Why Do We Have Morning Breath?

Morning breath or morning halitosis is a non-pathological form of halitosis characterized by a noticeably unpleasant breath odor on waking up. Morning breath impacts the majority of people (99%) and persists despite using preventive measures or taking care of oral hygiene.

Why do we have morning Breath?

According to the American Dental Association, bad breath can be either

Physiological − caused by factors related to the dorsal region of the tongue ( containing taste buds and serous glands ).

Exogenous − as a result of factors like food or medicine intake

Pathological − because of preexisting oral or systemic conditions like periodontal disease or diseases in the nose or throat.

Psychogenic − when the bad breath does not exist, but the person believes they suffer from breath-related problems.

Morning breath is a physiological form of halitosis resulting from decreased saliva production and dryness of the mouth. Saliva is vital in cleansing your mouth and removing the particles causing foul odors. The body produces less saliva at night when you are sleeping, drying up the mouth and allowing odor-causing bacteria to build up during this time.

Porphyromonas gingivalis, Prevotella Intermedia, and Fusobacterium nucleatum are a few such bacteria that invade the pockets and crevices of the teeth and break down detoxifying agents like sulfur-containing amino acids of the mouth. In addition, they produce substantial levels of volatile sulfur compounds through the putrefaction of glycoproteins and degradation of proteins and a resulting bad breath.

Left untreated, these VSCs ( Volatile Sulfur Compounds ) can alter the permeability of gingival tissues and penetrate deeper to damage the epithelium and underlying oral tissues.

Other than oral bacteria, the following reasons result in morning breath.

Food Particles

Foods like garlic, onions, horseradish, dairy, and canned tuna are readily absorbed by the bloodstream and travel to the lungs, resulting in bad breath when exhaled after a certain period.

Smoking

Nicotine contains chemicals that destroy the essential bacteria in the mouth, resulting in morning breath. The smoke enters the lungs and is exhaled regularly, giving rise to chronic bad breath.

Dry Mouth

Xerostomia ( either genetic or induced dry mouth ) can reduce saliva production and give rise to symptoms of bad breath, especially after getting up.

Systemic Conditions

Diabetic Acidosis, Hepatic Failure, blood dyscrasias, liver cirrhosis, and gastrointestinal dysfunctions are a few systemic conditions that result in morning breath.

Medicines

Lithium Salts, Penicillamine, Thiocarbamide, Diuretics, and Amphetamines, reduce saliva production as a side effect, resulting in overall bad breath.

Ill-Fitting Prosthesis

Ill-fitting dentures irritate the gums and cause mouth sores that, left untreated, can lead to fungal infections and bad breath. Besides ill-fitting dentures, unclean dentures, wearing dentures for long periods, and old dentures can result in bacterial accumulation issues and bad breath.

Poor Oral Hygiene

If you don't brush your teeth regularly, food particles get trapped in your mouth or between the teeth resulting in bad breath. Poor oral hygiene also causes plaque formation that adds to the unpleasant smell.

Snoring and Breathing through your mouth

Clinical trials have shown 71% of chronic snorers suffer from bad breath problems. Snoring and sleep apnea causes you to open your mouth to breathe air. This decreases saliva production and ultimately leads to bad breath.

Treatment option

Generally, morning breath dissipates by improving dental hygiene and preventing the mouth from drying. You should consult a dentist if

• Your bad breath persists even after taking care of dental hygiene

• You experience other symptoms along with bad breath, like mouth ulcers, fungal infections, or toothache

• When you experience bleeding gums or spit blood on chewing or after brushing your teeth.

Some of the chief methods of managing morning breath are

Mechanically removing biofilm and microorganisms

Brushing, flossing, and scrapping the debris off the tongue help remove any trapped food or plaque deposits and help in managing bad breath.

Using sugar-free chewing gum

Sugar-free chewing gum helps the mouth to produce more saliva that dissipates symptoms of bad breath. Peppermint and spearmint are popular sugar-free chewing gums that keep the mouth fresh.

Antibacterial mouth-rinsing agents

Chlorhexidine, Triclosan, and Cetylpyridinium Chloride are antibacterial mouth-rinsing agents that destroy the bacterial cell wall, cause bacterial enzymatic inhibition, and remove the dental plaques to fight bad breath.

Preventive Measures

Some of the preventive measures to avoid morning breath are

• Brush your teeth after you eat.

• Floss regularly to remove any debris caught in difficult-to-reach places

• Scrape your tongue using a tongue cleaner every day

• Use clean dentures or replace the old dentures with new and clean ones

• Change your toothbrush every six

• Avoid a garlic or onion-rich diet

• Get periodic dental check-ups to get timely dental help.

Conclusion

Researchers have even observed that it results in psychological changes like depression and anxiety, which are more common in women than men. Studies conducted on students with a healthy periodontium have shown that the problem can be reduced to a moderate extent but not eliminated despite using commercially available mouth rinses.