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White Coating and Bad Breath Issue
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dmogar posted:
Recently, over the past 3 months I noticed that after eating and drinking (especially alcohol) that I have been getting these horrible tastes in my mouth and now a white coating has began to appear on my tongue. I have done some research and determined that it can be a number of problems.

I live in Arizona, so dehydration was one of my main concerns but still over the past several month I have been drinking at least 128 oz of water or other hydrating beverages per day. I also exercise regularly and have a healthy diet. Just recently I began increasing my oral hygiene brushing 2-3 times a day, using (non-alcoholic) mouth rinses, using a tongue scrapper twice daily and drinking lots of water before bed.

But still the problem remains, so I sought further help. I first noticed this problem after a night of drinks with my friends and having to mask the smell on my breathe with an entire pack of sugarless gum. Some people have made suggestions of Candida infections and digestive infections but I don't want to jump in to anything right away before doing a little more research and seeking advice on what it might be or what to do?

From what I can tell when I scrape away the white layer I'm fine but as soon as I eat or drink my mouth gets dry, the layer comes back and I immediately get a horrid taste in my mouth.

Any advice or information that you have on the topic would be greatly appreciated.

Thank you
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dmogar responded:
I also just started recently taking Acidophilus and using a nasal cleansing to clear passages that could be in my nose.

Nothing seems to solve anything.
 
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dmogar responded:
Just left the dentist, he said there could be a number of causes that he determined from the symptoms that I told him.

1.) Switching toothpastes, especially one with a stronger mint or peppermint presence (which I did).
2.) Lack of oxygen to the mouth that can cause build of food particles allowing bacteria to build rapidly.
3.) Over usage of mints and gum...go figure right!

He told me to switch toothpastes, continue to floss and brush tongue regularly, stop chewing mints and gum and to drink a glass of water before bed. If this doesn't help it could be something internally causing the issue.
 
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Gwen Cohen Brown, DDS, FAAOMP responded:
Hi dmogar,

Both alcohol and tobacco are extremely drying to the oral mucosa. Alcohol desiccates (dries out) the tissue and breaks the cement that holds the epithelial cells together which may result in local irritation, mild sloughing and superficial dryness.Tobacco is also extremely drying and irritating and leaves a residue in the mouth.

When the oral cavity is extremely dry the salivary output is not enough to provide adequate salivary clearance and therefore the normal oral flora - microbial, bacterial and fungal organisms - become denser and more irritating to the oral mucosa. There are not more organisms but they are not diluted by saliva and therefore are a sludge. The organisms are both aerobic and anaerobic and as such can also "ferment".

So you are correct that dryness can cause bad breath, however your alcohol and cigarette use are most likely the culprit here. I strongly suggest that you try to decrease your alcohol and cigarette intake. In addition to making your mouth feel better you will find that your breath is fresher.

If this does not improve your breath you should see an Ear Nose and Throat doctor as post nasal drip and sinus infection can also cause a bad smell. If that is not the source of the smell you should see a Gastro-Intestinal doctor as reflux can cause bad taste as well.

I hope this helps.

Dr. Gwen Cohen Brown
 
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Gwen Cohen Brown, DDS, FAAOMP replied to dmogar's response:
Hi dmogar,
I believe that you should go directly and deal with the most likely cause of your bad breath and see if cutting back or stopping your alcohol and cigarette intake decreases the smell.

I am not quite sure what your dentist means when he said that you may have a lack of oxygen to your mouth. If you can provide more information it may be helpful as you dentist saw you clinically and I did not.

Changing toothpaste may help temporarily but this is not a long term solution and the stronger the mint/peppermint is in the toothpaste the more irritating it can be to the oral mucosa and can potentially also change the balance of the normal oral flora in your mouth.

To this end I strongly recommend that you do not use an "organic" toothpaste as they use volatile oils as flavorings and these oils will be painful if your tissue is irritated.

I believe that you should have a scrupulously clean oral cavity, brush and floss twice a day (gently), use a non alcohol based mouthwash or better yet no mouth rinse at all, and only use a tongue scraper gently and infrequently. Vigorously scraping your tongue could further alter the delicate balance of the oral flora in your mouth and make the smell worse.

If you have gum disease/bone loss you should see a dentist twice a year for routine check-ups and a dental hygienist 3 or 4 times a year.

Please write back if you have additional questions.

Dr. Gwen Cohen Brown


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