Halitosis, commonly known as bad breath, is a condition where a person suffers from undesirable mouth odour. It is a very common problem and is seen almost 50% of the general population. Bad breath is the third most common cause for a visit to a dentist after tooth decay and gum disorders.

Why does it happen?

The human mouth is a shelter to millions of bacteria, especially the dorsum of the tongue. The mouth’s warm and moist environment favours the growth of these bacteria. Poor oral hygiene or dry mouth results in the accumulation of food particles on and between the teeth. Bacteria in the mouth break down these food particles and release foul-smelling compounds like hydrogen sulfide that results in halitosis.

Types of bad breath

Halitosis is a major of two types:

Delusional halitosis (pseudohalitosis): In this case, a person complains of a foul odour from the mouth, but it is not felt by others or its diagnosis cannot be made objectively by a professional.

Genuine halitosis: This is a condition where a person suffers from bad breath, and the same can be experienced by the opposite person or a professional.

Cause of bad breath

Bad breath reasons can be divided depending on its cause and origin

Depending on the cause:

Physiological: It is a condition of transient bad odor from the mouth after waking up in the morning, and there is no pathological cause associated with it. Reduced secretion of saliva and bacterial activity at night while sleeping causes mouth odor after waking up. Physiological halitosis can also be due to exogenous causes like consuming food that release chemical with bad odor after consumption or upon digestion like onion, garlic, smoking, and alcohol.

Pathological: In this case, bad breath is a result of an underlying health condition that can be oral or non-oral. These conditions are described below.

Depending on its origin

Oral: 90% of causes of bad mouth odor are oral in origin.  Bacterial activity in the oral cavity due to reasons like poor oral hygiene, tooth decay, oral infection, and gum disorder is the major cause for halitosis. As mentioned above, bacteria in the mouth release various chemicals that have a foul odor.

Another factor that triggers malodor in the mouth is the reduced production of saliva and plaque (naturally occurring bacterial film on the teeth) formation. There is also a direct relationship between bacterial load on the dorsum of the tongue and halitosis. Thuspoororal hygiene, food impaction, soft diet, fungal infection (candidiasis), dry mouth, and using dentures are some of the causes for a bad breath of oral origin

Extraoral: Common reasons for extraoral halitosis are:

    • Diet: A diet rich in sugar and protein content is seen to cause bad breath. Moreover, reduced water intake results in dry mouth and hence bad mouth odor.
    • Medications: Halitosis can be observed while consuming certain medications like chemotherapy drugs, chloral hydrate, and phenothiazines.
  • Certain health conditions: Pneumonia, bronchitis, sinusitis, post nasal drip, acid reflux, liver, and kidney disorder are commonly associated with bad mouth odor.

Bad breath is a quite common problem faced by both genders and across all age groups. Bad breath solution depends on the underlying cause. Some of the common solutions are brushing and flossing regularly, tongue cleaning, mouth rinsing, consuming enough water, avoiding food items causing bad breath like onion and garlic, and regular dental check-up.