Bad breath since tooth extraction
 

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

He's an oral surgeon, not a general dentist.

I had a previous extraction done by a general dentist and it was a nightmare. It took 2 hours and I ended up with nerve damage on that side. He also chipped other teeth in the process. I didn't have any bad breath after though!

I went to an oral surgeon as I thought he would be more experienced and it has seemed that way as the extraction was a lot better than last time and I'd no chronic numbness or pain after. It seemed to heal up really well.

ripply,

Okay. I'm sorry you had such as awful experience with the other dentist and extraction. Yes, it is usually best to see an oral surgeon for the removal of a tooth but like all professions, there are good and bad in all of them.

I still recommend the xray and make sure you explain the foul odor to the dentist. Also, tell him you smoked and still smoke. Although there is always evidence of smoking in a patients mouth so he most likely already knew that. But tell him anyway.

Also, ask him if he was certain that there was no sinus perforation or sinus involvement with either the root of this tooth or during the extraction. Also, ask him if the adjacent look healthy on the xray.

If you are comfortable ... you can post the xray on this forum.

Bryanna

I've been to see the oral surgeon again. He took x-Rays and spent ages looking around my mouth, gums and other teeth. He showed me the x-Ray and the bone has filled in where the tooth was extracted. He said it all looks great and that he can't detect any odour. But I'm sure there is!

He was honest and said he has no idea what the problem is. He insisted that he can't smell anything but suggested seeing my doctor about it as he can't find any dental reason. So, my GP has prescribed Amoxicillin (thinking it must be a sinus infection) and I've been taking them for a day now. I don't think they're going to help as I told them I have no sinus pain, but it's all the doctor will offer and I'm so desperate I'll try anything.

ripply,

Did the dentist tell you that the bone had filled in or is that just your interpretation of the xray? The reason I ask is because it takes a few months to see the initial growth of new bone in a tooth socket and up to one full year before it fills in completely.

Mouth odor can occur ... from a sinus infection .... from food debris that is caught in the crevices of the tonsils or caught in the crevices of the tongue. It can also occur from a digestive disorder. Smoking also causes bad breath.

If you use mouthwash on a daily basis, that too can contribute to bad breath because the chemicals kill all of the bacteria in the mouth, both the good and the bad which unfavorably alter the chemistry and pH of the saliva.

Also, certain foods can contribute to bad breath.

So perhaps you could pay close attention to when you notice the odor and when you don't as that may give you a clue as to what is causing it.

Bryanna