Bad breath is breath that has an unpleasant odor. It’s also known as halitosis. This odor can strike from time to time, or it can be long-lasting, depending on the cause.
Millions of bacteria live in the mouth, particularly on the back of the tongue. In many people, they are the primary causes of bad breath. The mouth’s warm, moist conditions are ideal for the growth of these bacteria. Most bad breath is caused by something in the mouth.
Some types of bad breath are considered to be fairly normal. They usually are not health concerns. One example is “morning mouth.” This occurs because of changes in your mouth while you sleep. During the day, saliva washes away decaying food and odors. The body makes less saliva at night. Your mouth becomes dry, and dead cells stick to your tongue and to the inside of your cheeks. When bacteria use these cells for food, they produce a foul odor.

Causes

The causes of bad breath are numerous. They include:

  • Food. The breakdown of food particles in and around your teeth can cause a foul odor. Eating foods containing volatile oils is another source of bad breath. Onions and garlic are the best known examples, but other vegetables and spices also can cause bad breath. After these foods are digested and the pungent oils are absorbed into your bloodstream, they’re carried to your lungs and are given off in your breath until the food is eliminated from your body. Alcohol behaves in the same fashion, allowing the measurement of alcohol levels by breath tests. Alcohol itself has almost no odor, however. The characteristic smell on your breath is mainly the odor of other components of the beverage.
  • Dental problems. Poor dental hygiene and periodontal disease can be a source of bad breath. If you don’t brush and floss daily, food particles remain in your mouth, collecting bacteria and emitting hydrogen sulfur vapors. A colorless, sticky film of bacteria (plaque) forms on your teeth. If not brushed away, plaque can irritate your gums (gingivitis) and cause tooth decay. Eventually, plaque-filled pockets can form between your teeth and gums (periodontitis), worsening this problem — and your breath. Dentures that aren’t cleaned regularly or don’t fit properly also can harbor odor-causing bacteria and food particles.
  • Dry mouth. Saliva helps cleanse and moisten your mouth. A dry mouth enables dead cells to accumulate on your tongue, gums and cheeks. These cells then decompose and cause odor. Dry mouth naturally occurs during sleep. It’s what causes “morning breath.” Dry mouth is even more of a problem if you sleep with your mouth open. Some medications as well as smoking can lead to a chronic dry mouth, as can a problem with your salivary glands.
  • Diseases. Chronic lung infections and lung abscesses can produce very foul-smelling breath. Several other illnesses can cause a distinctive breath odor. Kidney failure can cause a urine-like odor, and liver failure may cause an odor described as “fishy.” People with uncontrolled diabetes often have a fruity breath odor. Chronic reflux of stomach acids from your stomach (gastroesophageal reflux disease, or GERD) and a slight protrusion of the stomach into the chest cavity (hiatal hernia) also can produce bad breath.
  • Mouth, nose and throat conditions. Bad breath is also associated with sinus infections because nasal discharge from your sinuses into the back of your throat can cause mouth odor. A child with bad breath may have a foreign object lodged in his or her nose. A bean or small item stuck in the nose can cause persistent nasal discharge and a foul odor. Strep throat, tonsillitis and mononucleosis can cause bad breath until the throat infection clears. Bronchitis and other upper respiratory infections in which you cough up odorous sputum are other sources of bad breath. Canker sores may be related to bad breath, especially if they accompany periodontal disease.
  • Tobacco products. Smoking dries out your mouth and causes its own unpleasant mouth odor. Tobacco users are also more likely to have periodontal disease, an additional source of bad breath.
  • Severe dieting. Dieters may develop unpleasant “fruity” breath from ketoacidosis, the breakdown of chemicals during fasting.

Preventing Bad Breath

Bad breath can be reduced or prevented if you:

  1. Practice good oral hygiene. Brush twice a day with fluoride toothpaste to remove food debris and plaque. Brush your teeth after you eat (keep a toothbrush at work or school to brush after lunch). Don’t forget to brush your tongue, too. Replace your toothbrush every 2 to 3 months. Use floss or an interdental cleaner to remove food particles and plaque between your teeth once a day. Dentures should be removed at night and cleaned thoroughly before being placed in your mouth the next morning.
  2. See your dentist regularly – at least twice a year. He or she will conduct an oral examination and professional teeth cleaning and will be able detect and treat periodontal disease, dry mouth, or other problems that may be the cause of bad mouth odor.
  3. Stop smoking/chewing tobacco-based products. Ask your dentist for tips on kicking the habit.
  4. Drink lots of water. This will keep your mouth moist. Chewing gum (preferably sugarless) or sucking on candy (preferably sugarless) also stimulates the production of saliva, which helps wash away food particles and bacteria.
  5. Keep a log of the foods you eat. If you think the foods that you eat may be causing your bad breath, record what you eat so that you can determine which foods may be contributing to the problem. Bring the log to your dentist to review. Similarly, make a list of the medications you take. Some medications may play a role in creating mouth odors.

Who Treats Bad Breath?

In most cases, your dentist can treat the cause of bad breath. If your dentist determines that your mouth is healthy and that the odor is not of oral origin, you may be referred to your family doctor or to a specialist to determine the odor source and treatment plan. If the odor is due to gum disease, for example, your dentist can either treat the disease or refer you to a periodontist, a dentist who specializes in treating gum conditions.

What Products Can I Use to Eliminate Bad Breath?

You can buy a number of mouthwashes over-the-counter that claim to eliminate bad breath. However, keep in mind that many of these mouthwashes generally provide only a temporary way to mask unpleasant mouth odor. There are, however, several antiseptic mouth-rinse products available that instead of simply masking breath odor kill the germs that cause bad breath. Ask your dentist about which product is best for you.

Sources: Simple Steps Dental, Mayo Clinic

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