Fluoride Use and Bad Breath

It’s long been known that fluoridating water and oral products can help prevent cavities, but we don’t hear much about fluoride use and bad breath (halitosis or oral malodor). Does fluoridation either cause bad breath or help guard against it? As one might expect, fluoridation can help to prevent halitosis, though its effect is rather subtle and indirect. The benefit is linked to fluoride’s ability to support dental health.

Fluoride inhibits both dental plaque and halitosis. Our teeth are protected by a resistant covering called enamel, built primarily with the minerals calcium and phosphate. These minerals can be removed from enamel by acids produced by oral bacteria that break down sugars in the foods we eat. These bacteria are found, among other places, in the plaque that builds up on our teeth between brushings. When calcium and phosphate are removed from the enamel faster than our bodies can put it back, cavities form. The link between fluoride use and bad breath lies in the fact that dental decay is often associated with a bad odor on the breath.

Manufacturers of oral products have typically used sodium fluoride. A few recent studies, however, suggest that stannous fluoride may work better against plaque and halitosis, and even against inflammation of the gums, which is also associated with oral malodor. This research is preliminary and needs to be backed up with further studies: it’s too soon to draw conclusions about stannous fluoride use and bad breath. In the interim, the benefits of using topical sodium fluoride on the teeth are well documented.

A few words of caution about fluoride use and bad breath are in order. First, in uncomplicated cases of oral malodor, the foul smelling gases are produced by bacteria living on the back of the tongue, not on the teeth, and there is no compelling evidence that fluoridated products have any significant effect on these bacteria. Secondly, exposure to too much fluoride to treat plaque and halitosis may create other health issues: Excessive exposure in children results in dental fluorosis, and the long term effects on adults remain uncertain. Avoid swallowing fluoridated oral products.

Mouthwash for Bad Breath

Is all mouthwash for bad breath or do consumers have to choose carefully from the wide range of products on the market? Actually, oral care products are often marketed as treatments for specific problems, and it’s important to read labels carefully before purchasing. In addition, you might want to consult a dental professional to be sure you are choosing a good product: professionals generally know what works and what doesn’t.

Oral rinses for odor reduction typically contain an antiseptic of some kind – a compound believed to act on the bacteria that are known to produce foul smelling gases in the mouth. Antiseptics in mouthwash for bad breath include essential oils from plants like thyme (thymol) eucalyptus, or mint (menthol), quaternary ammonium compounds such as cetylpyridinium chloride, oxygenating compounds such as peroxide, or an oil that physically picks up the bacteria and carries them away. Some of these antiseptics have been scientifically studied and proven effective, while others depend on anecdotal evidence and individual testimonials.

When shopping for rinses for odor reduction, be sure that you don’t buy a product intended for a different problem, such as tooth decay or gum disease. Though these dental diseases are often associated with oral malodor (they don’t so much cause oral malodor as arise from the same oral conditions) a product aimed only at them and not intended as a mouthwash for bad breath is unlikely to bring you the results you want.

Though many people now regard oral malodor as a medical, or even a social problem, oral rinses for odor reduction tend to be grouped with the cosmetic oral products – those that are intended to whiten teeth or reduce staining. Indeed, solving a halitosis problem may be as simple as paying more attention to oral hygiene and regularly using a mouthwash for bad breath. Unless you suspect an underlying medical condition—in which case, see your doctor—or more serious problems in the mouth, treat it cosmetically first. If this fails to bring relief, however, consult your dentist or dental hygienist. There are other products available only with a prescription.