Bad Breath

Dr. B, my husband had his gall bladder out in November 1999. Before and since surgery, he has had the most foul smelling breath about two to three hours after he eats. I thought once he had the surgery, this smell to his breath would disappear. He does have caps on his teeth. He has regular check-ups with his dentist and gets his teeth cleaned on a regular basis, but this smell to his breath persists. He does not seem to notice it himself, but I find it hard to talk with him at close range without getting a sniff of his foul odour. I have encouraged him to brush often, but this does not seem to dispel the odour for very long.

I would like to know what is causing this unusual odour and I would like to know what, if anything can be done to eliminate it or at least diminish it, asks a distressed Mrs. X.

Dear Mrs X: Removal of a gall bladder does not get rid of chronic bad breath. The commonest indication for removal of gall bladder (cholecystectomy) is for pain in the right upper quadrant of the abdomen due to gallstones not for bad breath.

Bad breath (halitosis) can be due to several causes. Infection in the mouth (stomatitis), gums (gingivitis), or extensive caries can give bad breath. Infection in the windpipe and the lungs, fishy odour of the breath due to liver failure, urinary odour in kidney failure, and sweet, fruity odour is typical of diabetic crisis. Infection and tumours of the oesophagus can give bad breath as well.

Occasionally, otherwise normal persons will have halitosis without obvious cause. Some who smoke heavily have halitosis. Common but harmless cause of bad breath is what we eat – garlic, onions, and high protein diet.

Most bad breath comes from something in the mouth. Food sticks between our teeth, around the gums and on our tongue. This food rots and allows bacteria to grow and thrive creating volatile sulphur compounds. The sulphur compounds give bad breath.

How can we prevent bad breath?

Brushing and flossing are two of the most crucial elements for attacking bad breath. Learn proper technique to floss and brush. Most of us spend less than one minute to brush. That is not good. We should spend atleast five minutes. Flossing is also very important in removing rotten food particles in the spaces between our teeth. As somebody has said – brushing without flossing is like washing only 70 percent of your body.

Keep your tongue clean. Scrap it with a tongue cleaner.

Avoid food and beverages that give bad breath: onions, garlic, and alcohol. Avoid tobacco products.

Avoid dry mouth by drinking water, chewing sugar-free gum and sucking on sugar-free mint. Remember alcohol, tobacco products and certain medications can make your mouth dry and result in bad breath.

Keep your dentures and removable braces clean. Have regular dental check-ups.

If you still have bad breath then see your family doctor to check for other causes.

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