Bad breath (halitosis)
What is halitosis?
Unpleasant smelling breath, or halitosis, is quite common in healthy people, especially when they first wake up. For some people bad breath is a chronic problem, affecting their personal, business and social life.
What causes bad breath?
Most halitosis originates in the mouth. The usual cause is the breakdown of food particles by bacteria. This process of breakdown is exactly the same as the process that causes food to 'go off'. This is known as putrefaction. Most people's mouths contain large numbers of bacteria, especially in dental plaque, the substance that builds up on, and between, teeth that are not cleaned regularly. The crevices in the surface of the tongue can also contain odour-causing bacteria.
What makes bad breath worse?
Infections in the mouth contain even more bacteria, which make halitosis worse - particularly gingivitis (infection of the gums) and periodontal disease (disease of the gums, teeth and bone around the teeth). Dentures that don’t fit or aren't cleaned regularly can add to the number of bacteria.
Dry mouth – where the flow of saliva is reduced – can contribute to bad breath as saliva helps clean the mouth. Saliva flow is reduced during sleep, leading to 'morning breath', which may be worse if you sleep with your mouth open. Some medicines and problems with the salivary glands also lead to dry mouth.
What are other causes of bad breath?
Sometimes foods that contain certain oils, such as garlic, onions and spices, will produce bad breath, but only on a temporary basis until the food is eliminated from your body. Dieters may have bad breath because of changes in their metabolism.
Some bad breath originates in the nose, throat and respiratory passages. For example, sinus infections, postnasal drip and respiratory infections can lead to bad breath.
Smokers, and those taking certain drugs, may have bad breath. Sometimes, people with diseases of the liver or kidney, complications of diabetes or digestive problems have unpleasant breath as a result, but this is not common.
Prevention and treatment of bad breath
The best way to treat and prevent halitosis that originates in your mouth is to clean your teeth and tongue thoroughly at least twice a day, especially after meals. This prevents plaque building up and removes the tiny food particles necessary for putrefaction to occur. Dental floss is a good way of cleaning the hard-to-get-at places. Some experts recommend that a tongue scraper is more effective than a brush for cleaning the tongue.
Although some mouthwashes can help, they are often expensive and are no substitute for good dental hygiene.
If your bad breath persists (and it might take a close friend to tell you), make a visit to the dentist your first priority.
Last Reviewed: 24 September 2010
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3. American Dental Association. Bad breath (halitosis). http://www.ada.org/2941.aspx (accessed Jan 2011).
4. Fedorowicz Z, Aljufairi H, Nasser M, et al. Mouthrinses for the treatment of halitosis. Cochrane Database Syst Rev 2008; 4: CD006701. doi: 10.1002/14651858.CD006701.pub2. http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD006701/frame.html (accessed Jan 2011).
