Why Some Older Adults Struggle With Bad Breath

For most of us, bad breath is a sign that we need to brush or floss regularly or more often. However, for many older adults, bad breath could be a cause for more serious concern.

Older adults are more vulnerable to dry mouth – one of the leading causes of bad breath – and they may find it difficult to maintain proper oral hygiene as they age, says geriatrics medicine specialist Taryn Lee, MD.

“They may not be able to take care of their dentures or brush their teeth well because they have arthritis,” she says. “It could also be a symptom of memory loss. Older patients may forget to brush their teeth regularly or care for their dentures."

Bad breath also could be a sign that an older adult is having difficulty caring for themselves, Dr. Lee says.

“I worry more about bad breath because it may be a sign of other geriatric problems," Dr. Lee says. "Things that we take for granted sometimes aren't that easy for our older patients to do.”

Other Causes of Bad Breath

In addition to poor oral hygiene, several other factors can contribute to bad breath in an older adult, including:

• Certain foods
• Tobacco use
• Dentures
• Gum disease
• Digestive, respiratory or other health problems, including diabetes and Parkinson’s disease
• Dry mouth, which may be a side effect of some medicines and cancer treatments or a blocked salivary gland

Saliva helps wash away bacteria that can lead to bad breath. As we age, we not only produce less saliva, we are also more likely to be on medications or combinations of medicines that can cause dry mouth.

“For patients very bothered by dry mouth, they may want to discuss with their doctor to determine which medicines are absolutely necessary, then work together to see if any of them can be stopped,” Dr. Lee says.

Getting Enough Fluids

Older adults also may be resistant to drinking the recommended amount of fluids with their medications because going to the bathroom may be physically difficult, she says.

“If you drink a lot, that's going to make you urinate more, and some people don't like having to go to the bathroom because they can't get there quickly enough,” Dr. Lee says. Still, it's important to drink fluids to prevent dehydration.

Fortunately, bad breath is rarely an issue for older adults who practice good oral hygiene, avoid tobacco and alcohol, eat a healthy diet and drink plenty of fluids. If you’re doing everything right and still find that people are recoiling from your breath, it may be time to see your doctor.

Taryn Lee, MD is a geriatrics medicine specialist and the program director of Geriatrics at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Lee or any other University Hospitals doctor online.