Medical Conditions - Halitosis

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The Facts

Halitosis is also referred to as oral malodor, but most of us know it quite simply as "bad breath." Even though it’s a comparatively minor health problem, bad breath can be distressing and a bit of a social handicap. It is not a wonder that we spend millions each year on efforts to freshen our breath with various gums, sprays, and mouthwashes.


The most common cause of bad breath is the food you eat. Garlic, onions, some kinds of fish, and diets rich in fat and meat can all result in halitosis. Saliva and bacteria naturally occurring in your mouth break down small pieces of food that are caught between your teeth. This releases volatile substances or chemicals that lead to bad breath.

The breakdown products of proteins in the body used for energy are exhaled through the lungs, and therefore missing meals, hunger, fasting, starvation, and low-calorie diets can also cause bad smelling "hunger breath."

Because there is no flow of saliva during sleep, putrefaction (decomposition or rotting) of saliva and debris in the mouth can lead to bad breath in the morning.

Halitosis is also caused by:

  • poor oral hygiene (not brushing or flossing regularly)
  • smoking
  • alcohol
  • dentures
  • dry mouth
  • periodontal or gum disease that causes teeth to become loose, thereby creating pockets in the gums that harbour bacteria and lead to bad breath
  • chronic lung or sinus infections
  • breathing through your mouth because of enlarged tonsils or adenoids
  • mouth infections such as thrush (candidiasis)
  • systemic diseases such as diabetes, liver disease, or kidney disorders
  • pregnancy
  • a change in the acidity of saliva

Taking certain medications can also cause bad breath, especially those that reduce the flow of saliva and dry out the mouth (e.g., some antidepressants, antipsychotics, antihistamines, decongestants, and medications to reduce high blood pressure).

Symptoms and Complications

The awkward irony of halitosis is that many people aren’t aware that they have it. This is because the cells in the nose that are responsible for the sense of smell actually become unresponsive to the continuous stream of bad odour. If you have bad breath, you may need to be told, or you may notice the negative reaction of other people when you’re just too close!

Making the Diagnosis

It’s easy to self-diagnose bad breath. You can lick your wrist, let it dry for a few seconds and smell the area, or cup your hands over your mouth and sniff your own breath. If you need a second opinion, ask a friend, family member, or your physician or dentist.

Treatment and Prevention

The manufacturers of mints and mouthwashes have made an industry out of the public’s desire for fresh breath. These products promise that your breath can be made sweet-smelling and "minty fresh." However, they’re only temporarily helpful at best in controlling breath odours. In fact, many often contain sugar and alcohol, which may lead to tooth decay or dry mouth and may aggravate certain mouth conditions.

Proper care of the mouth and teeth and regular visits to the dentist are important, and are the most effective way to control bad breath. Regular brushing, flossing, rinsing, and tongue scraping can help prevent problems.

Sometimes, halitosis may be caused by illnesses such as lung disease, impaired emptying of the stomach, liver failure, or kidney failure. In this case, treating the underlying condition can improve the halitosis as well.

Here are some tips for getting rid of bad breath:

  • Brush your teeth at least 2 times a day and floss once daily.
  • Gently clean your tongue before bedtime by scraping with a plastic tongue cleaner or brushing gently.
  • Prevent hunger breath by eating regularly and avoiding fasting or skipping meals.
  • Ask your dentist to recommend a specific cleaning system that can help clean your mouth more thoroughly than with just regular brushing.
  • Keep your nose and sinuses clean.
  • Stimulate saliva flow with acidic fruits such as oranges and lemons or sugarless gums and candy.
  • Eat more fibrous foods. Chew fibrous vegetables such as raw carrots and celery to stimulate saliva flow.
  • Drink at least 8 glasses of water daily to keep your mouth moist and to help rinse away odour-forming bacteria.
  • Decrease alcohol and coffee intake.
  • Ask your doctor or pharmacist whether your medications are causing problems of dry mouth that may be leading to bad breath.
  • Rinse and gargle with an effective mouthwash.

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