Bad Breath (Halitosis)

“Halitosis” is the medical term for bad breath. Everyone gets bad breath from time to time, especially after eating garlic, onions or other strong foods. But if you have bad breath all the time (chronic halitosis), it could be a sign of an oral health issue or something else going on in your body.

Bad breath isn’t usually a sign of something serious. But if it doesn’t get better despite changes you make to address it, it’s time to see a dentist.

Symptoms of halitosis

Halitosis involves having foul-smelling breath. Halitosis may smell like the cup of black coffee you just drank. Bad breath related to more chronic issues may smell like fish or rotten eggs. Smells can range from sour to unpleasantly sweet.

It’s tough to tell if you have bad breath just by cupping a hand over your nose and mouth and taking a quick whiff. It’s better to ask someone you trust if your breath smells OK.

Or you can go by this rule of thumb: If you have a bad taste in your mouth, you’ve probably got bad breath that others can smell.

Halitosis causes

The main cause of halitosis is poor oral hygiene. Without proper oral hygiene — like brushing, flossing and routine dental cleanings — harmful bacteria invade your mouth and cause bad smells. This can lead to several oral health issues like bad breath, cavities and gum disease.

Other bad breath causes include:

• Dry mouth: Saliva helps rinse out your mouth. Not having enough can lead to halitosis. Lots of medicines and conditions can cause dry mouth. Smoking can, too.
• Gum disease: Plaque that builds up on your teeth and tongue can cause gingivitis. Untreated gingivitis can lead to more serious gum disease called periodontitis.
• Tonsil stones: When food gets stuck in your tonsils, it sometimes hardens into bad-smelling calcium deposits in the back of your throat.
• Infections in your nose, throat or lungs: Infections in your nose and throat can lead to foul-smelling fluid in the back of your throat. Pneumonia can cause you to cough up fluid that smells bad.
• Diabetes: Having diabetes increases your risk of gum disease, which can cause bad breath. Low insulin can put you at risk of a medical emergency called ketoacidosis. It can make your breath smell fruity.
• Gastroesophageal reflux disease (GERD): This condition causes stomach acid to leak back into your esophagus and, sometimes, your mouth. The fluid may taste sour and smell bad.
• Head and neck cancers: Cancers in your mouth, throat and voice box can all cause bad breath.
• Kidney disease or liver disease: Kidney and liver disease may prevent these organs from filtering toxins out of your body as they normally do. The effects can show up as halitosis.
• Smoking: Smoking can change the balance of microbes (like bacteria) in your mouth. It can cause dry mouth and increase your risk of oral health issues.

How doctors diagnose this condition

A dentist can diagnose oral issues causing halitosis by smelling your breath and doing a dental exam. If the issue is advanced gum disease, they may refer you to a gum disease specialist (periodontist). If your bad breath isn’t related to your teeth or gums, your primary care provider can help figure out what’s going on.

How is halitosis treated?

Halitosis treatment depends on what’s causing it. For example, if bad breath is related to plaque build-up, a dental cleaning and improved oral hygiene at home will likely help. It’s especially important to scrape your tongue, as bacteria and food debris can hide out there.

Occasionally, your dentist may recommend special mouth rinses. Some mouthwashes only mask odors. Others fight the bacteria causing bad breath. You’ll need the bacteria-killing kind to fix the real issue. Your dentist can recommend brands.

If halitosis is a symptom of another condition somewhere else in your body, your primary care provider can help you with proper diagnosis and treatment.

When should I see my healthcare provider?

If you practice good hygiene and still have halitosis, schedule an appointment with a dentist. Some people build up plaque faster than others and may just need more frequent cleanings. If your dentist doesn’t find any oral health issues, then your primary care physician can determine if another condition is causing it.

What can I expect if I have halitosis?

Treating the underlying condition is the only halitosis cure. Often, getting fresher breath is as simple as improving your oral hygiene routine. But sometimes, conditions unrelated to your oral health are to blame. In that case, finding the right treatment can help.

Can halitosis be prevented?

Not all causes of halitosis are preventable, but most are. Here are things you can do:

• Brush twice a day and floss once a day.
• Clean your tongue with a tongue scraper.
• Clean oral appliances (like retainers and dentures) as directed by your dentist.
• Rinse with an alcohol-free antibacterial mouthwash.
• See your dentist regularly for cleanings.
• Drink a lot of water to help prevent dry mouth.
• Boost saliva production by chewing sugar-free gum or sucking on sugar-free candy or mints.
• Avoid alcohol, caffeine and tobacco products that can dry out your mouth.

If you’re worried about bad breath in the short term, avoid eating foods like garlic and onions. These foods contain compounds that linger on your breath long after you’ve finished eating. Mints and mouthwashes may mask the smell. But it won’t go away until the chemicals have left your system.

In the meantime, be aware that your breath may give away your food choices.