Wednesday, August 26, 2020


Morning breath is the term that people commonly use to describe breath that smells bad when a person wakes up. It is a very common problem.

The Academy of General Dentistry have estimated that 80 million people in the United States experience chronic bad breath. However, there are many straightforward ways to treat morning breath.

What is morning breath?

Good oral hygiene can help prevent morning breath.

Morning breath is a type of bad breath that affects people when they wake up. The medical term for bad breath is halitosis, which describes chronic bad breath that does not go away.

Causes of morning breath

According to the American Dental Association (ADA), morning breath occurs due to a buildup of bacteria in the mouth overnight.

Food particles

During the night, the enzymes in saliva will break down food particles remaining in between teeth, on the tongue, or around the gumline. This breakdown releases volatile sulfur compounds (VSCs), which give off a bad smell.

The specific foods that a person eats can also influence how their breath smells. The list of foods that can cause bad breath is very long and includes:

*       garlic

*       onions

*       coffee

*       spices


Smoking can also cause bad breath. A person may not be aware of the effect that smoking can have on their breath odor because smoking dampens the sense of smell.

Dry mouth

A person may experience morning breath if they have a dry mouth. Saliva helps the mouth clear out bacteria that build up over the day and night. If the mouth is not producing enough saliva, bacteria will be able to build up more often. As a result, the release of VSCs overnight may be higher, potentially causing morning breath.

One study that investigated the effect of water on morning breath found that drinking water or rinsing the mouth with water in the morning reduced VSCs by 30–50%, leading to an overall improvement in morning breath.

Breathing through the mouth can also dry it out. People who sleep with their mouth open or snore heavily may have a drier mouth and be more likely to have bad breath in the morning.

Poor oral hygiene

Poor oral hygiene is a common cause of morning breath. Proper brushing and flossing remove bacteria and food particles that cause bad breath.

If a person does not regularly and effectively clean their teeth, they could also develop tooth cavities and gum disease. Gingivitis and periodontitis are types of gum disease that can cause bad breath.

Tooth cavities resulting from bacteria that produce plaque can trap more bacteria in the mouth, as can the deep pockets that gum disease causes. A person can then find it hard to clean the bacteria away when they brush their teeth.

Underlying medical conditions that cause morning breath

The cause of morning breath can be as simple as poor dental hygiene, especially if it leads to complications. Tooth decay or a “dead tooth” can cause bad breath that may be even worse in the morning.

However, certain underlying chronic conditions that are not directly related to the mouth can sometimes be responsible for an unpleasant breath odor.

For instance, untreated diabetes can be a cause of bad breath. Some infections — such as tonsillitis, sinusitis, and bronchitis — and fungal infections of the mouth, lips, and tongue can also have an adverse effect on the breath.

In some cases, liver or kidney disease may result in bad breath.

A person will experience other symptoms alongside bad breath if an underlying condition is the cause.

Treatment and remedies

People can often improve their morning breath by doing the following:

Keeping the mouth clean

A person can treat morning breath or longer lasting halitosis by improving their dental hygiene.

Brushing the teeth twice a day and cleaning in between them with dental floss or interdental brushes can keep mouth bacteria under control. A person can also use mouthwash to help clear bacteria out of the mouth.

One study on the effectiveness of mouthwash against morning breath found that the daily use of mouthwash significantly reduced the number of bacteria in the saliva. Flossing and mouthwash can also ensure that no food remains in the mouth overnight.

A person can also use a tongue scraper as part of their brushing routine to remove bacteria from the tongue. Tongue scraping is a gentle technique, but some people may find it uncomfortable because it can trigger the gag reflex.

Anyone who wears removable dentures should take them out at night and clean them thoroughly before wearing them again the next day.

It is also important to make regular visits to the dentist to help maintain oral hygiene.

Drinking more water

A person may find that increasing their water intake and reducing how much caffeine and alcohol they consume leads to an improvement in their breath odor.

Staying well-hydrated by drinking water can increase the amount of saliva that the mouth produces, which will help keep mouth bacteria under control.

Caffeine, alcohol, and smoking can dry out the mouth. Certain types of medication can also have this effect.

When to see a dentist

Usually, there is no need to worry about waking up with morning breath.

However, if a person finds that their morning breath is not going away with conventional treatments, such as improving dental hygiene and keeping their mouth from becoming dry, they may need to seek advice from a dentist.

A person should see a dentist if:

*       they have a constant bad taste or smell in their mouth

*       they are experiencing other new symptoms along with bad breath

*       they spit blood when they brush their teeth

Blood in the saliva after brushing the teeth can be a sign of gum disease and requires medical treatment. If the dentist finds that the odor is not due to oral factors, they may advise the person to consult a doctor.

