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What is Halitosis (Bad Breath)?

Dr. Isha Malhotra 93% (4751 ratings)
Dentist, Gurgaon
What is Halitosis (Bad Breath)?

Halitosis, commonly known as bad breath, is an embarrassing health condition that affects approximately 30% of people around the world. Additional medical terms for this condition include stomatodysodia, fetor oris, and ozostomia. Regardless of the term used, this is the presence of a foul-smelling odor that seems to come from the mouth cavity. According to the Academy of General Dentistry, in more than 90% of cases, the odor originates in the mouth, throat, and tonsils. Although this is something everyone experiences at one time or another, if your case does not improve after brushing, flossing, and rinsing the mouth with an alcohol free mouthwash, it may be chronic.

The foul oral odor is usually caused by a group of anaerobic, sulfur-producing bacteria that breed beneath the surface of the tongue and often in the throat and tonsil area. The term "anaerobic" literally means living without oxygen, and in fact, these bacteria do not require oxygen to live. They occur naturally in the oral environment and are essential because they assist in digestion by breaking down proteins into amino acids. Proteins are commonly found in food, mucus or phlegm, blood, and in diseased oral tissue.

As these bacteria feast on proteins in your mouth, sulfur compounds are released from the back of your tongue and throat. The bacteria excrete waste as hydrogen sulfide, methyl mercaptan, and other odorous and bad tasting compounds known as volatile sulfur compounds. As long as the anaerobic bacteria feed on proteins and excrete volatile sulfur compounds unchecked, your breath will become worse and worse.

Four Common Bad Breath Causes

There are many underlying causes of halitosis, but four of them are very common.

1. Dry mouth: Xerostomia, the medical term for dry mouth, provides a perfect environment for anaerobic bacteria reproduction. Long periods of speaking, smoking, drinking alcohol, and snoring are a few common underlying causes. Most people experience foul breath in the morning due to lack of saliva production while they sleep. For healthy individuals, food odors are temporary and normal salivary flow will eliminate them within several minutes. However, those who suffer from dry mouth and lack of saliva find that even minor food odors may lead to long-term issues.

2. Foods: Halitosis can be exacerbated by certain foods such as onions and garlic because they contain smelly sulfur compounds, while dairy, meat, and fish contain dense proteins which are used as a food source by the anaerobic, sulfur-producing bacteria. Refined and processed sugars also provide a food source for bacteria. Coffee and juices can contribute to this problem because they are acidic and provide these bacteria with an ideal breeding environment.

3. Poor dental hygiene: Inadequate oral care causes bacterial buildup on the teeth and gums. Teeth cannot shed their surfaces the way skin can, so microorganisms can easily attach to the teeth and remain there for extended periods. If they are not continuously removed by adequate brushing, these bacteria develop into something called biofilm, commonly known as dental plaque. When plaque is allowed to accumulate near the gumline, it will harden and begin destroying teeth and gum tissues due to intense bacterial activity. This leads to gum disease such as gingivitis and periodontitis, which enable proteins from bleeding gums and diseased oral tissue to fuel odor-causing bacteria. Tooth decay and poorly fitting or dirty dentures can also contribute to this problem.

4. Illness and disease: According to studies, an estimated 10% of all halitosis cases are caused by certain illnesses. Individuals who suffer from diabetes, lung disease, kidney disease, cancer, liver disease, respiratory tract infections, or metabolic disorders often experience chronic foul breath due to dry mouth. Sinusitis, pneumonia, bronchitis, postnasal drip, and polyps affect the airways and may also contribute to the problem. Other common illnesses associated with bad breath include nasal odor and tonsil stones, yeast infections of the mouth, and gum disease. Certain drugs such as antidepressants, high blood pressure medications, and antihistamines can factor into dry mouth because they reduce saliva production.

Please Note: Halitosis is rarely associated with life-threatening diseases. However, it is important that you consult your doctor or dentist as soon as you notice consistent white spots on the tonsils and sores in the mouth with or without a fever. Sometimes bad breath is triggered by severe health conditions such as throat or mouth cancers, human immunodeficiency virus (HIV) infection, digestive system disorders, or diabetes – and further, can indicate dehydration or zinc deficiency. Taking proper care of your teeth and visiting the dentist at least twice a year are the easiest ways to avoid these issues.

Halitosis Symptoms

Offensive breath tells us that something is out of balance. In fact, anthropologists have reported that once humans started to kiss each other, the ability to smell one another's breath became a very important way to test a partner's compatibility. If the other person didn't pass the smell test, they were not able to get to the next step towards securing a mate.

