Bad breath?

Author: Jeff Salmeri

Have you ever noticed that your friends or co-workers take a step back when you say hello?  Do they turn away from you when you talk to them? This could be a sign that you have bad breath.  Bad breath can come from many things. bad breathThe food you eat and sinus problems are two common reasons. But more likely your bad breath is caused by periodontal disease (gum) disease.  Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque causes the gums to become inflamed.

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. The most common ones include the following.

Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.

Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.

An appointment with your dentist is needed for a thorough dental exam which includes a periodontal exam by the dental hygienist. 

Your gums can become infected with very few signs.  The disease may be advanced by the time you notice symptoms.  Left untreated you could lose your teeth and begin to suffer from many other health issues such as heart disease or diabetes.  Do your gums bleed a little when you brush and floss?  Do they look red and slightly swollen rather than pink and healthy?  Ask someone you are close to if your breath smells bad.  If the answer is yes you need to make an appointment for a dental exam as soon as possible.  Don’t wait until it is too late and it becomes necessary to have your teeth extracted.  Caught early enough and with the proper treatment you will be confident your smile and your breath are delightful!  Whatever the reason is for your bad breath, it is very important to be checked by your dentist. 

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