Todd Gandy, DDS: ‘Find the Source of Bad Breath’

(Editor’s note: This is from our best-of archives. It originally was published on Dec. 21, 2007. Enjoy.)

My son told me I have bad breath. I am using Listerine three times a day and it is not getting any better. What else can I do? – Gloria

There are three anatomical areas that can cause a person to have bad breath (call it halitosis if you want to sound official). They are the lungs, the back of the throat and the mouth.

If you are a smoker and the source of the malodor is coming from deep in your lungs, you need to see your physician and stop smoking! Some of the tips below may help if your lungs are the culprit, but will not resolve your symptoms as they don’t address the source.

The back of the throat can be a place that harbors mucus (especially if you have problems with post-nasal drip). The easiest way to reduce the amount of mucus, and the bacteria it can harbor, is to use a tongue scraper. Tongue scrapers can be purchased at most stores where toothbrushes can be found. Put out your tongue and try to gently scrape the back of the tongue as far back as you can. You’ll know you’re doing it right if you tend to gag yourself a bit.

In the mouth, any area of infection, be it tooth decay or gum disease, can be a source of bad breath. A dentist can examine you to determine if you have any of these problems and recommend the appropriate treatment. The home care recommendations are the same as always, brush twice a day and floss once a day.

A mouthwash like Listerine can be an effective means to reduce odor, but it can be used too much. Three times a day is too much and it may actually be drying out your mouth, causing the odor to worsen. Use Listerine a maximum of twice a day (once when you wake up and once when you go to sleep).

If you have a dry mouth (a side effect of many medications prescribed today) this can be a cause of bad breath while also increasing your chance of having tooth decay. The simplest way to promote an increase in saliva is with gum or mints sweetened with 100% Xylitol (an artificial sweetener that does not cause tooth decay). Severe cases of dry mouth need a consult with a dentist to see if a salivary substitute should be prescribed.

Try the tips above and hopefully we’ll have you (and your son) breathing easier.

I have seen ads for Invisalign to straighten teeth without the metal brackets. I was thinking about getting braces and I would like some more information. Do you recommend Invisalign over traditional braces? – Steve

Do I recommend them over traditional braces? No.

Traditional braces with metal brackets placed by an orthodontist are still the gold standard to move teeth. Invisalign moves teeth with a progression of clear plastic retainers and it is an alternative option to brackets, but you must consider the following pros and cons:

The biggest pro of Invisalign is the cosmetics. They are not invisible but they are less eye-catching than a mouth full of brackets. Also, the retainers, being removable, allow for easier brushing and flossing, resulting in healthier gums during treatment.

Cons are the cost (usually a significant increase from brackets as having the retainers made is a significant cost to the providing dentist) and the fact that difficult tooth movements (rotated and severely misaligned teeth) are tough, if not impossible to achieve with Invisalign alone and a patient may need traditional brackets to finish their case.

One other consideration before choosing Invisalign is whether or not you are receiving care from an orthodontist (a dentist who has specialized to focus only on the movement of teeth) or a general dentist. Any dentist can be certified to use Invisalign. This can be a bonus as you may not have to go to another office to receive care, but realize that braces are not the dentist’s specialty. Make sure to ask how many patients they have treated and if they think your case is routine or difficult. Then use your judgment whether or not to get a second opinion from an orthodontist.

The final decision on whether or not to get braces and what type is your own. Hopefully I’ve helped you to make an educated decision.

Todd Gandy is a Redding dentist whose journey to dentistry was circuitous. He first attended UC Davis and worked as a mechanical engineer in his then-chosen field before he realized dentistry was his true calling. He returned to school, this time in San Francisco, to become a dentist. He graduated from UOP School of Dentistry and returned to Redding with his wife and two daughters to start a practice. Todd T. Gandy DDS Comprehensive Dental Care is located at 2950 Eureka Way, Suite B, Redding, CA 96001. His office phone number is 243-1855.
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Todd Gandy

is a sixth-generation Shasta County resident who attended UC Davis and worked as a mechanical engineer before he realized dentistry was his true calling. He graduated from UOP School of Dentistry and settled down in Redding with his wife and two daughters to start his practice, Todd T. Gandy Comprehensive Dental Care. His office is at 2950 Eureka Way, Suite B, in Redding. He can be reached at 243-1855.