Bad breath

[Whitner]

Does anyone else with PMR also suffer from bad breath? I do suffer from a dry mouth and I realize that could be caused by another autoimmune disease, Sjögren, but was wondering if PMR also contributed to bad breath. My husband says it’s like a sulphur smell..... charming! I’m afraid to talk to people without a stick of sugarless gum in my mouth! Thanks!

[Hidden]

I have periodic sulphur breath and burps. I have dry mouth which doesn't help. It happened more during a enforced period of 6weeks when I had to eat carbs like white bread, pasta and potatoes. Since I have been back low carbing it's been better. But I don't eat meat. I say that as I know keto diet can make you smell. Try toothpaste without sodium lauryl sulphate and only use alcohol free mouth washes that don't dry mouth as much either. Good luck.

[Whitner in reply to Hidden]

Thanks for the information Scoopitup!

[Blearyeyed]

In simplest terms , eggy breath comes from bacteria , breeding , eating and making stinky parps!

In detail , Halitosis , is produced when anaerobic bacteria in the mouth breakdown the amino acids , cysteine and methionine , into volatile sulphur compounds ( VSCs).

90% of VSC Halitosis , is made by bacteria feeding on things that occur inside the mouth.

This comes from breaking down proteins left on the tongue from foods like meats , dairy , eggs and some high protein veg products , or from blood and foods stuck in bleeding gums.

If you suffer from a Dry Mouth from taking Medications , you have Dry Mouth Syndrome ,,or Sjorgrens , your tongue isn't cleared as well letting bacteria build up and do their work!

You can have Dry Mouth Syndrome and Dry Eye Syndrome ( like me !) but not have Sjorgrens.

If you eat a high protein or Keto diet it increases this type of Halitosis.

If you eat foods that increase stomach acid and gas like onion and garlic, green vegetables , coffee , spices , and sugars this can add to the strength of the smell of VSC Halitosis in your mouth.

Not just cleaning the teeth but cleaning the tongue and drinking more fluids like water and green tea regularly through the day helps reduce this.

Increasing the saliva with a sharp sugar free sweet or gum helps in cleaning your mouth after eating , don't brush but swill with water or drink green tea during the 45 mins after eating as cleaning too early reduces the bacteria that help control mouth acid and sugars to keep your mouth and teeth healthy .

Flossing , tongue cleaning and using mouth wash before brushing helps reduce gum bleed infections , after brushing rinse again but with water or cool green tea.

If using the brush back or a tongue scraper makes you gag. My simple tongue technique might help.

Take some dental floss between your fingers as you would to floss. Do not hold it tight or press it on the tongue or you will cut it. Mouth gently open hold your fingers at the sides if your mouth and flick , so that the loose loop of floss lays across the back of your tongue and gently glide it to the front of the tongue a few times. If the tongue is covered thickly you may need to use a few strips of floss.

Only up to 10% of VSC Halitosis that people can possibly suffer, is extraoral ( created from things outside the mouth ) . This can happen from blood after a throat infection or nose bleeds. If you suffer from GERD extraoral Halitosis is more common .

GERD , gives you a sensitive stomach , it can happen on acidic diets and on certain drugs like Steroids . Halitosis happens more with Coeliac , IBD , Crohn's and Ulcerative Colitis, it is also more common with Diabetes.

The least common cause of extraoral VSC is from things like Cancers and Tumours , but cancer sufferers will remember that Sulphur Breath was a common side effect / symptom both at diagnosis and during therapy.

Basically if Dental and Mouth Hygiene changes do not improve it , it is worth having it checked by a Dentist or telling your GP .

[Hidden in reply to Blearyeyed]

I agree with all. The simple carb diet really messed the balance of my gut and I had reintroduced onions.... And eggs. I often think I go through periods when all these aspects overlap and its much worse. Then it will just ease off. I have excellent oral hygiene (according to dentists etc) and have found sls free toothpaste has made a big difference.

[Blearyeyed in reply to Hidden]

Yes natural toothpastes and mouthwashes do help because they don't dry out the mouth more . Unfortunately , when you have Dry Mouth symptoms you can have excellent oral hygiene but can still get these build ups because you aren't constantly cleaning away things with saliva like other people.

[Hidden in reply to Blearyeyed]

Yes. I try to remember to sip water through out the day. Potato starch is worse than sugar I terms of clinging to the teeth which is why I was disappointed it is in grated cheese. If people eat wotsits or quavers or crisps it's like glueing bacteria to their teeth and gums.

[Whitner in reply to Blearyeyed]

Wow blearyeyed all sorts of things to try! I do eat a lot of protein. My dental health is good and my overall health is good except for the PMR 🥴 so I’ll try the green tea (I have worried that that would dry out my mouth more?) and tongue scrapping and see if that helps. I drink water all day every day.