A person may experience poor mental health and self-esteem if they are aware that they have morning breath or halitosis. They may feel constantly stressed about having bad breath, which might adversely affect their social life and relationships.

If a person is very worried about morning breath or halitosis, a psychiatrist may be able to help them overcome their anxiety around this issue.


Morning breath is very common among the general population, and it does not usually last long into the day.

A person can improve their breath odor by brushing the teeth thoroughly, using mouthwash and dental floss, and staying hydrated to stop their mouth from becoming dry.

A person should seek medical advice if their bad breath does not go away or if they are experiencing symptoms of an underlying condition that may also be causing bad breath.


Monday, March 9, 2020

What Vaping, Smoking Do to Your Mouth’s Microbiome — and How That Affects Your Health

  • Researchers say they’ve discovered that vaping and smoking cause changes in the mouth’s microbiome.
  • Those changes can lead to an increased risk of infection, inflammation, and gum disease.
  • It’s the latest research that links oral health to the overall health of the body.
Vaping e-cigarettes could induce changes to the composition of the mouth’s microbiome, leading to increased risks of inflammation, gum disease, and infection.
That’s the conclusion of a study published today from the New York University College of Dentistry.
Researchers looked at a group of more than 100 cigarette smokers, e-cigarette users, and nonsmokers.
They found that smokers and e-cigarette users had significantly higher rates of gum disease and infection — 73 percent and 43 percent, respectively —than nonsmokers, who had a 28 percent rate of disease.
The researchers then used saliva samples from study participants to investigate what was driving these rates of disease and infection.
They found that smoking and e-cigarette use led to bacterial changes in the mouth, including increased levels of two different types of bacteria in e-cigarette users known to cause periodontal disease.
Just like in the gut, the composition of the microbiome in your mouth affects your propensity for infection and other diseases.
In general, healthier bacteria leads to healthier outcomes.
The bacterial changes among vapers indicate that there will be a favorable environment for opportunistic pathogens to grow more in the mouth much faster, as compared to the good bacteria [normally there] and change the whole microenvironment, which may be which may further lead to other complications.
 The pathogens that are known to be the most aggressive are all anaerobic, which means they thrive in an oral environment without the presence of oxygen. The dry oral environment and presence of nicotine, which reduces blood supply and oxygen levels, help create an environment that allows these bacteria to proliferate at an increased rate.
The mouth’s health is a leading indicator of other health complications.
Essentially, vaping creates and promotes an environment that allows the impact of these bacteria to be exacerbated and further promote complications associated with poor periodontal health such as increased risk for cardiovascular disease, Alzheimer’s, dementia, stroke, heart attacks, respiratory infections that can lead to pneumonia, osteopenia, rheumatoid arthritis, uncontrolled diabetes, and even preterm or low birth weight babies as well as exposing the fetus to infections.
The reality, is that the microbiome changes might not just be happening in the mouth — it’s simply harder to test the microbiome of the lungs, for instance — but equally possible these changes are happening elsewhere.
This may be happening down the respiratory tract or the GI tract, which we don’t know because there is no data available. Anybody who is planning to start using e-cigarettes, use with the caution that this can happen in the mouth. This can happen in the lungs. This can happen in the skin or nostrils or other places also.
According to the new study, traditional cigarette smokers still had significantly higher levels of infection and inflammation than vapers, but nothing beats stopping smoking altogether for oral health.
While some people vape as a way to smoke less frequently or smoke “healthier,” that assumption of lower health risks has been thrown into contention as more studies into the health effects of vaping surface.
Recent research shows negative health consequences of vaping may include cell dysfunction, damage to DNA, and compromised cardiovascular health.
In addition, most of those studies pre-date the appearance of a mysterious vaping-related respiratory illness that emerged last year.
Part of this is simply because e-cigarettes have not been on the market long, so scientists don’t have a full understanding of all their effects, Saxena said.
Research has shown how interconnected the mouth and the rest of the body are.
The oral bacteria that cause gum disease have been found in the clots of both stroke and heart attack victims, showing they enter the bloodstream from diseased gum tissue and cause damage elsewhere in the body.
Because it is so common, the infection and inflammation from untreated gum disease is one of the most studied connections between poor oral and overall health risks.
Experts say if you want to have a healthier oral microbiome and better overall health, there is a simple solution: Stop smoking, whether that’s vaping or cigarettes.
The microbiome is reversible. So, if you stop now and the cells are not in stress and there is a good saliva production, the oral ecology will become normal again.

Thursday, March 5, 2020

What is trismus?

