Bad Breath (Halitosis)

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Bad Breath Causes: GERD

GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid content of the stomach backs up into the esophagus. The cause of GERD is complex and may involve multiple causes. GERD may damage the lining of the esophagus, thereby causing inflammation (esophagitis), although this is uncommon.

The symptoms of uncomplicated GERD include:

  • heartburn,
  • regurgitation, and
  • nausea.

Bad breath facts

  • Bad breath, or halitosis, is characterized by an unpleasant odor of the mouth.
  • Causes of bad breath include food, tobacco products, poor dental hygiene, health problems, dry mouth, mouth infections, dental problems, or medications.
  • Symptoms of bad breath include unpleasant odor or taste in the mouth, dry mouth, or white coating on the tongue.
  • Treatments for bad breath include proper dental hygiene, mouthwash, sugar-free gum, quitting smoking, and changing bad habits.
  • Bad breath can usually be prevented by proper tooth brushing, quitting smoking, and avoiding foods that cause bad breath odors.

What is the definition of bad breath?

The definition of bad breath, or halitosis, is an unpleasant odor of the mouth. It can occur on occasion, or it can be a chronic condition. It may be caused by foods a person eats, poor oral hygiene, medical conditions, or other factors.

What are the causes and risk factors of bad breath?

There are many risk factors and causes for bad breath; some common causes are listed below.

  • Food: Food is a primary source of bad odors that come from the mouth. Some foods, such as garlic, onions, spicy foods, exotic spices (such as curry), some cheeses, fish, and acidic beverages such as coffee can leave a lingering smell. Most of the time the odor is short lived. Other foods may get stuck in the teeth, promoting the growth of bacteria, which causes bad breath odor. Low carbohydrate diets may also cause "ketone breath." These diets cause the body to burn fat as its energy source. The end-product of making this energy is ketones, which cause a fruity acetone-like odor on the breath when exhaled.
  • Tobacco products: Smoking and chewing tobacco can leave chemicals that remain in the mouth. Smoking can also precipitate other bad-breath causes such as gum disease or oral cancers.
  • Poor dental hygiene: When a person does not brush or floss regularly, food particles remaining in the mouth can rot and cause bad odors. Poor dental care can lead to a buildup of plaque in the mouth, which causes an odor of its own. Plaque buildup can also lead to periodontal (gum) disease. The mild form of gum disease is called gingivitis; if gingivitis is not treated, it can advance to periodontitis.
  • Health problems: Sinus infections, pneumonia, sore throat (pharyngitis) and other throat infections, tonsil stones (tonsilloliths), thrush, bronchitis, postnasal drip, diabetes, acid reflux, lactose intolerance, other stomach problems, and some liver diseases or kidney diseases may be associated with bad breath.
  • Dry mouth: Also called xerostomia, dry mouth can also cause bad breath. Saliva helps moisten and cleanse the mouth, and when the body does not product enough saliva, bad breath may result. Dry mouth may be caused by salivary gland problems, connective tissue disorders (Sjögren's syndrome), medications, or breathing through the mouth.
  • Mouth infections: Cavities, gum disease, or impacted teeth may cause bad breath.
  • Dentures or braces: Food particles not properly cleaned from appliances such as braces can rot or cause bacteria and odor. Loose-fitting dentures may cause sores or infections in the mouth, which can cause bad breath.
  • Medications: Many medications, including antihistamines and diuretics, can cause dry mouth (see above), which can cause bad breath. Other medications that may lead to bad breath may include triamterene (Dyrenium) and paraldehyde.
  • "Morning breath": Bad breath in the morning is very common. Saliva production nearly stops during sleep, allowing bacteria to grow, causing bad breath.
  • Pregnancy: Being pregnant in itself does not cause bad breath, but the nausea and morning sickness common during pregnancy may cause bad breath. In addition, hormonal changes, dehydration, and eating different foods due to cravings may also contribute to bad breath during pregnancy.
  • Other causes of bad breath: Objects stuck in the nose (usually in children), alcoholism, and large doses of vitamin supplements may also cause bad breath.
Medically Reviewed by a Doctor on 1/25/2016
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