By Dr. Roshini Rajapaksa
April 22, 2013

bad breathQ: I often worry that I have bad breath, even though I brush regularly. How do I know if Im grossing people out?

A: Chances are, you dont have bad breath and are simply suffering from an anxiety many of us share. To be sure, ask a loved one to confirm that your breath is OK.

If your breath isnt so fresh, ramp up your dental hygiene. Brushing—even if you do it regularly—isnt enough, nor is using mouthwash or breath mints, which just mask the problem. You need to brush and floss daily. Flossing can get at those food particles that tend to collect bacteria and rot. Brush for at least two minutes, and scrub all surfaces of your teeth and tongue. (Odor-causing bacteria grow there, too.) And keep a kit—small toothbrush, travel-size toothpaste, and floss—in your purse.

If the odor persists, see your dentist to rule out gum disease, plaque, and gingivitis, all of which can cause bad breath and lead to other health problems. In fact, some studies have found a connection between dental diseases and poor heart health, so its important to have a thorough oral examination.

Also, have a look at your diet. Garlic, onions, and even coffee (it contains lots of acids that encourage bacterial growth) are notorious for causing bad breath; cut them out for a week to see if the odor subsides. And, finally, if youve recently had a cold or suffered from postnasal drip, see your doc. That bad-breath smell could be a sign of an infection, and you may need a good dose of antibiotics to help clear it up.

Q: After years of clear skin, Im breaking out with acne again. Is it something Im eating?
A: Theres no science to support the urban legend that foods like chocolate or pizza cause acne. Instead, the culprit could be lurking in your cosmetic case or bathroom. Makeup, soaps, shampoos, or even laundry detergents can sometimes cause a reaction that produces pimples. If youve recently switched brands, go back to your old ones. Makeup tip: Most acne sufferers should select powder blushes and eye shadow over cream products because theyre less likely to irritate skin and clog pores.

If the acne persists, see a dermatologist. She can determine if your breakouts are due to rosacea (a common skin condition that generally affects adults and can cause pimples and redness) or hormonal fluctuations. Both are treatable with over-the-counter or prescription drugs. Your derm will be able to recommend the best course of treatment.

Medical Editor Roshini Rajapaksa, MD, is an assistant professor of medicine at NYU Medical Center.