Halitosis (or bad breath) ... let's talk about it!

What causes bad breath? Is there a cure for it?

Store shelves are overflowing with mints, mouthwashes and other products designed to help people with bad breath. Yet, these products help control bad breath (halitosis) only temporarily, and they actually may be less effective than simply rinsing your mouth with water after brushing and flossing your teeth.

Certain foods, health conditions and habits are among the causes of bad breath.  In many cases, you can improve bad breath with proper dental hygiene. But, if simple self-care techniques don't solve the problem, you may want to see your dentist or doctor to rule out a more serious condition.


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 such 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 odorous bacteria. 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 and smoking also can lead to a chronic dry mouth, as can a problem with your salivary glands.

Disease:  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 body chemicals during fasting.


Treatment of Halitosis can be as easy as improving dental hygiene. I had a patient the other day complaining about bad breath and after investigating her hygiene habits, it turned out she brushed and flossed her teeth daily but never cleaned her tongue. I gave her a tongue cleaner with instructions on how to use it. She called a few days later to tell us that her bad breath was gone! (to her boyfriend's relief) .

Here at Torrey Hills Family Dentistry, we spend an unusual amount of time on our new patients and do a very thourough examination on everyone of them. We review hygiene together, and determine what hygiene regimen is appropriate for individual patients. If Halitosis is diagnosed, we determine the cause and if needed we refer patients to appropriate specialists or physicians.