[Blearyeyed in reply to Whitner]

Just remember gently does it as you clean your tongue xx

[PMRpro Ambassador]

scientificamerican.com/arti...

ncbi.nlm.nih.gov/pmc/articl...

both suggest your first port of call might be your dentist since this type of halitosis originates in the mouth,

[Whitner in reply to PMRpro]

Yep talked to dentist. He suggested Biotene which I use, no alcohol mouthwash which I had forgotten to use but my teeth, etc are fine thankfully.

[Blearyeyed in reply to Whitner]

I have Biotene toothpaste.

[Pixix]

Yes, but only when I’m on the keto diet, which is well covered in answers above! The taste is horrible...& yes, I’ve been told I have excellent mouth hygiene by my dentist, and it’s purely the diet, nothing else. S x

[granofthewest]

Do also suffer from dry mouth and waxy feeling in my mouth, can't taste food unless its spicy or strong flavour so drink lots of lemon squash. Don't know about bad breath, will have to ask my husband!

[Smokygirl]

No halitosis , but a horrible taste in my mouth after taking my vitamins/ minerals at lunch. This lasts until dinner time at 6:00pm

[Blearyeyed in reply to Smokygirl]

Does your supplement also contain Iron ?

This can often leave a long lasting nasty taste in the mouth. Some people find similar from taking Omega 3.

[Smokygirl in reply to Blearyeyed]

Yes Bee, iron and also omega 3. Can’t win can we! Xxx

[S4ndy]

I have suffered from dry mouth and eyes as an effect of prednisolone. Also had lots of mouth ulcers. My dentist has been great. The toothpaste he recommended which doesn't contain sls is Sensodyne Pronamel. I am allergic to sls and this is the first sensitive toothpaste I have heard of. I use it twice a day. Its currently available at Home Bargains in the uk for £2.99 which is a good deal compared to the £4.99 it is everywhere else.

My dentist also recommended a water pic to help clean between my very tight teeth. I also use little tiny interdental brushes.

All of these have helped me keep my breath fresh and tongue and teeth clean.

However I did still have a problem with deep tooth pain and a nasty taste in my mouth. My dentist did a xray of my whole mouth and found that 2 of my teeth had decay under the gum line. Neither can be saved and I need a general anaesthetic to have them removed which I am waiting on. I have nerves that run really close to the teeth and the usual numbing procedure doesn't work.

So its always worth seeing your dentist if you have bad breath as there may be something going on with the actual teeth too. x

[Whitner in reply to S4ndy]

Thanks! I did talk with dentist since this started before prednisone. It started with dry mouth. Fortunately my dental health is good.

[PMRpro Ambassador in reply to Whitner]

Dry mouth is a common cause of a bad taste - and sicca syndrome is not unusual in autoimmune disorders, Sicca syndrome is the same symptoms as Sjogrens (which is autoimmune) but there is no antibody to be found in the blood.

There are various ways of managing the bad effects of sicca - have a google.

[Blearyeyed in reply to PMRpro]

Yep , that's me a Sicca of Wisdom!😋

[PMRpro Ambassador in reply to Blearyeyed]

Can we manage you too?

[Blearyeyed in reply to PMRpro]

Sorry Pro , that pun was on the end if my very dry tongue I couldn't help it , I'll behave myself now .

[Whitner in reply to PMRpro]

Thanks PMRpro. So when I goggle I’m told Sicca is just another name for Sjögren. Fortunately my symptoms are not that severe and sort of come and go but never completely go away. Maybe the prednisone is treating it too? My biggest complaint right now is bad breath and dry mouth but that is helped by chewing gum or letting it sit in my mouth and always having water nearby.

[tangocharlie]

When I thought I might have Sjogrens I was referred to the Dental Hospital who gave me all sorts of things to stimulate saliva, like pastilles, gel and non-SLS toothpastes, so anyone suffering might ask the dentist to prescribe these things. Luckily mine turned out to be blocked saliva ducts which were sorted with a sialogram and industrial strength lemon juice! There is also something called Mikulicz syndrome which was hypothesized at one stage by a rheumatologist, which is a bit like SS but doesn't have the blood work, and often goes away.

[PMRpro Ambassador in reply to tangocharlie]

Celtic, erstwhile member of this forum and an occasional visitor, had that suggested too.

[tangocharlie in reply to PMRpro]

Thankyou, I was trying to remember the name of who gave me the advice

[Blearyeyed in reply to tangocharlie]

The Salivix pastilles are given to me on prescription from the dentist and have been a life saver when I'm at my worst . They help stimulate enough Saliva to eat more comfortably.

[tangocharlie]

Yes that's what they gave me. And from a Sjogrens group I got the recomenndation of Xylimelts that you use overnight, you get them on the internet.

[Jan_Noack]

with me those burps were GORD (gastro oesphagus refux disease). I had a hiatus hernia.. it just got worse. I had a dry cough with it..onl symtpm besides the sulfur burps especially when upset or anxious the burps would happen.