Thangam G (68) from Erode, Tamil Nadu says that her dentist removed several teeth as they started to loosen in the gums over time due to diabetes. Despite taking medications, her blood sugar levels did not come under control due to the lack of a healthy and sustainable diet plan.
“My dentist replaced the lost teeth with a partial denture. It helps me chew my food, but food particles get stuck between the denture and the remaining teeth,” she says.
Diabetes and oral health
“I would often get gum infections and my mouth used to be dry. The dentist told me that it could be because of uncontrolled diabetes,” says Thangam.
She also experienced bad breath due to the food particle remnants and dry mouth. Her dentist performed scaling (removal of plaque build-up and debris from the teeth) and deep cleaning to prevent gum infections.
She was advised to gargle and clean the denture with tap water after every meal. Her physician suggested a diet plan and some lifestyle changes that included restricting sugary foods, having six meals a day and avoiding longer intervals between meals. Moreover, she had to drink adequate water and go for a walk every day. These healthy measures helped her manage diabetes (along with medication) and bad breath.
Mouth odour
Halitosis or bad breath is an unpleasant odour experienced commonly by adults. It is harmless but causes discomfort and social embarrassment.
When the food particles stuck between the teeth, gums, and tongue are missed out while cleaning, they decay and cause bad odour.
Internal and external sources of bad breath
A 2022 study by Maaz Anwer Memon and his team from Khyber Medical University, Pakistan, shows that 80 to 90 per cent of bad breath occurs due to intra-oral factors and 10 to 20 per cent occurs due to extra-oral factors.
The intra-oral factors include gum infections, unclean tongue, cavities, dry mouth, oral ulcers, braces, dentures, and poor oral hygiene.
The extra-oral factors include the enlargement of adenoids (a part of immune system), allergic rhinitis (inflammation in the nose that causes runny nose), peptic ulcer with Helicobacter pylori infection, and kidney, or liver disorders.
Experts say that systemic conditions like diabetes, lung infections, long-term sinus problems, and bronchitis can also lead to bad breath.
Is bacteria the foe?
Saliva removes the particles and harmful bacteria from the mouth. “The salivary flow gets reduced due to various reasons like medications taken for systemic conditions or salivary gland disorders,” says Dr Athirai V, dentist from Kanyakumari, Tamil Nadu.
Reduced salivary flow causes dry mouth which in turn favours the multiplication of bacteria. These bacteria reside over the tongue producing sulphur compounds, causing an unpleasant odour, she adds.
Experts say that people with gastritis (inflammation of the stomach lining) caused by Helicobacter pylori experience a yellow-coloured tongue coating.
Dry mouth
Coimbatore-based dentist, Dr Divya Dharshini M, says, “People with enlarged adenoids and blocked nose due to common cold or respiratory infections breathe through their mouth. This dries out the saliva and causes dry mouth.”
Dehydration is another cause for dry mouth. However, everyone has decreased salivary flow during sleep and experiences a dry mouth, especially in the morning. Following a daily oral care routine helps to overcome the bad odour.
Other factors of bad breath
“Smoking increases the severity of bad breath. It affects the gums and bones surrounding teeth and alters the beneficial microorganisms present in the oral cavity,” says Dr Dharshini.
Regular consumption of alcohol for a long period produces certain by-products such as acetaldehyde in the body that causes bad breath, she adds.
A study published in International Dental Journal in 2002 found that some foods like onion, garlic, and certain spices aggravate bad breath due to the release of some like mercaptan and sulphur after consumption.
Some individuals may have bad breath while wearing a mask for long hours as it restricts the airflow. This phenomenon is called mask breath.
A step towards fresh breathe
A 2021 study published in the International Journal of environmental research and public health, states that cleaning the tongue is an effective oral hygiene procedure. Using a tongue scraper or toothbrush over the tongue helps reduce bad breath thereby decreasing the bacterial coating.
Dr Dharshini suggests the following remedies to overcome bad breath:
- Using an antibacterial mouthwash along with brushing and flossing helps to control bad breath and cleanse the teeth
Read more about oral benefits of mouthwash.
- Gargling with water after every meal is a must to remove the hidden food particles that are between the teeth
- Individuals with systemic conditions should consult a physician for the management of the underlying cause to improve their oral hygiene
- Chewing sugarless candies increases the salivary flow and prevents dry mouth
- Individuals wearing a denture should take extra care by removing it at night and placing it inside a jar filled with water
- People with gum ailments should consult a dentist and undergo deep cleaning at least twice a year
