an important solvent in its own right, its most typically used for cleaning laboratories and as nail polish remover. If your breath smells like acetone, or nail polish remover,  it may indicate that there are high levels of ketones in the blood. This may stem from your low carb diet, or diabetes, alcohol use, or dietary habits. If acetone is not needed for energy, it will break down and be removed from the body as waste through the breath or urine. Acetone is the cause of a characteristic fruity smell on the breath when someone is in ketosis or ketoacidosis.

Whether a person has type 1 or type 2 diabetes, an acetone-like scent in the breath can indicate diabetic ketoacidosis (DKA), a potentially life-threatening complication that needs immediate medical attention.

Acid Reflux can cause Halitosis

Chronic acid reflux, which is also known as gastroesophageal reflux disease is a medical condition. Acid reflux is the backward flow of stomach contents such as undigested food, regurgitated bile, and stomach acids into your esophagus. This can lead to tooth decay (as the acid dissolves enamel) and bad breath.

What causes acid reflux? The primary cause of this medical condition in most sufferers is a faulty or relaxed lower esophageal sphincter.  The LES for short is a valve-like muscle (like a thick rubber band) that forms a barrier between your esophagus and your stomach. When the LES works appropriately, it opens when you swallow to let food enter the stomach, and then it closes tightly. A faulty LES however, remains open, and this allows acids to flow back-up and into your throat.  The regurgitation of stomach contents can cause heartburn and a bitter or sour taste in your mouth. What’s more, you’re also likely to experience bad breath as a result of your symptoms. Bad breath can be controlled not only by managing your GERD, but also by making a few changes.  You can read more about how everyday acids and bases affect oral health and human homeostasis.

Tonsillitis can cause Halitosis

Tonsil Stones cause halitosisNormally your tonsils help fight infection. The small, soft, fleshy bits of tissue that reside at the back of the mouth evolved to help detect and filter bacteria and viruses that enter through the mouth. They protect the blood stream by producing white blood cells and antibodies.  But tonsils are sensitive instruments that are covered with the same mucous membrane, or mucosa, that lines your mouth, nose and throat. It’s the crevices, or crypts, in your tonsils’ mucosa that may lead to smelly health problems. Inflamed tonsils get red and swollen and can cause a sore throat. Bad breath and throat irritation can also be signs of tonsillitis.

Tonsils are designed to trap bacteria; that’s their job. Unfortunately, bacteria can cause infection, and is stinky, and has a host of other characteristics that spell trouble. This is why so many children (and adults) end up getting their tonsils removed. Sometimes this bacteria becomes struck, and attracts more bacteria and other things until it eventually forms a small mass that calcifies. Tonsil stones are small calcium deposits that harden and grow on the tonsils. These are actually visible in the featured image of this blog post. The model has tonsilloliths or tonsilliths which is the medical term for this phenomenon. It’s not a serious condition, but since it is entirely composed of bacteria and other debris, it smells bad. Some people say it smells like vomit.

Smoking can cause Halitosis

If halitosis is defined as regular occurring bad breath and smokers get their mouth fouled after every cigarette, then technically smoking cigarettes all by itself causes halitosis.

Tobacco products cause their own types of mouth odor as the smoke is filled with hundreds of toxic chemicals.  Additionally, tobacco smoke (and marijuana smoke) may increase the chances of gum disease which also causes bad breath.  Three common bacteria are involved in gum disease.  Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia are all present in higher amounts in smokers than non-smokers.  We could discuss prevention, and cessation but once again we would be departing the province of oral health and entering into the realm of mental health.

Fetor hepaticus – the breath of the dead

Fetor hepaticus occurs when your breath has a strong, musty smell. It’s a sign that your liver is having trouble doing its job of filtering out toxic substances, usually due to severe liver disease. As a result, sulfur substances end up in your bloodstream and can make their way to your lungs. When you exhale, these substances give your breath a distinct smell which some say is similar to the smell of rotting flesh.  This is how and why you may hear fetor hepaticus referred to as the “breath of the dead.”