Causes of Bad Breath

What causes bad breath?

Oral causes are responsible for 76% of oral malodor (bad breath).  The main sources are:

• tongue coating accounts for 43% of it
• gingivitis and periodontitis accounts for 18%

The Journal of Clinical Periodontology  reported on a study from the halitosis clinic at the Catholic University Leuven in Belgium.  A protocol for not eating onions, garlic or spicy food, not drinking coffee or alcohol or smoking cigarettes, and not using chewing gum, mints, drops, scents or mouthrinses before the breath measurements was established.  Medical history, oral hygiene habits, ENT problems and diet were recorded.  A clinical examination was performed, including and organoleptic (smelling of the breath) test and an evaluation of tongue coating visually and by weighing the scrapings from the back of the tongue.

Results for bad breath

The results showed clear correlations between organoleptic scores and tongue coating scores, weight of tongue scrapings, and the objective measure of volatile sulphur compounds by the OralChroma device.  In addition, subjects who smoked, did not floss between their teeth or had a diet of predominantly soft food had more tongue coating and higher oral malodor scores.

J Clin Perio 40:180-185, 2013, as reported in Dentaltown news


Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Oral Health--Osteoporosis Connection

What is Osteoporosis

Osteoporosis is a disease characterized by reduced density of bones, and subsequent tendency to fracture, caused by aging, menopause, and lack of vitamin D and calcium.  More women than men are affected by the condition.

Osteoporosis Affects Teeth

For those people with teeth, studies have shown that osteoporosis affects the bone surrounding the roots of the teeth, resulting in loss of bone height or causing tooth mobility.  Gingivitis refers to inflammation of the gum tissues.  When that inflammation spreads deeper, below the gumline, to the tissues that attach to the root or are close to the bone around the roots, then the condition has become periodontitis.  Therefore, for the patient with osteoporosis, who also has gum inflammation, there is a greater risk for that inflammation to progress to periodontitis and cause tooth loss.

For the patient who has no teeth and wears complete dentures, osteoporosis causes more rapid loss of the bone that forms the ridges upon which the dentures rest.  Less bone means a denture with less retention and stability, with concomitant discomfort and lack of function.  This bone loss also requires the dentures to be relined or replaced more frequently.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Don't Shy Away From Bleeding Gums

There are many causes of bleeding gums:

• Gingivitis: an often painless inflammation of the gums that is entirely reversible with meticulous oral hygiene--brushing and flossing.  Left untreated, however, it can lead to periodontitis, which is considerably more serious.
• Smoking: inhaling smoke directs toxins to the tissues and causes reduced oxygeneration of the blood supply of the tissues, making them more fragile.
• Hormones: hormonal changes during menstruation and pregnancy increase chances of bleeding gums.
• Medications: bleeding gums are a side effect of over 400 medications.
• Diet: carbohydrates from starchy and sugary foods create debris that sticks to the teeth and gums and can cause inflammation if not removed.
• Poor Oral Hygiene: eating food creates the formation of bacterial plaque on teeth and gums that needs to be removed daily to prevent the acids in the plaque from harming teeth and gums.

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Your Prosthodontist Knows About Lupus

Lupus is a chronic inflammatory disease that can affect various parts of the body, especially the skin, joints, blood and kidneys.  Approximately 95% of lupus patients suffer from some form of oral involvement.  The oral complications are either directly related to the disease or come about as a side effect of medical treatment.  Lupus patients may suffer from the following mouth symptoms: dry mouth, cracked lips, bleeding gums, sore jaws, gingivitis (gum disease), cracked or swollen tongue, lesions (ulcers) on any soft tissue surface including the cheeks, lichen planus and yeast infections. Denture wearers are more susceptible to soft tissue irritation and sore spots. Lupus patients should make sure their dentist has experience and knowledge of lupus and autoimmune diseases and takes a full medical history and updates the list of your medications regularly. 

Source:  Lupus Guide to Dental Care by HeatherGalusha-Phillips

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309

Alcohol-Free Chlorhexidine Mouthrinse

Chlorhexidine mouthrinse is a prescription rinse that specifically attacks the bacteria that cause gum inflammation, and is commonly used in patients with periodontal conditions.

A study by Todkar compared the efficacy of alcohol-free chlorhexidine mouthrinse, chlorhexidine containing alcohol and a placebo of water in terms of controlling gingival plaque and reduction of gingival inflammation in patients with gingivitis.

Measurements were made at the beginning, after 14 days and after 28 days.
The study concluded that the alcohol-free rinse was as effective as the one containing alcohol in controlling plaque and reducing gingival inflammation, and can be recommended for periodontal patients, especially those for whom the use of alcohol may lead to side effects.

Reported in: Dentistry Today, Feb., 2013, from Oral Health & Preventive Dentistry, Fall 2012, vol 10, issue 3, pp 291-296.


Robert G. Tupac, DDS, FACP, Inc.,
Diplomate, American Board of Prosthodontics
(661) 325-1275 | www.drtupac.com
5060 California Ave., #170, Bakersfield, CA 93309 (map)