I'd really appreciate any advice on this. I've never had a problem at all with bad breath but I had a tooth extracted 6 weeks ago and since a couple of days after the extraction, my breath has been awful. The tooth wasn't infected and I had no abscess or anything. It's healed up great but I still have this awful smell.

I thought it would stop within a few days but it's still as bad. I went to my dentist for a check up after 2 weeks and he said it had healed very nicely, though I didn't mention this breath problem as I assumed it would stop. I can't think of anything that would be causing it as nothing has changed diet wise, and I have no sinus pain or signs of infection. I brush twice a day and floss daily, as I've always done. I also use Tepe brushes regularly. I've tried using chlorhexidine but it only masked the smell for about 30 mins.

Could anyone help?

Hi ripply,

Bad breath after a tooth extraction is normal as the surgical wound is open and debris collects inside the wound. Once the wound closes, the odor should go away. If there is a lingering infection either in the extraction site or the sinus or the jaw bone, which is not always visible without an xray, then the odor would continue. Did the dentist take an xray of the area at your post operative appointment?

**Was this an upper tooth that was extracted? Had it been root canaled in the past?

**Why was it extracted?

**Do you have periodontal disease or any root canaled teeth?

**Do you smoke or drink alcohol?

**Do you have stomach or intestinal problems ... heartburn, GERD?

You cannot mask the odor as it is occurring for a specific reason or reasons.
The reasons need to be determined or the problem will become worse.

Bryanna

Thanks Bryanna, the dentist didn't take an X-ray at the check up. It was my upper first molar and it wasn't root canalled. It had a crack in it, which made it sensitive when I was eating. I was offered a root canal and crown, or extraction. I remember your advice previously about root canals and decided to get it extracted instead.

I have no periodontal disease and my dentist has commented about how healthy my gums are. I've no root canals in any other teeth. I do smoke and I drink alcohol occasionally, but very little. I've had stomach problems with ulcers and GERD previously but it seems to be ok now. I'm not taking any medication. None of this has changed since the extraction.

I had stitches after the extraction and I know the dentist used gelfoam, which I heard can cause bad breath whilst it dissolves. But it's still just as bad 6 weeks on.
Should I ask the dentist to X-ray it again? He did take X-rays before extracting it to check if my sinus could be affected by the extraction. He said they showed it wouldn't.

Ripply,

The smoking and alcohol slow down the healing of oral surgery. Smoking also causes the initial blood clots to be less than optimal which causes the jaw bone to become dry and predisposes the person to a bone infection. This infection may or may not be painful at the onset and could just release a foul odor until it spreads further. The gum tissue may close over and give an appearance of healing ... but underneath the gum may not be so healthy.

Yes, an xray would be helpful but it may not be conclusive if there is an infection that is not large enough to be picked up yet on the radio graph. But it is worth having it done.

Stomach problems or GERD do not go away on their own unless certain measures are taken to cure them. Like change of diet and lifestyle habits that promote proper function of the digestive system. The symptoms may be as subtle as bad mouth odor from subtle or occasional regurgitation.

Another thing that will cause bad mouth odor is the build up of debris and bacteria on the tongue. Do you brush or scrape your tongue every day? Is you tongue coated with white or does it have deep fissures?

Bryanna

Oh no, I'm terrified it's a bone infection now. I can't see what else it could be. I didn't smoke while it was healing but I did use nicotine patches and maybe they're as bad. I had a vodka and coke when we were out for dinner for my granny's birthday, which was only two weeks after the extraction. I wish I'd known alcohol should be avoided.

My doctor said the indigestion was caused by the stomach ulcer. It was treated then and I haven't had any problems for years. I can't see any white on my tongue. It looks pink and when I look really closely, there are tiny pink dots on it. I'm not sure if that's normal. I do tongue scraping and there doesn't seem to be any odour from it.

I'll ask my dentist to X-ray it again but if it's too early and isn't obvious, is there anything else I can do? Is there any type of specialist I should see? It's really scary to think of a bone infection. I'm imagining thay'll have to cut out lots of bone which is terrifying.

ripply,

Before you panic, get the xray done. Explain your constant mouth odor to the dentist. Is he an oral surgeon or a general dentist?

Nicotine lowers the body's natural healing ability. So yes, they could have affected the healing. Any smoking that you are doing is just adding to the problem. There is probably not better time to stop than now.

Bryanna