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Most people will suffer from some degree of bad breath at some time in their lives.
Contrary to popular belief, we cannot smell our own breath because we become accustomed to our own smell.
Causes & Development
Bad breath is a common problem that can be due to many causes. Only in rare cases do stomach or digestive problems contribute to bad breath. Most bad breath comes from the back of the mouth.
Temporary bad breath most commonly comes from the foods we eat such as onions, garlic and cabbage which will produce high amounts of sulfur compounds. The digested sulfur compounds are absorbed and carried by blood into the lungs where they are exhaled to produce bad breath. However, chronic bad breath is most commonly caused by bacteria that break down food debris left in the mouth.
Common Causes of Bad Breath:- Odor-causing foods. Most commonly, the smell is a result of breakdown of proteins by various bacteria in the mouth. For example, volatile sulfur compounds and other substances like cadaverine and putracine are produced by certain anaerobic bacteria . Foods including garlic, onions and some spices as well as tea and coffee can contribute towards bad breath.
- Tooth decay or periodontal (gum) disease. Gum disease and tooth decay will often lead to accumulations of bacteria that can cause bad breath. If there is gum disease or tooth decay, then treatment should be sought to eliminate these problems first. Your dentist will examine you and take some radiographs (X-rays) to check for the presence and extent of such problems. Early detection, diagnosis and treatment of gum disease and tooth decay will help keep teeth functional for life. Preventive maintenance is essential to ensure continued good oral health.
- Prolonged mouth dryness
- Use of tobacco products
- Sinus or respiratory infections
- Inadequate oral hygiene. Poor oral hygiene from infrequent brushing of teeth or cleaning of dentures will lead to food debris left in the mouth, around teeth, on dentures, tongue and cheek surfaces, which will be broken down by bacteria resulting in unpleasant breath.
- Medications e.g. anti-depressants, diurectics (used for high blood pressure)
- Medical disorders e.g. oesophageal-gastro reflux, chronic tonsil infections
- Certain bacteria that produce foul-smelling compounds. The bad smell can also come from the back of the surface of the tongue. The scraping obtained by the dentist from this portion of the tongue may suggest that this may be the primary source of bad breath in the individual. In such cases, it will help to use a tongue scraper daily to clean the tongue surface and reduce and prevent the accumulation of bacteria and foul-smelling, bacterial products.
Possible causes of various problems:
Problem: Odor after fasting, dieting, prolonged speaking, exercise, sleeping or taking medications.
Possible Cause: Dryness in the mouth caused by insufficient saliva flow.
Problem: Gums that bleed and bad breath.
Possible Cause: Gum disease caused by poor cleaning between teeth.
Problem: Odor when talking.
Possible Cause: Postnasal drip onto back of tongue.
Problem: Small whitish stones with foul odor appearing on tongue.
Possible Cause: Tonsilloliths from crypts in tonsils.
Problem: Odor appears suddenly from mouth of young child.
Possible Cause: Onset of throat infection.
Problem: Odor in denture wearers.
Possible Cause: Dentures kept in mouth all night or not cleaned properly.
Problem: Odor from nose.
Possible Cause: Sinusitis, polyps, dryness, foreign body, hindered air or mucous flow.
Problem: Bad taste all day long.
Possible Cause: Poor oral hygiene, gum disease, excessive bacteria on tongue surface.
Diagnosis & Tests
The key to effective treatment and management of this condition is proper diagnosis. Recent research has enabled dentists to understand the causes of bad breath and therefore treat it more effectively. The main problem is accepting that one has bad breath as most individuals cannot smell their own breath. Asking friends or seeking other's opinion is usually the best way. Dentists usually begin by checking for the presence of oral disease or conditions that can contribute to bad breath.
Treatment & Prevention
Good brushing and flossing habits will help reduce bad breath. However, most people do not brush their teeth properly as it takes nearly 3 minutes to do so and most spend 45-60 seconds. Furthermore, bad breath can come from bacteria residing deep within crevices on the back of the tongue and thus a tongue scraper is required.
Mouthwashes will only provide temporary relief from bad breath. In fact, most mouthwashes contain alcohol, which has a drying effect in the mouth allowing bacteria to grow better. There are newer mouthwashes without alcohol as well as those which have compounds that react with and neutralize odor-causing volatile sulfur compounds produced by bacteria in the mouth.
The DOs and DON'Ts of bad breath
DO...- Visit your dentist and have your teeth cleaned regularly
- Floss and clean between your teeth as advised by your dentist
- Brush your gums and teeth using the proper technique
- Practice regular cleaning of your tongue, either by scraping or brushing
- Use an alcohol-free mouthwash regularly
- Drink plenty of liquids
- Chew sugar-free gum especially when your mouth feels dry. Alternatives include parsley, mints, fennel seeds or dill seeds.
- Clean your mouth after eating or drinking milk products, fish or meat
- Keep your dentures clean and soak them overnight in antiseptic solution
- Eat fibrous vegetables and fruits to stimulate saliva flow and reduce build-up of food particles.
DON'T...- Ignore the problem
- Drink too much coffee
- Let young children use mouthwash as they tend to swallow it
- Rely solely on mouthwashes - instead, practice good oral hygiene and eating habits
- Let your concern about bad breath affect your life adversely.
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Signs, symptoms & indicators of Bad Breath (Halitosis):
Risk factors for Bad Breath (Halitosis):
Bad Breath (Halitosis) suggests the following may be present: | | | | | Diet |  Effects of a Low Carbohydrate Diet | The acetone resulting from a state of ketosis escapes through the lungs - giving Atkins Diet followers, for example, what one weight-loss expert calls "rotten-apple breath." [Health 19 (1996): p.102] The other ketones have to be excreted by the kidneys. In a study funded by Dr. Atkins himself, most of the people that could stick with the diet reported headaches and halitosis (bad breath). |
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Environment / Toxicity |
General Detoxification Requirement |
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Recommendations and treatments for Bad Breath (Halitosis):
KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | May do some good |  | | Highly recommended |
GLOSSARY
Anaerobic (Anaerobically)
Of, relating to, or being activity in which the body incurs an oxygen debt (for example weight training or resistive exercises) and does not immediately burn off a lot of calories and fat.
Antiseptic
Inhibiting growth of infectious organisms.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.
Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Mucus (Mucous)
The viscous, slippery substance that consists chiefly of mucin, water, cells, and inorganic salts and is secreted as a protective lubricant coating by cells and glands of the mucous membranes.
Polyp (Polyps)
A usually nonmalignant growth or tumor protruding from the mucous lining of an organ such as the nose, bladder or intestine, often causing obstruction.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Saliva (Salivary)
The watery mixture of secretions from the salivary and oral mucous glands that lubricates chewed food and moistens the oral walls.
Sinuses (Sinus)
Four pairs of air pockets lined with membranes in the bones around the nose. The ethmoid sinuses are located on each side of the nose between the eyes; the maxillary sinuses are located in the cheek above the teeth and below the eyes; the sphenoid sinuses are located deeply behind the eyes; the frontal sinuses are located in the forehead.
Sinusitis
Inflammation of the sinuses, with causes ranging from dust to hay fever. Obstinate cases can be caused by chronic sinus infections or the continued exposure to allergens from food, pets or environmental irritants.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
X-rays (X-ray)
High-energy radiation used to take pictures of areas inside the body.
Last updated: Oct 08, 2008
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