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.