Acid reflux is a condition in which your stomach contents flow backward into your esophagus -- the tube that connects your throat and stomach. Although typical symptoms include heartburn or a burning sensation in the throat, almost 50 percent of people with long-term acid reflux also struggle with bad breath, according to a July 2008 study published in the "Journal of Oral Pathology and Medicine." The good news is there are steps you can take to improve your breath, starting with oral hygiene to clean and freshen your mouth. In addition, effective management of your acid reflux via lifestyle measures and medications is the way to treat this problem at its source.
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Rinsing and Gargling
When you have acid reflux, good oral hygiene can help improve the foul odors that arise from the regurgitated stomach contents and belched gases that have traveled up into your esophagus and mouth. Gargling with a flavored mouthwash can at least temporarily mask this bad breath. Mouth bacteria and their waste products are also responsible for unpleasant mouth odors, and rinsing with an effective mouthwash can be beneficial. The mouthwash ingredients chlorhexidine or cetylpyridinium can help control this offending bacteria, and mouthwashes that contain chlorine dioxide and zinc help neutralize the foul-smelling sulfur compounds these bacteria create in your mouth.
Brushing and Flossing
Brushing your teeth and tongue after meals, cleaning your dentures if applicable, and flossing between your teeth daily can also minimize odors and keep your mouth clean. Most of your mouth's odor-creating bacteria live on the tongue, so brushing your tongue well can be an effective strategy in controlling your bad breath. The extent acid reflux affects breath odors may be linked to the severity of the condition. However, good oral hygiene is important to counteract bad breath whether your acid reflux is mild or severe enough to be classified as gastroesophageal reflux disease, or GERD.
Controlling acid reflux is an important strategy in preventing the bad breath this condition may cause. Certain lifestyle changes can help control heartburn symptoms. According to the 2013 recommendations from the "American College of Gastroenterology," weight loss can be an effective way to control and improve acid reflux. Also, these guidelines recommend waiting 2 to 3 hours after a meal before lying down and sleeping with the head of your bed slightly elevated. Other lifestyle changes, like chewing gum to stimulate saliva production and not smoking, can also help keep bad breath at bay.
Your doctor may recommend medications to help control your reflux, which in turn can help minimize or prevent the associated bad breath. Examples of medications used for reflux include antacids, which help neutralize the acid produced by the stomach, and proton pump inhibitors and histamine 2 receptor antagonists -- often called acid reducers or acid blockers since they actually reduce the amount of acid produced. Even though many of the drugs used to treat acid reflux are available without a prescription, it's important to work with your doctor on a medication strategy to manage your symptoms.
In addition to its effects on your breath, acid reflux can erode your teeth and oral tissue. Be sure to see your dentist for regular exams and cleaning and if you experience any pain in your mouth. If you have frequent episodes of heartburn that require medications, see your doctor to determine if you have gastroesophageal reflux disease. Also contact your doctor if you experience any other worrisome symptoms of uncontrolled acid reflux, such as hoarseness, chronic cough, or persistent ear and sinus infections. Seek immediate medical attention if you experience persistent chest pain, especially if it's accompanied by shortness of breath, jaw pain or arm pain, since the symptoms of heartburn and a heart attack can be similar.
Medical advisor: Jonathan E. Aviv, M.D., FACS