Trismus, or lockjaw, is a painful condition in which the jaws do not open fully. As well as causing pain, trismus can lead to problems with eating, speaking, and oral hygiene.
Trismus occurs when a person is unable to open their mouth more than 35 millimeters (mm). It can occur as a result of trauma to the jaw, oral surgery, infection, cancer, or radiation treatment for cancers of the head and throat.
Most cases of trismus are temporary, typically lasting for less than 2 weeks, but some may be permanent.
In this article, we explore the causes and symptoms of trismus. We also look at the current treatment options for this condition.
Trauma and inflammation are possible causes of trismus.
There are many possible causes of trismus, including the following:
Injury or damage to the jaw can lead to trismus. Examples of such trauma include fractured jawbones or tissue damage following dental surgery.
Others include:
  • contusion of the temporomandibular joint (TMJ)
  • hematoma, which is a collection of blood outside of blood vessels
  • injury to the muscles of mastication, which people use when chewing
Some medical conditions that cause inflammation in the mouth may cause trismus. One example is pericoronitis, which is inflammation of the soft tissue around a tooth, potentially leading to an impacted molar.
Others include:
  • arthritis in the jawbones
  • scleroderma, which is an autoimmune disease that affects connective tissue
  • soft tissue fibrosis, which occurs when excess fibrous connective tissue forms
Dental surgery
Oral surgery, including wisdom tooth extraction, may cause inflammation in the mouth, which can lead to trismus.
Hyperextension, which is having to open the mouth wider than its usual range of motion, during surgery may also lead to lockjaw.
Infections can contribute to trismus in some cases.
Types of infections that may do this include:
  • mumps
  • tetanus
  • tonsillitis
  • peritonsillar abscess
  • other types of abscess
Cancer or cancer treatment
Cancerous tumors in the head or throat can affect the function of the jaw.
Radiation treatment for these tumors can also cause trismus.
According to a small 2016 study consisting of 30 participants with oral cancer, trismus affected 53.3% of them at the time of diagnosis.
This number increased to 86.7% after surgery and 85.7% after radiotherapy.

While anyone can develop trismus, some factors may increase the chance of developing it.
These include:
  • having head or neck cancer
  • undergoing radiation treatment for head or neck cancer
  • recent oral surgery to remove a wisdom tooth
  • recent trauma to the mouth or jaw
  • having certain types of mouth infection
The defining symptom of trismus is the jaw not opening fully or opening to 35 mm or less.
Other symptoms include:
  • jaw pain and cramping
  • difficulty biting, chewing, or brushing the teeth
  • inability to swallow some foods
  • headaches
  • earache
Typically, treating the underlying condition should resolve many cases of trismus.
Generally, the earlier a person seeks treatment, the better the outcome.
Treatment options include:
It may be necessary to take medication to reduce pain and relax the jaw muscles. Common medications for trismus include muscle relaxers and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
Depending on the severity of the symptoms, a doctor may prescribe oral medications or drugs that require injection into the jaw.
Some forms of NSAIDs are also available over the counter.
Jaw-stretching devices
A doctor or physical therapist may recommend the use of a jaw-stretching device.
In a 2014 study, people who used such a device when performing specific mouth exercises had an average increase in mouth opening of 5.5–7.2 mm.
Dietary changes
Individuals may need to make dietary changes until the condition improves.
For most people, moving to a soft foods diet is helpful because it is possible to eat these foods without opening the mouth too much.
Examples of soft foods include:
  • soup
  • smoothies
  • yogurt
  • mashed potatoes
  • oatmeal
  • beans
  • steamed vegetables
  • stewed fruits
  • cheese
  • fish
  • scrambled eggs
Until trismus resolves, it may be beneficial to avoid foods that are hard, crunchy, or chewy, such as candy bars, uncooked apples, and tough meats.
A doctor will carry out a physical examination and take a person’s medical history to diagnose trismus.
They may ask about recent injuries or dental work and look for signs of cancer or abnormalities in the bones or tissues of the jaw.
A doctor may use one or more of the following tests to help them diagnose or rule out trismus:
  • a measurement of the mouth opening
  • a CT scan
  • an MRI scan
Trismus may cause a variety of complications that can affect a person’s quality of life, including:
Oral hygiene problems
If a person cannot open their mouth fully, this makes maintaining oral hygiene more difficult.
Poor oral hygiene can lead to:
  • bad breath (halitosis)
  • dental caries (cavities)
  • infection
Trismus may also make it challenging for those wearing dentures to insert the dentures or remove them for cleaning.
Difficulty eating
If people cannot bite, chew, or swallow properly, there is a chance of malnutrition and dehydration.
Temporarily moving to a predominantly liquid and soft foods diet may help reduce these risks.
Many of the infectious and traumatic causes of trismus may also have associated complications. For example, an odontogenic infection that causes trismus may lead to further infection with facial cellulitis or mandibular osteomyelitis.
If an infection is the cause of trismus, there may be associated complications, such as cellulitis.
Cellulitis is skin inflammation that is often due to infection. The symptoms include:
  • edema, or swelling
  • reddening of the skin
  • warmth emanating from the infection site
  • pain
Trismus is a painful condition involving a reduction in the size of the mouth opening between the jaws.
Most cases are temporary, and medications, physical therapy, and other treatments can often effectively alleviate trismus and reduce or prevent complications. Early treatment typically provides the best outcomes.
Individuals who have concerns about trismus or their risk of developing it should speak to their doctor or dentist.

