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Understanding Halitosis (Bad Breath): Causes, Symptoms, Treatments & More

Understanding Halitosis (Bad Breath): Causes, Symptoms, Treatments & More

Have you ever experienced bad breath, despite having followed a regular brushing and mouth-cleaning routine? Clinically referred to as halitosis, bad breath is a condition that affects us when we least expect it. Read on to learn more about bad breath, including the causes, symptoms and treatments.

What is Halitosis (Bad Breath)?

halitosis bad breath

Halitosis is a condition in which a person gives off an unpleasant odour when they speak or exhale.

Did you know that bad breath is actually fairly common, and it can affect almost anyone we know. According to a study conducted in 2017, bad breath has an estimated prevalence of 31.8% among the general population (1).

What Is the Impact of Halitosis On Our Lives?

Bad breath will badly affect one’s social and professional lives. As bad breath comes in the way of face-to-face communication, it will interfere with social interactions by ruining first impressions and subsequently lowering one’s self-esteem. However, it may also be a signal for more serious health issues.

What Are the Indications or Signs of Halitosis?

It’s challenging to smell your own breath, and to tell whether you have bad breath. Some people with halitosis do not notice their bad breath, while some perceive that they have bad breath while they don’t. This has been called the "bad breath paradox". Therefore, in most cases, you might only discover it after an unfavourable interaction with a peer. In instances where you have to put on face masks, it becomes easier to pick up the smell of your breath, so don’t be alarmed. For peace of mind, always consult a dentist.

What Are the Causes of Halitosis?

Finding the cause or reason of one’s bad breath issues is the first step toward treating this preventable condition. Halitosis is a multifaceted condition that can be caused by a variety of factors. 85% of the causes of halitosis are located within the oral cavity (2). More often than not, the dentist will be the first person to notice this condition, understand its severity, and suggest different treatments to you.

The Causes of Halitosis from Dental Origins Include:

Poor Oral Hygiene:

One of the most common reasons for bad breath. It is caused by improper brushing and flossing techniques, leaving behind accumulated food debris that can rot. This causes an unpleasant odour and taste in the mouth.

Improper Hygiene Care of Oral Prosthesis:

Removable or fixed oral prosthesis like dentures, crowns and bridges can facilitate the build-up of plaque and harbour bacteria that can cause halitosis.

Dry Mouth (Xerostomia):

The saliva we produce is meant to wash away food debris and clean the mouth. If a person has a low salivary flow rate, dry mouth occurs, which is one of the many reasons for bad breath.

Dietary Preferences:

The food you consume has more impact on your breath than you think. Foods with strong odour profiles such as garlic, onions, and various spices may contain smelly sulfur compounds that linger in your mouth and are expelled when you exhale. Coffee and alcohol also have a drying effect that allows the bacteria to stay longer in your mouth.

Smoking Habit:

As a result of chronic smoking, tar and nicotine from cigarettes are deposited in your oral cavity. These chemicals alter the oral environment, enabling bacteria to thrive and trigger halitosis.

Dental Infections:

One of the more common reasons for bad breath. Any kind of dental infections, such as gum abscess, infection of gum tissue around wisdom tooth (pericoronitis), inflammation of supporting bone around teeth (periodontitis) are likely to cause foul odour and produce pus, which gives out a salty taste in the mouth.

The Causes of Halitosis from Non-Dental Origins Include:

Nose and Throat Infections: Infections in the nasal cavity (nose and throat area) such as tonsillitis and sinusitis can cause post-nasal drip, which is an excessive production of mucus that ends up moving down to the back of the throat. The bacteria inside feeds on the excessive mucus produced by it, causing you to have foul-smelling breath.

Drug Consumption: Antihistamines, sedatives, antidepressants, diuretics, decongestants, anticholinergics and antipsychotics usually come with adverse effects that dry out the mouth, and can lead to halitosis.

What Are the Treatments for Halitosis?

