Persistent bad breath or a bad taste in the mouth may be a warning sign of gum (periodontal) disease. Gum disease is caused by the buildup of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums. If gum disease continues untreated, it can damage the gums and jawbone.

Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and dental caries (cavities). The medical condition dry mouth (also called xerostomia) also can cause bad breath. Saliva is necessary to moisten the mouth, neutralize acids produced by plaque, and wash away dead cells that accumulate on the tongue, gums, and cheeks.

If not removed, these cells decompose and can cause bad breath. Dry mouth may be a side effect of various medications, salivary gland problems, or continuous breathing through the mouth.

Many other diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems.

Smoking: Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.

Hormonal changes in girls/women: These changes can make gums more sensitive and make it easier for gingivitis to develop.

Diabetes: People with diabetes are at higher risk for developing infections, including gum disease.

Other illnesses and their treatments: Diseases such as AIDS and its treatments can also negatively affect the health of gums, as can treatments for cancer.

Medications: There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean.

Genetic susceptibility: Some people are more prone to severe gum disease than others.

Symptoms of gum disease include:

• Bad breath that won’t go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Receding gums or longer appearing teeth

Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist.

1. Ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to gum disease.
2. Examine your gums and note any signs of inflammation.
3. Use a tiny ruler called a “probe” to check for and measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. This test for pocket depth is usually painless.