Booze Causes Bad Breath

alcohol causes bad breath

Story at-a-glance -

  • Your gut and oral microbiome are intricately linked to your health, which means imbalances increase your risk of inflammation and chronic disease
  • Drinking just one alcoholic beverage a day creates an imbalance in your oral microbiome, which may increase your risk of hypertension, cancers and bad breath, and a woman’s risk of PMS
  • Naturally improve your oral microbiome by avoiding antibacterial mouthwashes and fluoridated toothpastes, flossing and oil pulling daily, and reducing your overall net carbs

By Dr. Mercola

Science is only beginning to unravel the importance your gut and oral microbiome have in relationship to your overall health. With nearly 700 microbial species colonizing the hard surfaces of your teeth and soft tissue, your mouth houses the second most diverse microbial community in your body. The complexities of the oral microbiome have given scientists new insights into the role it plays in both health and disease.

Modern-day lifestyle choices may have detrimental consequences allowing disease-promoting bacteria to thrive and trigger health conditions. Effectively balancing your oral microbiome is important to restoring oral health and maintaining good physical health. Oral disease can contribute to diabetes, heart disease and Alzheimer's disease, just to name a few.

According to Dr. Gerry Curatola, founder of Rejuvenation Dentistry, who has over 30 years' experience in biological dentistry, advanced gum disease can raise your risk of a fatal heart attack up to 10 times.1 If you have a heart attack related to gum disease, 9 times out of 10 it will be fatal.

Achieving good oral health is about promoting balance in the bacteria growing in your mouth. Contrary to popular belief, alcohol mouthwashes and antimicrobial agents actually do far more harm than good. Therefore, it's no great surprise that drinking alcohol can disrupt the oral microbiome, contributing to bad breath (halitosis) and the development of other chronic health conditions.2

Spit Test Demonstrates Alcohol Changes Oral Bacteria

In a previous study, senior investigator Jiyoung Ahn, Ph.D., epidemiologist at the New York University School of Medicine, found types of bacteria in the mouth could influence the development of oral and upper digestive tract cancers. Following this discovery, Ahn and her colleagues moved to investigate the types of diet and lifestyle factors influencing your oral microbiome.3

Gathering a group of over 1,000 healthy individuals between the ages of 55 and 87, researchers included 270 nondrinkers, 614 moderate drinkers and 160 heavy drinkers. Each provided a spit sample with detailed information about other lifestyle habits, such as foods and drinks.4

Laboratory tests were then used to sort and quantify bacteria in each sample, plotting the results to better understand the heaviest bacterial growth found in drinkers compared to nondrinkers. They discovered individuals who drank had more actinomyces, neisseria and bacteroidale species than nondrinkers. Each of these species have a history of causing periodontal disease or reducing the growth of beneficial bacteria.

Participants who also drank cocktails also had fewer lactobacilli, a family bacterial family known to reduce gum inflammation. Researchers found microbial diversity in wine drinkers was different from liquor and beer drinkers. They concluded alcohol consumption may influence oral microbiome composition and will have implications for understanding the potential role bacteria play in alcohol-related diseases.5

On average, those who reported higher levels of alcohol consumption had higher numbers of bacterial colonies known to cause gum disease and halitosis. The researchers theorized the oral microbiome imbalances may be the result of acids found in alcoholic beverages or a buildup of byproducts from the breakdown of alcohol, both making the environment more hostile for certain bacteria.

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Oral Microbiome Imbalances Increase Your Risk for Disease

Although connected to your gut microbiome, your oral microbiome is unique. It functions as a protection from deadly viruses and bacteria and the environment, and aids the early stages of digestion. Protection from deadly viruses extends to more than your own health.

Until recently, scientists believed the uterus was a sterile environment. While science has demonstrated unhealthy gums are linked to preterm birth,6 only recently have they discovered an association between the types of microbes found in a mother's mouth and those found on the placental tissue directly after birth. The microbial species on placental tissue more closely resembled the oral microbiome of the mother than bacteria from her vagina or gut.7

In a recent review8 of the bacterial composition of saliva and periodontal disease, researchers found high levels of Prevotella and Veillonella in the salivary microbiota were associated with poor oral health, including dental caries, periodontitis and poor oral hygiene. The relative abundance of predominant bacteria was also associated with specific health conditions, including poor oral health, high body mass index and old age, suggesting salivary microbiota impact both oral and systemic conditions.

