Halitosis itself may not be life-threatening, but it could be the symptom of a medical condition you should address for your overall health and well-being.
Bad breath (fetor oris) is a fetid odor that is present when you exhale and is mostly caused by bacteria along and below the gum line and on the back of the tongue.
A proper dental checkup may reveal you have gum disease or tooth decay. If no dental condition is present, you may suffer from other conditions such as sinus problems, throat, lungs, stomach, esophagus or nasal cavity issues.
Rarely is halitosis the sign of a serious medical problem and most of the time it can be addressed with the proper oral hygiene – such as proper brushing and flossing of teeth and scraping the back of the tongue to remove odor-causing bacteria.
Bad breath is a social problem and can make you anxious about going out and meeting or being around people. It’s a condition which can usually be corrected easily with a little time and effort, so you simply need to find out the causes, diagnosis and treatment procedures to eliminate halitosis from your life.
Your Mouth Is a Hotbed of Bacteria
In over 90% of halitosis cases, the problem lies within the mouth and is referred to as oral malodor, intra-oral halitosis or oral halitosis. Over 600 varied types of bacteria can be found in an average mouth and they may be living and breeding on the back of the tongue or beneath the gum line.
The bacteria are produced by the transformation of proteins into amino acids, which then break down into gases, causing the foul odor from the mouth. The tongue is the main breeding ground for these bacteria, but other areas of the mouth may also contribute.
For example, faulty dental work, food gathering areas between and in the teeth, abscesses, dirty dentures and lesions caused by viral infections such as Herpes and the HPV virus may contribute to the reasons for halitosis.
Less exposure to oxygen is the reason why the mouth is prone to the moist, bacteria-growing conditions which can produce a foul odor. When you’re sleeping, the mouth is exposed to even less oxygen, causing the condition known as “morning breath.”
Morning breath happens when you’re sleeping because the body produces less saliva at night to wash away food and odors. The mouth is dryer and dead cells adhere to your tongue and elsewhere inside the mouth. Bacteria then use these decaying cells for food and a bad odor is the result.
Bad breath may also be caused from certain foods you eat such as onions, garlic, fish, cheese and meats. Smoking and alcohol are also contributors to halitosis, but may be eliminated completely by proper brushing and flossing of teeth or using a special mouthwash.
Halitosis isn’t usually a health concern and can be treated by certain changes in oral hygiene and lifestyle habits. Regular dental visits and cleaning are necessary to detect cavities or periodontal (gum) disease.
Dry mouth, internal diseases, infections and fasting or dieting may also contribute to bad breath and should be addressed immediately by a dentist or healthcare provider. Problems such as a sore or inflamed throat, sinus, acid reflux and respiratory infections can also be culprits of halitosis, but these are usually temporary conditions.
Signs of an infection within the mouth might be causing a bad breath problem. If you experience red or swollen gums and they bleed profusely after flossing or brushing, you may have gingivitis or another type of gum infection.
If you notice an abscess (pocket of pus) at the gum line of a tooth or between teeth or have loose teeth or dentures, you may be suffering from a bacterial infection. Also, open sores on the gums or tongue that may or may not be painful are likely to emit a foul odor.
Some women experience bad breath during their menstrual cycles – and keep in mind that certain medications may cause dry mouth, which increases bacterial growth in the mouth.
Fasting, stress and anxiety may also cause dry mouth or other conditions that contribute to halitosis. Certain medical conditions may also result in dry mouth – for example, you may have a salivary gland condition that makes you have to breathe from your mouth.
Symptoms of dry mouth include difficulty when speaking, cavities, difficult swallowing foods, burning in the mouth area and dry eyes. Be sure to drink lots of water every day to keep your mouth hydrated – and use sugar-free gums and mints to stimulate the salivary glands.
Other than mouth and tongue issues, there are a few more conditions you should know about when attempting to diagnose your halitosis problem. And, keep in mind that you may not even know you have bad breath because the odor-detectors in your nose could condition itself to the smell.
Ask your dentist or a family member or close friend for the truth and then take action to fix the problem.
Other Symptoms and Causes of Halitosis
It’s rare that a serious illness can cause bad breath, but occasionally, halitosis may occur because of conditions such as diabetes, liver or lung disease, acid reflux, sinus problems and kidney disease or kidney failure.
If you experience a sore throat, fever, swollen glands in the neck area, runny or stuffy nose that includes a yellow or green discharge or a mucus-producing cough, chances are you also have halitosis.
A checkup by a doctor or dentist may reveal certain issues by the nature of the breath odor. For example, if your breath produces a urine type of odor, you may need to be tested for kidney disease or failure.
When your breath is noticed to have a fruit-like odor, it could be a sign of diabetes. Other conditions include acid reflux disease (GERD) or chronic liver or kidney disease. Call a dentist for an appointment if your bad breath seems to be related to dental problems, and call a doctor if you suspect physical reasons.
The nose and sinus region is also a hotbed of bacteria. Breath produced from the nostrils has a different odor that is produced from the mouth and could be caused by a sinus infection or foreign elements inside the nose.
Stomach issues such as reflux aren’t common as a cause for halitosis, but when the contents of the stomach are involuntarily brought up into the esophagus, it produces a flow of gas and odors from substances within the stomach and bad breath will occur.
