In most cases of persistent bad breath (halitosis), the smell comes from a build-up of germs (bacteria) within the mouth. These are in food debris, in plaque and gum disease, or in a coating on the back of the tongue. Good oral hygiene will often solve the problem.
That is, regular teeth brushing, cleaning between the teeth, cleaning the tongue, and mouthwashes. Other causes of persistent bad breath are uncommon.
Bad breath facts
- Bad breath, or halitosis, is characterized by an unpleasant odor of the mouth.
- Causes of bad breath include food, tobacco products, poor dental hygiene, health problems, dry mouth, mouth infections, dental problems, or medications.
- Symptoms of bad breath include unpleasant odor or taste in the mouth, dry mouth, or white coating on the tongue.
- Treatments for bad breath include proper dental hygiene, mouthwash, sugar-free gum, quitting smoking, and changing bad habits.
- Bad breath can usually be prevented by proper tooth brushing, quitting smoking, and avoiding foods that cause bad breath odors.
What is bad breath?
Bad breath (halitosis), means that you have an unpleasant smell on your breath that other people notice when you speak or breathe out. The exact number of people with bad breath is not known, but it is common.
How can I tell if I have bad breath?
A main problem with bad breath (halitosis) is that often the only person not to notice it is the person affected. (You become used to your own smell and do not tend to notice your own bad breath.) Often, the only way to know about it is if a person comments on it.
However, most people are too polite to comment on another person’s bad breath. You may have to rely on a family member or a close friend to be honest and tell you if you have bad breath.
Perhaps you could ask your dentist next time you have a check-up. A dentist will normally be able to say if you have bad breath.
Gum disease is a common cause of bad breath and a dentist will be able to advise on treatment if you have gum disease.
Some people suggest a simple test which you can do yourself to detect bad breath. Lick the inside of your wrist. Wait a few seconds for the saliva to dry.
Then smell the licked part of the wrist. If you detect an unpleasant smell, you are likely to have bad breath.
What are the causes of bad breath?
Food: Food is a primary source of bad odors that come from the mouth. Some foods, such as garlic, onions, and spicy foods, exotic spices (such as curry), some cheeses, fish, and acidic beverages such as coffee can leave a lingering smell.
Most of the time this is short term. Other foods may get stuck in the teeth, promoting the growth of bacteria, which causes bad breath odor. Low carbohydrate diets may also cause “ketone breath.” These diets cause the body to burn fat as its energy source.
The end-product of making this energy is ketones, which cause a fruity acetone-like odor on the breath when exhaled.
Tobacco products: Smoking and chewing tobacco can leave chemicals that remain in the mouth. Smoking can also precipitate other bad-breath causes such as gum disease or oral cancers.
Poor dental hygiene: When a person does not brush or floss regularly, food particles remaining in the mouth can rot and cause bad odors.
Poor dental care can lead to a buildup of plaque in the mouth, which causes an odor of its own. Plaque buildup can also lead to periodontal (gum) disease.
The mild form of gum disease is called gingivitis; if gingivitis is not treated, it can advance to periodontitis.
Health problems: Sinus infections, pneumonia, sore throat (pharyngitis) and other throat infections, thrush, bronchitis, postnasal drip, diabetes, acid reflux, lactose intolerance, other stomach problems, and some liver or kidney diseases may be associated with bad breath.
Dry mouth: Also called xerostomia, dry mouth can also cause bad breath. Saliva helps moisten and cleanse the mouth, and when the body does not product enough saliva, bad breath may result.
Dry mouth may be caused by salivary gland problems, connective tissue disorders (Sjögren’s syndrome), medications, or breathing through the mouth.
Mouth infections: Cavities, gum disease, or impacted teeth may cause bad breath.
Dentures or braces: Food particles not properly cleaned from appliances can rot or cause bacteria and odor. Loose-fitting dentures may cause sores or infections in the mouth, which can cause bad breath.
Medications: Many medications, including antihistamines and diuretics, can cause dry mouth (see above), which can cause bad breath. Other medications that may lead to bad breath may include insulin shots, triamterene (Dyrenium), and paraldehyde.
“Morning breath”: Bad breath in the morning is very common. Saliva production nearly stops during sleep, which allows bacteria to grow, causing bad breath.
Other causes of bad breath: Objects stuck in the nose (usually in children), alcoholism, and large doses of vitamin supplements may also cause bad breath.
What are the symptoms of bad breath?
Others may notice someone has bad breath before they do, so they may tell him or her about their bad breath or give them a larger than normal personal space. The most obvious sign or symptom is noticing an unpleasant odor coming from the mouth.
Other symptoms of bad breath include
- unpleasant or sour taste or changes in taste,
- dry mouth,
- coating on the tongue.
How is bad breath treated? What can be done to prevent bad breath?
- Brush and floss teeth regularly. Remember to brush the tongue, too. This can help with bad breath caused by foods a person has eaten.
- See a dentist regularly to ensure dentures or braces are properly fitted and cleaned.
- Quit smoking or using chewing tobacco.
- Keep the mouth moist by drinking water and chewing sugarless gum or sugar-free hard candy to stimulate the production of saliva. Mouthwash may temporarily mask bad breath odors, but it may not treat the underlying cause.
- Natural remedies to treat bad breath include chewing on mint or parsley
If bad breath is due to a health problem such as a sinus infection, diabetes, acid reflux, etc., then the underlying medical issue needs to be treated.
If bad breath is a side effect of taking a medication, discuss with a doctor whether there are other options for medication that can be taken. Never stop taking a medication without first consulting a doctor.
For patients who suffer from dry mouth (xerostomia), artificial saliva may be prescribed by a dentist.
When to seek further help
- If the bad breath (halitosis) does not go
- If you have done everything you can and still have bad breath then see a doctor or dentist. You may need some tests to assess if you have a less common cause of bad breath.
Fear of bad breath (halitophobia)
Some people think they have bad breath when they do not, and nobody else can smell it. This can result in odd behaviour to try to minimise what they think of as their bad breath.
For example, they may cover their mouth when talking, avoid or keep a distance from other people, or avoid social occasions.
People with halitophobia often become fixated with teeth cleaning and tongue cleaning and frequently use chewing gums, mints, mouthwashes, and sprays in the hope of reducing their distress. Treatment from a psychologist may help.