Bad Breath — Its Causes and Treatments 

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Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

November 7, 2018

Bad breath or halitosis, is a condition which affects roughly 25% of all people around the globe. While it is often no more harmful than causing embarrassment in social situations, there are times when it can be an indicator of a more serious health issue. In the vast majority of cases, halitosis is caused by a lack of good oral hygiene. However, it’s an issue that is easily treatable and can be managed by conscientious brushing, flossing, and mouthwash.

What exactly causes bad breath?

Believe it or not, the third most common reason that people seek some kind of dental treatment is halitosis. The only two dental conditions which are more prevalent than halitosis are gum disease and tooth decay. Everyone is subject to developing bad breath, because everyone eats food and drinks liquids. Any person who smokes or uses tobacco products, is likely to suffer from bad breath as well as increasing the chances for gum disease. Tobacco products create their own kinds of mouth odors, apart from food or drink which is ingested.

Speaking of food, whenever food is eaten and broken down in the mouth, particles can become stuck in the teeth and produce odors. Some kinds of foods produce more powerful odors than others, for instance garlic and onions. People who experience dry mouth frequently can be more subject to bad breath, because saliva acts as a cleaning agent in the mouth, and the lack of it can promote bad breath.

In that same vein, some medications taken by patients can significantly reduce the presence of saliva in the mouth and increase bad breath. Some of these medications can generate odors as they break down in the mouth, releasing chemicals. For example, some nitrates, chemotherapy chemicals, and vitamin supplements can all contribute to halitosis in an individual.

A diet which is heavy in fats can produce halitosis, because when fats are broken down they produce chemicals called ketones, and these give off a strong aroma. In some cases, conditions affecting the sinuses, nose, throat, and mouth can trigger bouts of halitosis. Sometimes infections or inflammation can be enough to generate unpleasant odors in the mouth. It’s also possible for some diseases to produce a side effect of bad breath in various stages of their development. Diseases such as cancer, liver failure, gastroesophageal reflux disease (GERD), and some metabolic diseases can all trigger halitosis because of the chemical mixes they produce.

Less common causes of bad breath

There are some other causes of bad breath which are far less common than the standard oral hygiene factors. Unpleasant as it sounds, bowel obstructions can actually cause your breath to smell like feces, in cases where a bowel obstruction triggers prolonged vomiting. A condition called bronchiectasis can lead to bad breath, when airways become wider than normal. When this happens, mucus tends to build up, and that mucus gives off an unpleasant odor.

Another medical condition called aspiration pneumonia can cause swelling or infection in the airways or in the lungs, and this can be another trigger for halitosis. Ketoacidosis is a medical condition in which a diabetic has low insulin levels, causing the body to use less sugar and instead uses stores of fat. When these fats are broken down, ketones are created and begin to accumulate. Ketones can accumulate to the point where they generate a quite unpleasant odor, and if allowed to build up indefinitely, they can be poisonous and potentially life-threatening.

Remedies for bad breath

As mentioned previously, as long as halitosis is not an indicator of some more serious disease, it can be readily treated. By brushing your teeth twice a day and flossing at the same time, food particles which cause bad breath can be effectively removed. Both of these practices must be conscientiously applied, however, since brushing alone only removes about 60% of food particles.

If you have dentures or any other dental apparatus which goes in the mouth, it should be cleaned on a daily basis to prevent the buildup of bacteria. Avoiding dry mouth is another good way to prevent the buildup of bacteria in the mouth, because saliva will help to keep things clean when it’s present. You can reduce the potential for bad breath by avoiding certain things in your diet like onions, garlic and various spices.

Sometimes it’s necessary to use a tongue brush to discourage the buildup of bacteria and dead cells which accumulate on the tongue. When these home remedies prove to be ineffective, it may be an indication that something more serious is present. In situations like this, it’s a good idea to set up an appointment with your dentist and get it checked out, and then maintain regular checkups for good oral health.


Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

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