The tonsils (tonsillitis) have long been thought to be the next most common cause of halitosis after the mouth. Chronic caseous tonsillitis is emitted from the tonsils in the form of a cheese-like substance causing inflammation and sometimes abscesses and causing the resulting halitosis.
Systemic diseases such as diabetes, carcinoma, respiratory (bronchial and lung) infections, liver failure, renal failure, trimethylaminuria (fish odor) syndrome, diabetes and certain types of metabolic conditions could cause bad breath, but are rare occurrences in the general population.
Only a small section of the adult population may suffer from a condition called delusional halitosis. This is a condition where the person affected thinks he has bad breath and may even seek professional advice for it.
It’s a much exaggerated condition where the person is positive he has halitosis and his life becomes affected by it, even though those around him do not notice any sign of foul smelling breath.
Testing and Seeking Help for Halitosis
A visit to the dentist should be your first option for seeking testing and help if you suspect or know you have bad breath. The dentist will review your dental and medical history, including medications you might be taking that could cause dry mouth.
The dentist will also thoroughly examine your teeth, gums, salivary glands and the mouth condition. You’ll also be evaluated for bad breath by exhaling from your nose and mouth.
If the dentist suspects a medical issue, you’ll be referred to your family doctor – or, in some cases of gum disease – you’ll be referred to a periodontist who specializes in gum diseases.
If you see your family doctor for halitosis, he’ll likely perform tests if he suspects kidney, lung or liver disease. This may include urine or blood tests, X-rays of the sinus or chest areas and other types of testing.
When all possible medical and dental issues have been checked and ruled out, more specialized and in-depth testing is required. Specialized help is readily available in hundreds of dental offices and breath clinics which use a myriad of laboratory methods.
Science has proven that it’s difficult, if not impossible to test one’s own breath, but most are able to detect it in others. You may have a certain taste in your mouth that’s metallic or sour and suspect bad breath, but that’s usually a poor indicator for testing.
Self-diagnosis may be possible by licking the back of the wrist, letting the saliva dry for a couple of minutes and then sniffing the results, but that’s not always a reliable method.
One better method would be to scrape the back of the tongue lightly with a plastic spoon and then smell the results after it dries. Swabs are now available in pharmacies which test for combinations of polyamines and sulfur, but the results may not be totally reliable.
When you’re tested by a dental office or commercial breath clinic, other testing methods are available. The halimeter is a portable monitor which tests for sulfur emissions from the mouth.
This test may not always be reliable because some food and drink can cause false readings on the device. A BANA test involves the salivary glands and tests the levels of an enzyme which indicates odor-causing bacteria.
The enzyme, galactosidase, can be tested for salivary levels and is associated with halitosis. Breath clinics use these devices, but the actual gold standard of knowing if you have halitosis is by trained experts in “organoleptic measurements” who use the sniff and score method to rate the type and level of odor involved. They commonly use an intensity scale up to six points.
What You Can Do to Prevent Bad Breath
Causes of halitosis aren’t well understood by the medical community, so you may have difficulty finding effective treatment. Some strategies on your part may be used to prevent bad breath most commonly originating from the mouth.
Cleaning the surface of the tongue twice a day can help eliminate odor-inducing bacteria and can be accomplished by using several proven strategies such as cleaning the tongue’s surface using a toothbrush or tongue scraper to eliminate the debris, bacteria and mucus.
Use some antibacterial mouthwash or tongue gel to cleanse even more efficiently and thoroughly. Chewing gum helps get rid of dry mouth which is one cause of bacteria build-up and bad breath.
Chew sugarless gum to produce more saliva and when you can’t use oral hygiene methods to clean your teeth and mouth after you eat. Some gums may also contain odor-killing ingredients such as mint.
Gargling with an effective mouthwash just before bedtime can help reduce mouth odors for hours. Some mouthwashes contain ingredients that are de-activated by the ingredients in toothpaste, so it’s best not to rinse your mouth with mouthwash just after brushing.
Consuming a healthy breakfast such as oatmeal each morning helps cleanse the back of the tongue. Try some old folk remedies such as chewing on cinnamon sticks, fresh parsley, fennel seeds and mastic gum to get rid of leftover food odors.
The probiotic treatment, Streptococcus salivarius K12, is said to prevent odorous bacterial growth in the mouth, but it hasn’t been scientifically proven. Maintaining proper and effective oral hygiene is the best way to prevent mouth-type halitosis.
Clean your tongue daily, brush and floss after meals and see your dentist periodically to prevent most causes of bad breath. If you wear dentures, make sure you clean and soak during the night in an anti-bacterial product.
If you’re into alternative medicine, you’ll find a wide range of products claiming to treat and eliminate halitosis. This includes vitamins, oral probiotics and dietary supplements and antifungal medications, which treat fungal infections.
When a halitosis problem is the result of poor dental hygiene, you’ll get immediate results when you begin to take care of your mouth properly. Regular brushing and flossing will prevent periodontal disease and abscesses of the teeth, which are major causes of halitosis.
If a medical condition is the reason for your bout with halitosis, seeking immediate care will produce good results. Such chronic conditions as sinusitis may occur frequently, but can be controlled with certain medications.
Luckily, bad breath is usually an easy fix for most people. With proper treatment and lifestyle changes you can quickly be on your way to the clean and fresh breath you desire.
Frances Richman says
This is a useful article but shockingly repetitive. Good editing would have made it about 50-75% shorter, and people would be more likely to read it throughly.
Mike Schuttler says