Scleroderma is a very debilitating disease that affects all aspects of life. It begins with a thickening of the fingertips, but as the disease progresses, it affects the skin, joints and internal organs. When it hits the esophagus, it leads to difficulty swallowing, chronic heartburn and our focus here, persistent bad breath.

The bad breath associated with scleroderma occurs for two reasons. The first cause is similar to bad breath that comes with reflux diseases. The scar tissue in the esophagus causes food from the stomach to work its way back up the esophagus, leaving a bitter, acidic taste in the mouth all the time.

The other reason scleroderma contributes to bad breath is that the disease makes dental hygiene extremely difficult. When the scarring spreads to the face and mouth area, it becomes very difficult for the patient to open their mouth or move their tongue. In more severe cases, the gums become scarred, and pull away from the teeth. Good dental hygiene is also more difficult because often the patient experiences difficulty with muscle control in the hands, making it tough to brush properly.

Dry mouth is still another symptom that leads to bad breath. When the salivary glands become scarred by the disease, they don’t produce enough saliva, which is a natural helper in the fight against halitosis. Dry mouth becomes worse if the patient’s lips are affected, because they fail to close properly, drying and staining the teeth, and making the dry mouth worse.

Doctors have a few suggestions for combating bad breath despite these severe limitations.

First, to combat dry mouth, doctors suggest patients sip fluids or suck on finely crushed ice as often as possible. Other recommendations include chewing sugarless gum and sucking on sugarless candy to stimulate the salivary glands. Certain medications can also increase salivary gland production.

As far as oral hygiene is concerned, doctors suggest using high-fluoride toothpaste, regular visits to the dentist, and using an electric toothbrush, because it cleans teeth more efficiency and requires less manual coordination. There are also a number of over the counter medications that are quite helpful, including the Biotene line of products that include toothpaste, mouth rinse and chewing gum all designed for dry mouth problems.