Straight talk on bad breath, period problems, and acne

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MOST EMBARRASSING QUESTIONS

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Q: I often worry that I have bad breath, even though I brush regularly. How do I know if I'm grossing people out?
A: Chances are, you don't 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 isn't so fresh, ramp up your dental hygiene. Brushing — even if you do it regularly — isn't 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 it's 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 you've 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: I always get diarrhea during my period. Is there any way to avoid this?
A: Changes in your bowel habits at this time are common, albeit irritating. Here's why it happens: During your menstrual cycle, prostaglandins, hormone-like substances, cause your uterine muscles to contract, creating those cramps so often associated with "that time of the month." Sometimes these prostaglandins also escape into your bloodstream and affect other smooth muscles, including those in your colon, causing diarrhea.

To help bulk up your stool, try eating more fiber — rich foods — like broccoli, cauliflower, and apples — as your period rolls closer. Taking ibuprofen is also a good idea. Besides relieving other menstrual symptoms, it's an effective prostaglandin inhibitor. If the diarrhea is very severe, talk to your doctor about trying an antidiarrhea medication like Imodium to calm your bowels.

Q: After years of clear skin, I'm breaking out with acne again. Is it something I'm eating?
A: There's 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 you've 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 they're 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.

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By Roshini Rajapaksa

MEDICAL EDITOR ROSHINI RAJAPAKSA, MD, is an assistant professor of medicine at NYU Medical Center.

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