Halitosis is a medical condition that lowers self-esteem and affects everyday life and personal relationships. People with chronic or recurring bad breath often lose their self-confidence. It can be difficult to know if you have this problem, because it is often challenging to pick up on one's own scent. Furthermore, family members and colleagues may not feel comfortable telling you. One of the best ways to find out if you have foul breath is to lick the inside of your wrist, wait five seconds, and then take a whiff.

Most symptoms of halitosis depend on the underlying cause. The most common symptoms include postnasal drip, a bitter metallic taste, a white coating on the tongue, and thick saliva. Many individuals who have foul breath associated with dry mouth can experience difficulty speaking or swallowing, a burning sensation in the mouth, or dry eyes. Fever, sore throat, persistent cough, and swollen lymph nodes in the neck indicate respiratory tract infections, which can also be a contributing factor.

Getting a Proper Diagnosis

The best way to truly identify the source of chronic halitosis is to visit a dentist or doctor for a professional diagnosis. When you are ready to tackle this situation, be sure to be open and honest with the healthcare professional performing the examination. It is important for him or her to understand all the health problems you are experiencing in order to determine the underlying cause and recommend appropriate treatment.

The Halimeter (also known as a portable sulfide gas monitor) is the most commonly used clinical diagnostic instrument utilized in this field. It measures the concentration of hydrogen sulfide in parts per billion (ppb) in mouth air. The Halimeter uses a patented electrochemical voltammetric sensor, which has provided reproducible results to clinicians for the past 20 years.

Getting Proper Treatment

For more than a century, pharmaceutical companies attempted to alleviate halitosis by using mouthwash that contained alcohol. This is the exact opposite of what should be done because alcohol is a drying agent. Clinicians have learned a good deal in the ensuing years, and in most cases, this condition can be successfully treated. Like the symptoms, treatment depends on the underlying cause.

It is important to keep in mind that you cannot eliminate the bacteria from the tongue that cause bad breath. Consequently, scraping or brushing the tongue is a temporary remedy at best, and is typically frustrating for those who believe tongue scraping or tongue brushing is a permanent solution. The bacteria that cause this are part of your normal oral flora and are essential to breaking down proteins, a key step in normal digestion.

A much simpler and clinically-proven method to treat bad breath is to interrupt the bacteria's chemical production of odors by introducing oxygenating compounds to your oral environment. Oxygen is the natural enemy of the bacteria that cause this problem because they are anaerobes and cannot function in the presence of oxygen.

In general, a dentist will recommend mouthwashes and toothpastes that contain oxygenating agents such as chlorine dioxide or sodium chlorite to neutralize volatile sulfur compounds and help control odor causing bacteria found in the mouth.

If you are experiencing mouth dryness, your dentist will recommend a saliva substitute to moisten the mouth throughout the day. Some effective, natural ingredients to look for in oral care products are zinc gluconate, aloe vera, green tea, tea tree oil, xylitol, CoQ10, glycyrrhizic acid and oral probiotics like K12 and M18.

Six Bad Breath Home Remedies

The practice of a few, simple, self-care techniques can help to minimize halitosis. There are several things you can do at home.

  • Advanced oral care products: Use oral care products such as mouthwashes and toothpastes that have been shown to be effective in fighting bad breath.
  • Proper oral care: Brush and floss your teeth at least twice a day. Be sure to get a toothbrush with soft bristles (as to not damage tooth enamel or gums) and also use fluoride toothpaste. Brushing and flossing helps to remove any food and plaque which can be used as a fuel source by the anaerobic, sulfur-producing bacteria that are at the root of this problem.
  • Stimulate your salivary flow: Prevent dry mouth with chewing gum, lozenges, or mints that are sugar free. Look for Xylitol, a non-sucrose sweetener, which in recent years has been shown to have anti-cavity properties.
  • Eat fibrous fruits and vegetables: One of the best ways to remove bacteria in the mouth is to eat an apple a day. It helps moisten the mouth, too.
  • Take a dietary supplement: Vitamin C, Vitamin D, Vitamin E, and Vitamin B are effective at helping your body eliminate excess mucus and toxins naturally.
  • Brush your teeth occasionally with baking soda: The bacteria that cause bad breath thrive in an acidic oral environment. Brushing your teeth with baking soda helps neutralize excess acids found in the oral cavity.

12 Easy Ways to Prevent Bad Breath

Please remember, preventing halitosis is always easier than treating it. By developing the right habits, you can effectively help prevent it.

