1. What is bad breath?

Bad breath (halitosis, oral malodour) is a condition where an unpleasant odour comes from the mouth, often due to the activity of anaerobic bacteria. It is a common issue, affecting 50–65% of people, not only causing discomfort for those affected but also significantly impacting their quality of life, confidence in communication, and overall health.

Approximately 90% of bad breath cases stem from issues within the mouth. However, it can also serve as an early warning sign of serious systemic conditions, including liver or kidney failure, uncontrolled diabetes, or respiratory diseases.

2. Causes of Bad Breath

• From inside the mouth: The most common cause of bad breath is bacteria that break down proteins in the mouth, producing volatile sulphur compounds (VSCs).
  • Bad breath can result from oral health issues such as:
    • Tongue coating (a layer on the surface of the tongue)
    • Gingivitis and periodontal disease
    • Cavities and dental plaque
    • Food trapped between teeth
    • Dry mouth due to reduced saliva production

• From outside the mouth:
  • Respiratory diseases:
    • Sinusitis, pharyngitis, tonsillitis, pneumonia
    • Post-nasal drip or foreign objects in the nose causing odour
  • Gastrointestinal diseases:
    • Gastroesophageal reflux disease (GERD), gastric ulcers
  • Systemic diseases
    • Uncontrolled diabetes: Can cause a breath odour smell similar to rotting apples
    • Kidney failure: Often results in a fishy breath odour
    • Liver failure: Produces an unpleasant sulphur-like smell

3. Classification and Identification of Bad Breath

– Physiological Bad Breath:

Temporary and typically caused by:

• Inadequate brushing.
• Consumption of strong-smelling foods like onions or garlic.

– Pathological Bad Breath:

Temporary and often due to:

• Poor oral hygiene.
• Consumption of strong-smelling foods like onions or garlic.

– Pseudo-Bad Breath:

• The patient believes they have bad breath, but no detectable odour is present.

– Halitophobia:

• The patient refuses to accept the test results showing no bad breath and becomes obsessed, often associated with obsessive-compulsive disorder (OCD) or anxiety.

4. Prevention and Treatment of Bad Breath

– Oral Hygiene:

• Brush your teeth at least twice a day and clean the surface of your tongue.
• Use dental floss or an interdental brush to clean between your teeth.
• Rinse with a mouthwash containing chlorhexidine or other antibacterial agents.

– Healthy Habits:

• Drink plenty of water to maintain moisture in the mouth.
• Avoid smoking and alcohol consumption.
• Limit foods with strong odours like onions and garlic.

– Regular Dental Check-ups

• Schedule a professional cleaning and oral health check-up every six months.
• Detect dental issues or underlying health conditions early.

5. When to See a Doctor?

• Persistent bad breath despite maintaining good oral hygiene.
• Accompanied by symptoms such as dry mouth, toothache, or mouth and gum sores.
• Causes embarrassment or affects quality of life and social interactions.

Bad breath is a common concern and can also indicate underlying health issues. Visit the Oral & Maxillofacial Surgery – Dental Surgery Department at FV Hospital for a comprehensive examination and expert treatment by our leading specialists. We are here to help you achieve fresh breath and overall health.