Thursday, December 12, 2019

Dry mouth, how to deal with it.

Sometimes, the solution is as simple as drinking water to avoid a dry mouth from thirst. Dry mouth may also appear due to other reasons, such as a medication or underlying condition.
Learn about 11 home remedies for dry mouth, as well as when to speak to a doctor.
Anyone experiencing dry mouth should ensure that they are drinking enough water.
Drinking water throughout the day can help prevent the minor dehydration that may lead to dry mouth.
Sipping water slowly and regularly throughout the day can help prevent an upset stomach that can occur as a result of drinking too much water at once.
Poor oral health can cause dry mouth, and dry mouth may also lead to poor oral health. Taking steps to improve overall oral hygiene is vital, no matter what the underlying cause of dry mouth is.
Good oral hygiene includes brushing and flossing each day, as well as rinsing the mouth with water or mouthwash after meals to help wash away food particles.
Some people choose to use a tongue scraper to help reduce bacteria on their tongue, which may also improve overall oral health.
Mouthwash can play a positive role in maintaining oral health, but it is important to consider the ingredients in a mouthwash. Mouthwashes that contain alcohol kill bacteria, but they may also dry out the mouth.
However, mouthwashes containing ingredients such as xylitol may help kill bacteria while also keeping the mouth moist.
Xylitol and Betaine, which are common ingredients in some mouthwashes, may effectively improve dry mouth when it is a side effect of medication.
Sucking on a sugar-free lozenge or candy may help prevent the mouth from drying out. Sucking on the candy keeps the mouth closed and helps keep the saliva circulating.
This could temporarily relieve dryness or prevent it from occurring. It is important to choose a sugar-free variety, as sugary sweets can damage the teeth.
Similar to sugarless candies, chewing sugar-free gum may help keep saliva flowing and stimulate saliva production, which could prevent the mouth from drying out.
Chewing gum is a temporary solution, but may provide quick relief.
Ginger sprays, tea, and other products with ginger may help stimulate the salivary glands and increase saliva production.
Some over-the-counter (OTC) products contain medicines or artificial forms of saliva designed to stimulate the saliva or prevent dry mouth.
These may provide temporary relief, and generally have fewer side effects than stronger prescription options.
OTC products for dry mouth include lozenges, sprays, mouth rinses, and more.
If a person spends a lot of time indoors, they may notice that the dry indoor air makes symptoms of dry mouth worse.
Many people find relief by using a humidifier in the rooms they use most. Adding humidity to the air with a humidifier may help keep the airways and mouth moist, helping prevent a dry mouth.
Many medications can cause dry mouth, including drugs to treat:
  • obesity
  • diarrhea
  • hypertension
  • epilepsy
  • urinary incontinence
  • asthma
  • Parkinson's disease
Anyone taking medications for any of these conditions who experiences dry mouth may want to talk to their doctor about alternatives or solutions for the side effects.

Avoiding drying habits

While some remedies may help temporarily relieve a dry mouth, making lifestyle changes to help reduce symptoms may also be necessary.
For instance, the National Institute of Dental and Craniofacial Research note that substances such as tobacco and alcohol use can dry out the mouth. Avoiding tobacco and alcohol use may help prevent dry mouth in some cases.
Caffeine may also dry out the mouth. Avoiding sources of caffeine, such as coffee, tea, and energy drinks, may prevent dryness.

Breathing with the mouth closed

Breathing with an open mouth can quickly dry out the airways. Some people breathe with their mouth open when they have a respiratory illness, such as a cold, or due to underlying medical conditions.
Engaging in activities that cause heavy breathing, such as heavy exercise, may also cause a person to breathe with their mouth open.
Additionally, if a person wakes up every morning with a dry mouth, they may be sleeping with their mouth open and inhaling the dry air.
Making a conscious effort to keep the mouth closed and breathe through the nose may help improve saliva flow in some people. Other tips may help with this effort, such as sucking on a sugarless candy.


Dry mouth can be irritating and may even lead to other problems in the mouth if left unchecked. Many home remedies can help a person get relief.
Anyone struggling with treating dry mouth at home should talk to a doctor. They may recommend a change in medication or other tests to help diagnose and treat any underlying issue.