The law of unintended consequences contends that positive and purposeful actions always have unanticipated effects. This law has been made malodorously clear over the past six months. Wearing a face mask to prevent the spread of the coronavirus — an unambiguously positive action — has revealed to many of us our own bad breath.
The mask itself is not causing or exacerbating bad breath, says Dr. Melissa Santilli, a dentist in Cross Roads, Texas. “Mask-wearing is just making many become aware of it. The bad breath has always been there,” she says.
The face mask will make you more aware of you own breath, known medically as halitosis, because you are re-breathing more of your own exhaled air. “The mask material may also become saturated with some of the exhaled fragrant materials, so that you will be more aware of them as well,” says Dr. Matthew J. Messina, assistant professor at the Ohio State University College of Dentistry, clinic director of Ohio State Upper Arlington Dentistry and interim director of the Dental Oncology Clinic. For example, if you eat a meal with garlic or onions and put a mask on, you may be more aware of the onion or garlic odors.
“When the nose and mouth are trapped in the same small recycled airspace, it is much easier to smell and sense your own bad breath. You are forced to inhale the breath you exhaled,” Santilli says. “This creates a unique opportunity for each individual to experience their breath from a third-person perspective.”
Unique but, in the case of a garlicky dinner, perhaps you’re simply smelling temporary odors. But halitosis is a more chronic condition — and given mask-wearing mandates these days — one that we all should be more aware of, if only for our own less pungent quality of life.
Causes of Bad Breath
Santilli says that many patients have become aware of their own bad breath, especially during quarantine and lack of access to professional dental care, including deep cleanings under gums. Chronic bad breath is often caused by increasing levels of bacteria in gums, teeth and surrounding soft tissues of the mouth, including the tongue and back of the throat. Lack of dental care and cleanings allows bacteria to grow, especially on gums for those who already have serious chronic gum disease, she says.
Social distancing has also caused many people to let their own personal hygiene slip, including regular brushing and flossing, Santilli says. “This creates the perfect storm for an unfair advantage for bacterial overload,” she explains.
Along with the common offenders, such as garlic, onions and other powerful foods, “any food that remains wedged between your teeth or around the gums will be broken down by bacteria in the mouth, many of which produce gasses that can have an odor as they metabolize the food particles,” says Messina, an official spokesperson for the American Dental Association.
In addition, certain gastrointestinal conditions, like GERD or acid reflux, can cause stomach gasses to be present in the mouth, which can give breath a funky odor. And some cancers — of the tonsils, throat, sinuses, nasal cavity, tongue and floor of mouth — can also cause bad breath, says Messina, but those are rare. Whatever the cause, “chronic bad breath should not just be ignored. A thorough examination by your dentist is very important to help with the warning signs of bad breath,” he says. “It may be more than just garlic linguine for lunch.”
Prevention and Treatment
What’s the best way to prevent and treat bad breath? ” Going to the dentist is an easy solution,” Santilli says. “A professional cleaning will reduce millions of bacterial colonies in the mouth and remove them from the surface of teeth, roots and under gums.” Most dental professionals recommend a thorough cleaning every six months.
Vigilant daily home dental care is also key. “This will include not just flossing, brushing and oral rinses, but also proactively removing bacteria from the surface of the tongue,” she says. Do this by brushing or lightly scraping the tongue as far back as you can go before your gag reflex kicks in.
Messina lists what he calls the Healthy Four:
— Brush twice a day with a fluoride toothpaste.
— Clean between your teeth once a day.
— Eat a healthy diet.
— See your dentist on a regular basis.
“In my opinion, it’s good to add brushing after meals; I’ll call that social oral hygiene,” Messina says. “If you can’t brush, at the very least least swish water aggressively around your mouth and between your teeth and either spit it out or swallow if there’s nowhere to spit it out.”
Messina also suggests drinking more water. “If we are dehydrated, and most people are, there is less saliva and any odors would be more concentrated. If we drink more water, we make more saliva, which adds to the washing and buffering action in the mouth,’ he says.
If you’re not sure which toothpaste or cleaner will work best for you, Messina says to look for the ADA Seal of Acceptance. “That’s a surefire way to know a product does what it says and says what it does,” he says.
Don’t Stop Wearing the Mask
“The most important message is that face masks do not cause bad breath, but they are an agent of awareness,” Santilli says. “This is a good thing. This means you are now in control of your own oral health and becoming aware of the importance of reducing bacterial load in your mouth, not only to help you achieve a healthier mouth, but also the rest of the body. Making sure your mouth is healthy is a great way to protect the rest of your body from unnecessary levels of bacteria.”
Messina agrees: “With a mask on, it reminds us to do the things we know we should do for our own good oral health. At the end of the day, we should be practicing good oral hygiene for ourselves anyway. That’s the best way to stay healthy.”
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