Institute of Stomatology, Riga Stradins University

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Bad breath and gum diseases – what do they have in common?


Almost every person has experienced bad breath or halitosis due to various reasons. Dr Inguna Grīnvalde, Manager of the Periodontology Department at the RSU Institute of Stomatology, explains the causes of bad breath, the connection between gum diseases and bad breath, how to treat and prevent gum diseases and why it is crucial to initiate periodontal (gum) disease treatment early on.

Reasons for bad breath

Dr I. Grīnvalde informs that potential reasons for bad breath or halitosis are various and associated both with intraoral and extraoral problems. Possible intraoral causes of bad breath are: poor oral hygiene, food residue between teeth, poor maintenance of dental prostheses, coated tongue, multiple dental cavities, presence of specific bacteria in the plaque, deep and purulent periodontal pockets, necrotising ulcerative periodontal diseases.

There are also extraoral causes of bad breath, such as inflammation of paranasal sinuses, inflammation of tonsils and nasopharynx, respiratory inflammation, smoking, alcohol, severe general diseases (diabetes, renal failure etc.).

Diagnostics of bad breath

First of all, a patient should consult his dentist in order to detect the cause of bad breath. If halitosis is caused by gum disease, this problem usually goes away after adopting proper dental hygiene habits and planned periodontal treatment by a periodontist. A periodontist performs diagnostics and planned treatment of gum and dental connective tissue diseases, as well as teaches patients proper and customised oral hygiene techniques.

Causes of periodontal or gum diseases

Dr I. Grīnvalde reminds us that periodontal or dental connective tissue diseases are very common. If they are not detected and treated in a timely manner, they eventually lead to loose or mobile teeth or even the loss of them.

The main cause of periodontal diseases is dental plaque bacteria. When teeth are cleaned poorly, the bacteria multiply rapidly and ever more new microorganism species colonise the oral cavity. The interaction between these microorganisms causes inflammation – gums become red, swollen, loose and bleed during teeth cleaning or when eating hard food.

Gum inflammation or gingivitis just affects the soft tissue without damaging the bone and periodontal ligaments. The inflammation goes deeper with time, because the gums recede closer to the tooth root. As the tooth root becomes more and more uncovered, the gap between the tooth root and the gums becomes wider and turns into a periodontal pocket. Importantly, this process is accompanied by gradual bone decay. This lesion is called periodontitis.

Diagnostics and treatment of periodontal diseases

Several methods are used in diagnostics of periodontal diseases. It is based on clinical examination of the oral cavity with various probes in order to assess the severity of the periodontal lesion. Also, diagnostic radiology is always used.

Periodontitis is a chronic disease and successful treatment may result in complete cure or radical reduction of the periodontal inflammation and stop the further loss of supporting tissue. However, it is often no longer possible to regenerate the supporting tissue that has already been lost. Therefore, timely detection and early treatment of these diseases is crucial. Both conservative and surgical methods are used for the treatment of periodontal pockets. However, cooperation between a patient and a dentist and good daily oral hygiene are the most important factors. Whereas regular visits to a dentist or dental hygienist several times per year will allow one to control the gum condition and prevent a recurrence of the disease.