There are a number of treatments and remedies to halitosis. Depending on the root cause and severity of it, here’s what a dentist will normally recommend:

Diagnosis & Suggested Treatment

1. Dental/Ear, Nose, Throat (ENT) Infection

Your doctor or dentist will treat the source of infection and may give you antibiotic medication as an adjunct treatment

2. Poor Oral Hygiene

Your dentist will advise and demonstrate the effective ways to maintain good oral hygiene

3. Improper Hygiene Care of Oral Prosthesis

To use individualized oral hygiene kit like super floss, denture cleanser and interdental brush for different types of prosthesis

4. Medical Conditions

To find out the underlying medical illness and treat it accordingly

What Are the Ways to Prevent Halitosis?

Bad breath does not happen overnight. With simple adjustments to your everyday lifestyle, bad breath can be minimised and even prevented. Here are some of the things you can do:

1. Brush your teeth at least twice a day, with a toothbrush and a pea-sized amount of toothpaste. To effectively prevent bad breath from happening, choose a toothpaste that prevents bad breath.

When choosing, look for key ingredients such as natural mint, as it helps freshen up your breath. Ultimately, the major source of bad breath is bacteria, so choosing a toothpaste with a unique multi-care formulation helps freshen up your breath even more.

    2. Floss at least once a day after brushing your teeth before bed. Here are some simple instructions on how to floss your teeth:
  • Wind around 18 inches of dental floss around the middle finger of both hands.
  • Slide the floss gently into the space between your teeth. You must floss both sides of the space between each tooth. Run the floss up and down the surfaces until it is clean.
  • Once you have finished flossing, discard the floss. Never reuse the floss as bacteria will grow on a used floss.

3. Rinse your mouth thoroughly with water or a mouth rinse after each meal if you are unable to brush your teeth.

4. Brush your tongue with your toothbrush or scrap the tongue with a tongue scraper. The surface of your tongue can actually harbour bacteria. Hence, cleaning the tongue does make a difference.

5. Take your denture out at night and gently brush all the surfaces of the denture with a toothbrush, minus the toothpaste, if you are a denture user. You may also soak the denture in a denture cleansing solution, according to the product’s instructions.

6. Avoid foods with a strong odour profile like onions, garlic, coffee, cheeses and spices.

7. Reduce the intake of coffee and alcohol consumption, as it can cause reduction in salivary flow.

8. Stop smoking. It promotes a better-smelling breath and is definitely better for your overall health.

9. Avoid dry mouth by drinking plenty of water. Alternatively, eating healthy foods can also stimulate the production of saliva.

10. Visit your dentist bi-annually. Routine dental check-up can help detect dental issues like gingivitis, caries, infection and dry mouth before it develops into something worse. If the dentist wasn’t able to discover the cause of your bad breath issue, they may refer you to a primary healthcare centre for a more complete body check-up.

If your bad breath issue persists despite following these recommendations, pay a visit to your dentist. If you were able to identify the specific type of bad breath smell you are experiencing, pointing it out will help with their assessment. They can advise you on the appropriate types of dental products to use, treatment plans to take care of your dental problems or refer you to the right medical practitioner.

References :

Silva MF, Leite FRM, Ferreira LB, Pola NM, Scannapieco FA, Demarco FF, Nascimento GG. Estimated prevalence of halitosis: a systematic review and meta-regression analysis. Clin Oral Investig. 2018 Jan;22(1):47-55. doi: 10.1007/s00784-017-2164-5. Epub 2017 Jul 4. PMID: 28676903.
2. Dudzik, A., & Chomyszyn-Gajewska, M. (2014). Pseudohalitoza i halitofobia [Pseudohalitosis and halitophobia]. Przeglad lekarski, 71(5), 274–276.

Dr. Jimmy Yap

Founder and principal dentist of a successful private dental practice in Kuala Lumpur, Dr Jimmy Yap cherishes all the beautiful smiles he has helped make possible. Graduating from the prestigious University Malaya with the Hadiah Buku Universiti Award, he has a special interest in Orthodontics, Root Canal Treatment and Aesthetic Dentistry. In his free time, he shares his rich knowledge in dentistry with those who are keen.

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Understanding Halitosis (Bad Breath): Causes, Symptoms, Treatments & More