Bad Breath, Halitosis

Self Conscious About Your Breath

Bad breath, also called halitosis, can be an embarrassing problem. It can be caused by the foods you eat, dry mouth, tobacco products, or a medical disorder. Maintaining proper oral health can help reduce or eliminate bad breath.

Bad Breath Causes

Bad breath (halitosis) can be caused by a variety of things including diet, medication, poor oral hygiene, and diseases or conditions such as diabetes, GERD, lactose intolerance, gum disease, and more. Treatment for bad breath depends on the cause.

There are many things that can cause bad breath, including the following:


* When a person does not brush or floss their teeth thoroughly, food particles may remain in the mouth. These particles may rot and cause foul odors. In addition, food particles over time can promote the growth of bacteria, which can also cause foul odors. The bacteria can also lead to tooth decay and gum disease.

* Foods with strong odors also affect the air a person exhales. Foods commonly known to contribute to bad breath include onions and garlic, exotic spices (such as curry), some cheeses, fish, and acidic beverages such as coffee. Foods are absorbed into the bloodstream and then transferred to the lungs, causing noticeable odors when exhaled. These foods may also cause gastrointestinal upset and belching, which can contribute to bad breath. In addition, certain supplements such as fish oil capsules can contribute to bad breath.

* Low carbohydrate diets may also cause what is known as ‘ketone breath.’ So-called ‘low carb’ diets cause the body to burn fat as its energy source. The end-product of making this energy are ketones, which cause a fruity acetone-like odor on the breath when exhaled.

Dry Mouth

* Bad breath can also be caused by decreased flow of saliva, which is a vital part of the digestive process and removes odor-causing particles in the mouth. Also called xerostomia, dry mouth may be caused by medications, breathing through the mouth, or salivary gland problems.

Tobacco Products

* In addition to causing bad breath, smoking or chewing tobacco-based products can stain teeth, irritate gum tissue, and exacerbate tooth decay.

Medical Disorders

Certain medical disorders may cause bad breath, for example:

* gum or periodontal infection,

* throat infection (pharyngitis or tonsillitis),

* local infection in the respiratory tract,

* chronic sinusitis and/or post-nasal drip,

* chronic bronchitis,

* diabetes,

* gastroesophageal reflux disease (GERD),

* liver or kidney disease,

* Sjogren’s syndrome (causes xerostomia), and

* lactose intolerance.

Dentures or Dental Appliances

* Dentures or dental appliances, such as braces, can contribute to bad breath. Most often it is due to food particles that are not properly cleansed from the appliances. Loose-fitting dentures can contribute to sores and localized infections in the mouth, which can cause bad breath.

Morning Breath

* Overnight, bacteria accumulate in the mouth, causing bad breath that is commonly referred to as ‘morning breath.’ Some people breathe through their mouth at night, which can cause dry mouth and worsen morning breath.

Bad Breath Symptoms

Many individuals with bad breath may be unaware they have it, or their symptoms may only be temporary. The odor often depends upon the source or underlying cause of the bad breath.

Some common symptoms of bad breath include:

* bad breath smell,

* bad taste or taste changes,

* dry mouth, and

* a coating on the tongue.

When to Seek Medical Care

Most causes of bad breath are due to inadequate oral hygiene and are rarely life-threatening. If good oral hygiene practices do not eliminate the bad breath, see a dental professional. In most cases, a dentist can treat the cause of bad breath.

An individual should consult their physician if they have:

* persistent dry mouth,

* sores in the mouth,

* pain with chewing or swallowing,

* white spots on the tonsils,

* fever,

* just started a new medication,

* had recent dental surgery, or

* any other symptoms that are of concern.

Bad breath in babies or young children may be a sign of infection or undiagnosed medical problems. Consult the child’s doctor or dentist if an infant or young child has bad breath.

Exams and Tests

* A complete medical and dental history should be taken. The patient will be asked about their bad breath problem, dietary habits, tobacco use, medications, medical conditions and family history.

* A dentist will examine the patient’s mouth. X-rays may be taken, and periodontal charting may be done to determine if the odor is due to gum disease.

* A Halometer measures volatile sulfur compounds in the breath and may be used.

Bad Breath Treatment

Self-Care at Home

People who suffer from bad breath want to know how to get rid of bad breath. Some examples of measures an individual can do to prevent or get rid of bad breath include:

* Practice good oral hygiene to include:

o brush at least twice a day with fluoride toothpaste,

o brush the teeth after meals,

o brush the tongue,

o replace your toothbrush every two to three months,

o use dental floss regularly,

o dentures should be removed at night and cleaned thoroughly before being placed in your mouth, and

o see your dentist at least twice a year.

* Stop smoking/chewing tobacco-based products

* Keep your mouth moist by:

o drinking water, and

o chewing sugarless gum or hard candy to stimulate the production of saliva.

* Avoid foods such as onions or garlic which may cause bad breath.

* Mouthwash provides a temporary way to mask bad breath odors, but it may not treat the underlying cause.

* Natural bad breath remedies include chewing on mint or parsley.

Medical Treatment

* Specific medical treatment to cure bad breath depends upon the cause.

* In patients who suffer from dry mouth (xerostomia), artificial saliva may be prescribed by a dentist.

* Dentists can also prescribe special toothpaste and mouthwash that can improve the symptoms of bad breath.

Next Steps- Follow-Up

* Follow all instructions provided by the dental or medical professional, and use any prescribed mouthwash or toothpaste as directed.

* If the patient’s dentist determines that the bad breath odor is not of oral origin, the patient may be referred to a physician.

* If the odor is due to gum disease, the dentist may refer the patient to a periodontist, who specializes in treating gum conditions.


Good oral care, regular dental visits, tobacco cessation, and avoiding certain foods can prevent most cases of bad breath.


Bad breath is usually more of a nuisance rather than a serious medical condition. Most individuals with bad breath can treat and eliminate the condition on their own. Additionally, dentists and physicians can help with cases of chronic bad breath.

from 3-20-2010

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