  • Eat foods rich in fiber: High fiber foods help prevent halitosis. Avoid eating heavily processed foods that contain refined carbohydrates such as cookies, cakes, sweets and ice cream.
  • Use mouthwash: Some mouthwashes or oral rinses are effective at preventing bad breath. However, you should never use alcohol based mouthwashes because the alcohol makes the mouth very dry, which will actually make the problem worse.
  • Drink green and black teas: They contain polyphenols that help eliminate sulfur compounds and reduce oral bacteria.
  • Avoid drying medication: Try not to take antidepressants, diuretics, pain relievers, and antihistamines unless it is absolutely medically necessary. These drugs inhibit saliva flow and can cause chronic dry mouth.
  • Avoid products with sodium lauryl sulfate or alcohol: Do not use any oral hygiene products that contain sodium lauryl sulfate or alcohol because the alcohol makes the mouth very dry, one of the most common causes of bad breath.
  • Clean your mouth after eating meat, fish or dairy products: Practicing consistent and thorough oral hygiene is an effective prevention tool.
  • Stop smoking: Studies have shown that smokers are at higher risk of developing periodontal disease and dry mouth. Furthermore, people who smoke may also engage in other habits that promote this condition such as dieting, drinking alcohol, and suffering from chronic anxiety conditions that require exacerbating prescription medications.
  • Breathe through your nose instead of your mouth: Try to address any snoring or sleep apnea issues that could be affecting your breath and causing dry mouth.
  • Drink water: Keep your mouth moist by drinking plenty of water.
  • Clean your dentures at least once a day: Practice the same, proper oral care that you would with your original teeth.
  • Eliminate dairy products from your diet: Lactose intolerance can be an underlying cause of halitosis.
  • Use an oral probiotic like S. salivarius K12 and M18: Use probiotics to balance the oral cavity and prevent an overgrowth of the odor-causing bacteria involved in halitosis.
5 people found this helpful

I'm suffering from dry mouth and bad breath even after I brush. I have started using mouthwash but still of no use after some while again I need to scrap my tongue.

Dr. Pulak Mukherjee 91% (3730 ratings)
Homeopath, Hooghly
I'm suffering from dry mouth and bad breath even after I brush. I have started using mouthwash but still of no use af...
Brush at night with baking soda and rinse ur mouth with lemon water,,,chew few leaves of basil in the morning,,,use mouth wash having hydrogen peroxide,,,this will help
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I am 58 years old. MY TONGUE sticks to upper mouth becomes dry while I am asleep causing suffocation. Please advise how get rid off the problem?

Dr. Gaurav Sethi 91% (95 ratings)
Dentist, Una
I am 58 years old. MY TONGUE sticks to upper mouth becomes dry while I am asleep causing suffocation. Please advise h...
Hello, You might be suffering from problem of dry mouth. There are some gels available at medical stores that can help is Duestom gel. Moreover you might be having some problem in your respiratory system may be nose. So get your self checked with ENT specialist and a dental surgeon too to reach to a perfect diagnosis. All d best.
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I'm get dry mouth (Xerostomia) during sleep, particularly at night. Although I am Diabetic (DM II) but well controlled.

Dr. R.Ravindranath 87% (94 ratings)
MD - General Medicine, MBBS Bachelor of Medicine and Bachelor of Surgery, Post Graduate Diploma In Diabetology (PGDD)
Diabetologist, Chennai
I'm get dry mouth (Xerostomia) during sleep, particularly at night. Although I am Diabetic (DM II) but well controlled.
Dry mouth is not always due to diabetes, it can be due to unusual causes or some other illnesses to be evaluated by the special ist.
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My oral hygiene is poor. My gums and teeth are not healthy. Despite frequent brushing, plaque is forming and causing bad smell. I was told that it is due to dry mouth. While brushing I observed that my saliva is very gummy. Is there any advanced treatment to improve enamel. My teeth are frequently turning into yellow colour. Please guide me.

Dr. Prerna Agarwal 89% (12 ratings)
Dentist, Bangalore
My oral hygiene is poor. My gums and teeth are not healthy. Despite frequent brushing, plaque is forming and causing ...
Undergo scaling. Consult your nearest dentist immediately. To increase saliva you can eat n chew candies, lozenges etc. So many medications are also available.
1 person found this helpful
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My mouth always remain sour and smelly. Although visited dentist also for full cleaning.

Dr. Pulak Mukherjee 91% (3730 ratings)
Homeopath, Hooghly
My mouth always remain sour and smelly. Although visited dentist also for full cleaning.
I think ur having acidity problem or u may have other gastric problem also,,brush twice daily,,at night brush with baking soda and rinse ur mouth with lemon water,,use mouth wash having hydrogen peroxide,,use floss to eradicate the food stuffs between teeth,,with this u need proper homoeopathic treatment to cure ur problem permanently
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I am suffering from dry cough from 1 month I consulted to doctor but no any relief whenever I cough then I am enable to through from my mouth and it also creates breathing problem I am enable to take proper breadth please suggest me what should I do.

