World Oral Health Day: Why do you still have bad breath even though you brush your teeth in the morning and evening?

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Fresh breath is a healthy oral condition that modern people pursue. In the past, people used toothpaste and brushing to eliminate bad breath. Today, chewing gum, mouthwash, breath fresheners, and other oral products are emerging in an endless stream. But we still find that even if we brush our teeth every morning and evening, we still have bad breath in our mouths. Why is this?

To understand this problem, we need to first understand how bad breath is produced.

Oral odor, also known as halitosis, has a complex etiology. The most common types are physiological halitosis and pathological halitosis. Physiological halitosis is often caused by the reduction of the self-cleansing function of saliva, such as the reduction of saliva secretion at night when sleeping. This type of halitosis is characterized by short duration and does not require special treatment. Pathological halitosis includes two sources: oral and systemic. Oral sources are mainly caused by oral diseases such as periodontal disease, while systemic sources are mainly related to some non-oral diseases such as the respiratory tract, digestive tract, and endocrine system.

It is currently believed that the bacteria in the mouth are the root cause of all oral halitosis, which is caused by the metabolism of food residues, desquamated epithelial cells, blood, gingival sulcus fluid, plaque, etc. by microorganisms in the mouth. The large number of bacteria colonized on the surface of the tongue is the main cause of physiological halitosis, which explains why brushing teeth alone cannot effectively remove halitosis. It is necessary to clean the tongue while cleaning the mouth every day to achieve the effect of effectively removing halitosis.

Patients with periodontal disease need to go to a dental hospital for periodontal treatment. Patients with systemic diseases that cause bad breath need to receive systemic disease-related treatment. Only by solving the source of bad breath can the bad breath problem be completely eliminated.

So, can oral products such as mouthwash eliminate bad breath? And can we use them for a long time?

Mouthwashes without active ingredients usually cover up bad breath through the taste of the mouthwash itself, but do not really remove bad breath, and the effect is short-lived. Some mouthwashes containing antibacterial ingredients may cause side effects such as disturbance of normal oral flora, taste changes, and coloration if used for a long time, so they need to be used under the guidance of a doctor.

To maintain fresh breath, you need to choose a method that suits you according to your oral health. For people with physiological halitosis, they need to clean their tongue every day on top of regular oral hygiene. For patients with periodontal disease or related systemic diseases, they need to go to a medical institution for treatment of the disease on top of regular oral hygiene and cleaning their tongue. Long-term use of mouthwash containing active ingredients should be used under the guidance of a doctor.

Author: Liu Xuenan, Director of the Oral Medical Division of the Chinese Stomatological Association and Associate Researcher at Peking University School of Stomatology

Review | Si Yan, a researcher at the Chinese Stomatological Association and chief physician at Peking University School of Stomatology