Bad breath, sometimes called halitosis, is an unpleasant odor of the breath.
Bad breath is likely to be experienced by most adults at least occasionally. Bad breath, either real or imagined, can have a significant impact on a person's social and professional life.
Causes and symptoms
Bad breath can be caused by a number of problems. Oral diseases, fermentation of food particles in the mouth, sinus infections, and unclean dentures can all contribute to mouth odor. Many non-oral diseases, such as lung infections, kidney failure, or severe liver disease, can also cause bad breath, though rarely. Many people think that bad breath can originate in the stomach or intestines; this is extremely rare. The esophagus is usually collapsed and closed, and, although a belch may carry odor up from the stomach, the chance of bad breath being caused from air continually escaping from the stomach is remote. Cigarette smoke can cause bad breath, not only in the cigarette smoker, but also in one who is constantly exposed to second-hand smoke.
The easiest way to determine if one has bad breath is to ask someone who is trustworthy and discrete. This is usually not too difficult. Another, more private, method of determining if one has bad breath is to lick one's wrist, wait until it dries, then smell the area. Scraping the rear area of the tongue with a plastic spoon, then smelling the spoon, is another method one can use to assess bad breath.
The most effective treatment of bad breath is to treat the cause. Poor oral hygiene can be improved by regular brushing and flossing, as well as regular dental checkups. Gentle brushing of the tongue should be part of daily oral hygiene. In addition to good oral hygiene, the judicious use of mouthwashes is helpful. Mouth dryness, experienced at night or during fasting, or due to certain medications and medical conditions, can contribute to bad breath. Dryness can be avoided by drinking adequate amounts of water. Chewing gum may be beneficial.
As mentioned, some medications, such as some high blood pressure medications, can cause dry mouth. If this problem is significant, a medication change, under the supervision of one's health care provider, may improve the dry-mouth condition. Oral or sinus infections, once diagnosed, can be treated medically, usually with antibiotics. Lung infections and kidney or liver problems will, of course, need medical treatment.
Depending on the cause, a multitude of alternative therapeutic remedies can be used. For example, sinusitis can be treated with steam inhalation of essential oils and/or herbs.
Most bad breath can be treated successfully with good oral hygiene and/or medical care. Occasionally, for patients who feel that these therapies are unsuccessful, some delusional or obsessive behavior pattern might pertain, and mental health counseling may be appropriate.
Halitosis— The medical term for bad breath.
American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-2500. 〈http://www.ada.org〉.
American Medical Association. 515 N. State St., Chicago, IL 60612. (312) 464-5000. 〈http://www.ama-assn.org〉.
Bad breath, also called halitosis, is an unpleasant odor of the breath. Usually it is due to poor hygiene, but it can be an indication of underlying health problems.
Bad breath is likely to be experienced by most adults and many children, at least occasionally. Some people are strongly convinced that bad breath is present when it is not. Bad breath can have a significant impact on a person's social and professional life.
Causes & symptoms
Accumulation of plaque on the teeth is a major cause of bad breath. Plaque is a mucus film that mixes with food particles, saliva, and bacterial residue in the mouth. Bad breath can also be caused by any number of other problems. These include sores in the mouth, infected tonsils, tooth or gum disease , fermentation of food particles in the mouth, sinus infections , and badly cleaned dentures. Conditions that may cause bad breath are not only limited to the oral and nasal areas. Other possible sources of the problem might be indigestion , lung infection, kidney failure, tuberculosis, syphilis , liver disease, stomach and intestinal problems, stress , dehydration, zinc deficiency, and cancer .
Cigarette smoking can also lead to bad breath, not only in the smoker, but also in someone constantly exposed to secondhand smoke. A diet high in fats, spicy foods, or one that includes coffee may contribute to un-pleasant breath odors. Medications causing dry mouth or dehydration may also be a source of problems, since the flow of saliva helps clean out the mouth. Antihistamines, decongestants, antidepressants, anti-anxiety medications, diuretics, and some heart medications may have a dehydrating effect, and could be a cause of bad breath.
The easiest way to determine if one has bad breath is to ask a friend who is trustworthy and discrete, or to ask a doctor or dentist. A test that can be attempted on one's own, is to cup a hand over the mouth, exhale, and then inhale through the nose while smelling the breath. A physical examination by a doctor or dentist may be used to diagnose other problems that may be causing the bad breath.
Leaves of parsley , Petroselinum crispum; winter-green , Gaultheria procumbens; or peppermint , Mentha piperita; can be chewed to freshen the breath by the introduction of their aromatic substances into the lungs. A strong tea made of Echinacea spp.; myrrh , Commiphora molmol; and bloodroot , Sanguinaria canadensis; can be used as a daily mouthwash. Fresh apples, citrus fruits, and celery are also good foods for helping to clean out the mouth. Possible homeopathic remedies that may be useful for bad breath include Nux vomica and Kali phosphoricum. Supplementing with zinc and vitamin C may also be of benefit.
The most effective treatment of bad breath is to treat the cause. If bad breath is a continuing problem or there are other symptoms, such as bleeding gums, a doctor or dentist should be consulted. A medication change may be warranted if a prescription drug is contributing to bad breath. A physician should be consulted any time a change in medication is planned.
Most bad breath can be treated successfully with good oral hygiene or medical care. Occasionally, a person may develop delusional or obsessive behavior regarding breath odor problems, and mental health counseling may be appropriate.
A healthy diet, high in fresh fruits and vegetables and whole grains, should be eaten. Processed foods such as sugar and white bread and grains contribute to plaque formation and should be avoided. Spicy foods such as onions, peppers, garlic , pastrami, salami, pepperoni, anchovies, and others should be avoided. Plenty of water should be consumed throughout the day to avoid dehydration and dry mouth. Water should be consumed after taking any food or drink to wash away residues that may accumulate with plaque.
The teeth should be brushed and flossed daily after meals. Toothbrushes should be changed monthly, since there may be a tendency for bacteria to accumulate on them. Baking soda is a good choice to use for cleaning the teeth when bad breath is a problem. The baking soda makes the mouth pH less hospitable to odor-causing bacteria. Gentle brushing of the tongue should also be included in the routine of daily oral hygiene, since the tongue itself may harbor tiny particles of food. A device called a tongue blade can be useful for cleaning the tongue. It may be available from a store that sells Asian or Middle Eastern products. An oral irrigation device, such as a Water Pik, is recommended to more thoroughly remove food and debris from the teeth. Mouthwashes are often helpful, especially those containing zinc. A dentist should regularly check the health of the gums and teeth for disease. A dental hygienist should clean the teeth regularly, especially if there is an increased tendency to form plaque.
Rosenberg, M. "Clinical Assessment of Bad Breath: Current Concepts." Journal of the American Dental Association 127 (April 1996): 475-482.
American Dental Association. Box 776, St. Charles, IL 60174-0776. http://www.ada.org.