A growing body of evidence suggests several chronic diseases are linked to high levels of inflammation in the body. Periodontal disease, an infection of the tissue supporting your teeth caused by plaque-forming bacteria, is often linked to how well diabetes is under control. Periodontal disease is also linked to the development of:9,10

Respiratory disease

Cardiovascular disease

Low birth weight babies

Bacterial pneumonia


Type 2 diabetes



Reduce Your PMS Symptoms by Saying No to Alcohol

Premenstrual syndrome (PMS) is a health condition occurring in women of reproductive age. In a meta-analysis of 17 worldwide studies,11 researchers found the pooled prevalence of PMS was nearly 50 percent. France had the lowest prevalence (12 percent), while Iran had the highest (98 percent).

Women with PMS suffer a wide variety of signs and symptoms, including mood swings, tender breasts, food cravings, fatigue and irritability. For some women the symptoms are severe enough to affect their daily lives. A small number of women suffer disabling symptoms every month, also called premenstrual dysphoric disorder.12 Symptoms occur in a predictable pattern as they are related to a woman's menstrual cycle.

While the exact cause of PMS is unknown, it is believed two primary factors contribute to the condition: cyclical changes in hormonal levels and chemical neurotransmitter changes in the brain affected by hormonal changes. In a recent study,13 researchers found women who were heavy drinkers had a higher risk of PMS. In this study, researchers found up to 40 percent of women in the U.S. suffer at least moderate symptoms of PMS, starting just after ovulation and lasting approximately 14 days, ending with menstruation.

Dr. Bahi Takkouche, the study's senior author and professor of preventive medicine at the University of Santiago de Compostela in Spain, analyzed 19 studies of alcohol and PMS, finding the risk for PMS was 45 percent higher when women drank alcohol. Heavy drinkers, defined as those who drank more than one drink per day, were 79 percent more likely to have PMS than nondrinkers.14

Based on the results of their analysis, the researchers estimated 1 in 10 cases of PMS may be related to alcohol intake.15 While the symptoms of PMS may be difficult to manage alone, Takkouche associates PMS with the development of hypertension, and writes:16

"Together with other researchers we believe that alcohol increases PMS risk by altering the level of hormones, such as gonadotropin, during the menstrual cycle. I know of at least one U.S. study, very well designed, that found an increase in the risk of hypertension among women who had suffered PMS, especially among those who had suffered from hypertension before 40 years of age.

We do not pretend to make recommendations on the basis of one study only, even if it is a 'study of studies' as ours, we think it would be better to avoid heavy drinking for women who are prone to PMS. I think this disorder should be taken as seriously as any other disease, both by women who suffer from it and by the community of health professionals, part of which disregards this syndrome and considers it a social construct only."

Alcohol- and PMS-Related Hypertension

A prospective epidemiological study from the University of Massachusetts17 was the first to consider a diagnosis of PMS may represent a future risk for hypertension. Researchers found clinically significant PMS that affects daily life may impact as many as 15 percent of American women. They collected information from over 1,200 women who developed clinically significant PMS and adjusted for a number of factors, including age, weight, cigarette use and postmenopausal hormone use.

They followed the participants for six years, finding those with PMS had a 40 percent greater risk of developing hypertension than those without PMS.18 The authors suggested this risk factor may be modifiable and definitely presents a means of identifying a potential future risk, enabling better early evaluation. The data also revealed women with high dietary intake of thiamin and riboflavin had up to a 35 percent lower risk of developing PMS, thus reducing their overall risk of developing hypertension. The authors write:19

"High total folate intake has previously been associated with a lower risk of hypertension in the NHS2, even after adjustment for intakes of sodium, potassium and vitamin D and for standard hypertension risk factors. Our results are consistent with these findings and suggest that improving B vitamin status in women with PMS might both reduce menstrual symptom severity and lower hypertension risk."

