Bad Breath (Halitosis)

Facts on Bad Breath (Halitosis)

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

What Causes Bad Breath?

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.

Medications that cause a dry mouth can trigger bad breath. In addition, certain medications, such as triamterene and paraldehyde, have bad breath as a side effect.

Causes of bad breath include the following:

Diet

  • When a person does not brush or floss their teeth thoroughly, food particles that may remain in the mouth can 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. These foods may also cause stomach and 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 is 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

The following medical disorders may cause bad breath:

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, which can cause bad breath, commonly referred to as "morning breath." Some people breathe through their mouths at night, which can cause dry mouth and worsen morning breath.

What Are the Symptoms of Bad Breath?

Many individuals with bad breath may be unaware they have it, or their signs and 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 in the mouth, sour taste, or taste changes,
  • dry mouth,
  • a coating on the tongue.

When to See a Doctor for Bad Breath

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 for a diagnosis if they have

  • persistent dry mouth,
  • sores in the mouth,
  • pain with chewing or swallowing,
  • white spots on the tonsils,
  • fever,
  • any other symptoms of concern.

Those who have bad breath and have just started a new medication or who have had recent dental surgery should consult their health-care provider.

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.

Diagnosis of Bad Breath

  • 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.

What Are Home Remedies for Bad Breath?

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 the following:

  • Practice good oral hygiene, which involves
    • brushing at least twice a day with fluoride toothpaste,
    • brushing the teeth after meals,
    • brushing the tongue,
    • replacing one's toothbrush every two to three months,
    • using dental floss regularly,
    • removing dentures at night and cleaning them thoroughly before placing them back in the mouth,
    • dental check-up at least twice a year.
  • Stop smoking/chewing tobacco-based products.
  • Keep the mouth moist by
    • drinking water,
    • chewing sugarless gum or sucking on sugar-free 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.

What Is the Treatment for Bad Breath?

  • 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.

Follow-Up for Bad Breath

  • 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.

How Do I Prevent Bad Breath?

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

What Is the Prognosis for Bad Breath?

The prognosis for bad breath is generally good as 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.

Reviewed on 1/18/2018

Medically reviewed by Joseph T. Palermo, DO; Board Certification Internal Medicine/Geriatric Medicine

REFERENCE:

The American Dental Association, "Bad Breath (Halitosis)."

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