“GERD can certainly contribute to bad breath problems,” says Chin Hur, MD, MPH, an assistant professor of medicine at Harvard Medical School in Boston and director of gastrointestinal health outcomes research at Massachusetts General Hospital. In some people, he explains, food doesn’t move efficiently out of the stomach, starts to decay there, and can contribute to bad breath and GERD. Others with GERD may actually regurgitate small amounts of undigested food, which can also cause bad breath. “Bad Breath Reflux:” How a Dentist Can Help If you have bad breath you just can’t shake, your first stop probably should be your dentist’s office. Marc Nock, DDS, of Zenthea Dental in New York City, says your dentist will first rule out typical bad breath causes like periodontal disease, poor oral care, and sulfur molecules on the tongue. The dentist may then investigate whether there’s a connection between your bad breath and GERD or other medical conditions. A sensation of acid reflux and frequent heartburn are the most typical GERD symptoms, although it’s also possible to have atypical or “silent” GERD - without the usual symptoms. Silent GERD symptoms can include a bad taste in the mouth, chest pain, coughing, hoarseness, and tooth decay, explains Dr. Hur. Even if you’re unaware that you have GERD, dentists can often tell by looking in your mouth and throat. Sally Cram, DDS, a periodontist in Washington, D.C., and a consumer adviser for the American Dental Association, says that people with GERD often experience acid erosion of their teeth and an inflamed red throat, especially around the tonsil area. Other signs include areas of irritation on the tongue and gums, and sour smelling breath. Dr. Cram says that if it’s suspected that your bad breath and GERD are linked, your dentist will suggest a visit to your primary care physician or a gastroenterologist for diagnosis and treatment. After all, the bad breath won’t go away until the GERD symptoms are under control. Treatment for GERD and “Bad Breath Reflux” Doctors often diagnose GERD by getting a detailed description of your symptoms. Hur says that your doctor may start you on GERD medication (either prescription or over-the-counter) to see if your symptoms improve with treatment. Your physician may also suggest making lifestyle changes. Many people find that GERD symptoms get better when they avoid common triggers like fatty and spicy food, alcohol, and big meals, especially close to bedtime. In most people, the combination of lifestyle changes and the right medication can get and keep GERD under control. Though not common, a pH probe study may be used to diagnose GERD. For this diagnostic test, a thin tube is place through the nose and deep into the esophagus. The tube is attached to a monitor to measure how much acid travels up from the stomach and into your esophagus in a given time period. If the amount of reflux is above a certain percentage, this is highly suggestive of GERD. From there, doctors can decide on the best course of treatment. When can you expect the bad breath to go away once treatment begins? Cram says it could take a week or even longer, especially if the doses of GERD medication need to be adjusted. In the meantime, Hur suggests drinking plenty of water and chewing gum (sugar-free) because it stimulates saliva production and clears acid from the mouth. Giving up cigarettes is especially important because smoking contributes to GERD symptoms and smoker’s breath, he adds. Follow your doctor’s advice, and you should be able to banish “bad breath reflux” for good.
