Husband has bad breath

Dear Ask The Doctor: My husband has bad breath almost 24 hours a day 7 days a week. He still has it even though I have witnessed him brushing his teeth. What could it be caused from? It is really hurting on relationship. I can smell it even if he isn't right next to me, like if he's talking to one of our kids and I am a foot away if he talks in my direction I can smell it.

Dear Monica: Bad breath sometimes referred to as halitosis, is often a health-associated problem that incurs a great amount of suffering and affects personal relations. The exact incidence of bad breath is not known. There are hundreds of bacteria species in the mouth. They each have preferences to various food products and proteins and the digestion of these proteins lead to the fetid odor. In most cases the bad breath arises for the mouth itself. It may also arise for the back of the tongue, nasal passages, lung infections and the esophagus. Patients with an identifiable cause of bad breath (eg, periodontal disease, gingivitis, postnasal drip, systemic illness) can be treated for these conditions. Many cases of bad breath may be readily alleviated by:

• Proper dental care and oral hygiene, including daily flossing.
• Gentle cleaning of the posterior portion of the tongue dorsum (eg, with a plastic tongue cleaner).
• Rinsing and deep gargling with an effective mouthwash (in order to get the liquid as far back as possible without swallowing it, one can extend the tongue while gargling). This is most effective when done at bedtime.
• Eating fibrous foods (a healthy breakfast can be recommended).
• Chewing gum briefly (five minutes is often sufficient) if the mouth is dry, or after meals, especially with high protein intake. Sugarfree gum is preferable.
• Sufficient water intake.
• Decreasing alcohol and coffee intake.