Published December 20, 2020, 12:10 AM

by Dr. Jose Pujalte Jr.


Dr. Jose Pujalte, Jr.

 “Do you mind if I sit back a little? Because your breath is bad – it really is.” – Donald JohnTrump (b.1946), 45th US president, to Larry King on CNN’s “Larry King Live”

That quotation appears in Stanley Bing’s book “What Would Machiavelli Do?” opening the chapter “He would make a virtue out of his obnoxiousness.” In our culture of course, hardly anyone will tell it to your face that you’ve got bad breath. The caring friend would probably give you a travel toothbrush instead.

Halitosis. The medical term for bad breath is “halitosis.” The clinicalese, of course, doesn’t make it redolent but it does allow enough distance (pardon the pun) to analyze the condition.

Causes of Bad Breath.  You cannot fully and permanently mask bad breath on a diet of mints and mouthwashes. Rinsing the mouth with these products, without finding out the cause of foul breath, gives the false confidence of getting up close to that special someone. Big stench of a mistake.  The usual suspects are:

  • Food – The top bad breath generators are onions, garlic, and coffee. Some spices have such strong odors that others have to be restrained from spray-deodorizing the offending mouth. While brushing may help, the smell doesn’t disappear until the food is digested and passed from the body.
  • Gum disease and cavities – Healthy gums are pink and firm. If they are swollen and bleed easily on brushing or flossing, there is gingivitis. The common cause for gum disease and tooth decay is dental plaque. Plaque forms from deposited bacteria that coalesce into a sticky film and later on becomes a hard layer.
  • Smoking (big surprise!) – Tobacco products not only stain teeth, gums, and tongue, they also impart that oh so distinctive “smoker’s breath.” This is a variant of bad breath which is fine if your friends are chimneys too. Smoking may also cause periodontitis, a severe form of gingivitis that extends to the supporting elements of teeth. Chronic periodontitis not only means cavities and loose teeth, but baaaad breath as well.
  • Extreme dieting – Yes, even low-carb diet gurus will tell you that if the diet is working, one of the signs is bad breath. A body deprived of carbohydrates turns to protein and fat to use. As these are broken down, chemicals are released that give unpleasant breath.

Bad Breath as a Bad Sign.  Sometimes bad breath may point to something more serious. It’s not hard to imagine the result of a dry mouth (xerostomia), a condition where saliva is deficient. Without saliva, the mouth is unable to neutralize acid from food and plaque. Dry mouth can be a side-effect of certain medications.  In patients with chronic kidney problems, the breath is described as “urine-like.” Those with long-standing liver disease have “fishy” breath while a patient with untreated diabetes has a “fruity” breath. In obstruction of the intestines, the breath becomes “fecal.” More commonly, nose and throat infections characteristically will want your boss to move three feet away after you open your mouth. Unless these are treated, bad breath will not disappear.

Self-Care. You need good oral habits.

  • Brush teeth after eating. Yes, even at work.
  • Invest in a tongue scraper. Supermarkets carry this plastic, spoon-shaped dental device. The tongue is ignored as a source of bad breath when it is, in fact, likened to a dirty carpet in need of regular vacuuming. Food debris is efficiently removed with a tongue scraper.
  • Floss at least once a day. You may never know what ancient, rotting food lie between the teeth!
  • If you wear dentures, clean them every day.
  • Hydrate, hydrate, hydrate. It’s best to drink water and not more of those sugary beverages. Water keeps the mouth moist.
  • Stop smoking.
  • See your dentist at least twice a year.

Try simple solutions for bad breath. If it doesn’t go away, go to a dentist or


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