Dt. Siva Teja Gadepalli 89% (142 ratings)
M.Sc - Dietitics / Nutrition
Dietitian/Nutritionist, Faridabad
Hi, Basil/tulsi leaves boiled in water and gargling salt water at least thrice a day also has good effect. Warm milk with turmeric or pepper works really well for cough when taken twice a day. Honey along with lemon has good anti-inflammation properties which soothes the throat and its better taken in the morning. Tea which is made of cinnamon and ginger once a day will alleviate the itching and pain sensation of throat. Make sure that you avoid cold foods or leftovers from refrigerator which might increase the condition. Inhaling hot air through vaporiser helps you feel better from chest and nasal blockage and clears the mucus. Avoid going out in to cold air and exposure to dust which might again increase your cough and cold. Decrease your intake of sugary foods and foods high in oil and fat which might prolong your illness.
1 person found this helpful
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My mouth becomes dry and most of the time feel thirsty. If I consume water. I feel to urinate. Please help me.

Dr. Nirav Patel 90% (893 ratings)
BDS, FOI, MDS - Orthodontics, FPFA, Ph.D.
Dentist, Ahmedabad
drink less amount of water and increase frequency of drinking water. do not drink much water at single time. anyways drinking more water is good for health.
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The tip of my tongue always remains dry. It's like a slight burning sensation. Why is this happening? It is affecting my speech too when I'm under pressure so what can I do to improve this?

Dr. Vineet Dubey 90% (140 ratings)
Dentist, Secunderabad
Hi lybrate-user, Kindly get your blood sugar level test done because usually sugar patients get dry tongue. Than let me know. If things are normal den aplly sensoform gum paint over the affected area. Avoid taking spicy items. Drink lot of water to.
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What are the medicine for overcome dry mouth problem. How to overcome dry mouth problem.

Dr. Srikanth Md 91% (943 ratings)
General Physician, Secunderabad
What are the medicine for overcome dry mouth problem. How to overcome dry mouth problem.
The best way to treat dry mouth — known medically as xerostomia (zeer-o-STOE-me-uh) — depends on what's causing it. You can do some things to relieve dry mouth temporarily. But for the best long-term dry mouth remedy, you need to address its cause. To relieve your dry mouth: Chew sugar-free gum or suck on sugar-free hard candies to stimulate the flow of saliva. For some people, xylitol, which is often found in sugar-free gum or sugar-free candies, may cause diarrhea or cramps if consumed in large amounts. Limit your caffeine intake because caffeine can make your mouth drier. Don't use mouthwashes that contain alcohol because they can be drying. Stop all tobacco use if you smoke or chew tobacco. Sip water regularly. Try over-the-counter saliva substitutes — look for products containing xylitol, such as Mouth Kote or Oasis Moisturizing Mouth Spray, or ones containing carboxymethylcellulose (kahr-bok-see-meth-ul-SEL-u-lohs) or hydroxyethyl cellulose (hi-drok-see-ETH-ul SEL-u-lohs), such as Biotene Oral Balance. Try a mouthwash designed for dry mouth — especially one that contains xylitol, such as Biotene Dry Mouth Oral Rinse or ACT Total Care Dry Mouth Mouthwash, which also offer protection against tooth decay. Especially one that contains xylitol, such as Biotene Dry Mouth Oral Rinse or ACT Total Care Dry Mouth Mouthwash, which also offer protection against tooth decay. Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse. Breathe through your nose, not your mouth. Add moisture to the air at night with a room humidifier. Saliva is important to maintain the health of your teeth and mouth. If you frequently have a dry mouth, taking these steps to protect your oral health may also help your condition: Avoid sugary or acidic foods and drinksbecause they increase your risk of tooth decay. Brush with a fluoride toothpaste — ask your dentist if you might benefit from prescription fluoride toothpaste. Use a fluoride rinse or brush-on fluoride gel before bedtime. Occasionally a custom-fit fluoride applicator (made by your dentist) can make this more effective. Visit your dentist at least twice yearly to detect and treat tooth decay or other dental problems. If these steps don't improve your dry mouth, talk to your doctor or dentist. The cause could be a medication or another condition. Medications are one of the most common causes of dry mouth. Long-term relief from your dry mouth may mean stopping or changing your medication or its dosage, or addressing underlying health issues.
1 person found this helpful
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