Your risk of hypertension also rises with your intake of alcohol. A variety of epidemiological and clinical studies have established a connection between hypertension and alcohol intake.20 One mechanism accounting for the development of hypertension may be the loss of endothelial relaxation, oxidative damage and inhibition of nitric oxide production. Limiting your alcohol intake is the first step in the treatment of hypertension.21

You may significantly reduce your risk for hypertension and PMS by eating a diet high in thiamin and riboflavin and reducing or eliminating your alcohol intake. Foods high in thiamin include acorn squash and sunflower seeds.22 Foods high in riboflavin include almonds and spinach.23 Foods high in both thiamin and riboflavin include organic and pasture raised pork, beef and dairy products.

How to Naturally Improve Your Oral Microbiome

Improving the balance of your oral microbiota may help reduce your risk for chronic illness and halitosis (bad breath), often triggered by bacterial growth. The following steps help prevent such disruptions and give your body the tools needed to heal your gums.

Avoid antibacterial mouthwash and fluoridated toothpastes

Both of these products will create an imbalance in your oral bacteria and provide a unique environment where harmful bacteria may flourish.

Improve your oral microbiota

The second highest concentration of vitamin K2 in your body is in your salivary glands, and vitamin K is secreted in saliva. Research24 shows that when vitamin K2 is administered, it reduces bacterial counts in your saliva. Specifically, vitamin K2 reduced the concentration of a bacteria involved in tooth decay, Lactobacillus acidophilus, from a count of 323,000 to 15,000.

This is intriguing, since fermented vegetables, which are loaded with friendly bacteria that improve digestion, alter the flora in your mouth as well. And when made using a special culture, fermented vegetables are an excellent source of vitamin K2. Since the addition of vitamin K2-rich fermented vegetables to my diet, my plaque has decreased by half and is much softer.

Nutritional support

Your gums thrive on vitamin C and CoQ10. Your gums should not normally bleed and if they do it may be a sign of a CoQ10 deficiency.25 Healthy gums are more resistant to damage by harmful bacteria. Read more about the benefits of vitamin C in my previous article, "Vitamin C May Be a Potent Adjunct to Cancer Treatment" and the differences between CoQ10 and ubiquinol in my article, "CoQ10 — The No. 1 Supplement Recommended by Cardiologists"

Oil pulling

Curatola's clinical and experimental experience over the last 30 years suggests most toothpastes should be avoided.26 A strong nutritional program for systemic health with an oral rinse specifically designed to nourish your oral microbiome is preferable. Oil pulling is an important strategy Curatola recommends, noting: "If you don't have a good nutritional that promotes oral microbiome homeostasis, coconut oil pulling is great."

Coconut oil pulling has a lipophilic effect, helping to eliminate unhealthy biofilm from your teeth. And while it has a natural detergent effect, it doesn't do the damage chemical detergents do. Coconut oil also contains a number of valuable nutrients helping promote oral health. Another tip: If you want a healthy oral care rinse, Curatola suggests rinsing with some Himalayan salt dissolved in water, as it contains more than 85 different microminerals.


While most people brush their teeth every day, the practice of flossing is more frequently overlooked. This is unfortunate, as flossing is perhaps even more important than brushing. It removes bacterial precursors of plaque, which eventually turns into hard tartar that cannot be removed by regular brushing or flossing.

If you're among those who rarely or never floss, consider adding this practice to your daily routine slowly. If you find it difficult to include in your routine simply floss a single tooth on the first day, two on the second and so forth until by the end of the month you're flossing your entire mouth every day.

Reduce your net carbs

Digestion of carbohydrates, such as breads, pastas, beans, rice and oats, begins in your mouth with saliva. This increases the amount of sugar deposited in your mouth, feeding harmful bacteria. Focus instead on fresh vegetables, fermented foods and healthy fats such as organic, grass fed meat and dairy products, avocados and coconut oil.

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