Bad Breath (Halitosis)

• 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, oral 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.

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

There are many risk factors and causes for halitosis, and even healthy people have bad breath on occasion. Some common causes of halitosis include the following:

• 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 and dental plaques, 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. This fruity odor in a diabetic might indicate uncontrolled blood sugars.
• 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 oral health: When a person does not brush or floss his/her teeth 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 on the teeth can also lead to an unhealthy condition called periodontal (gum) disease. When plaque hardens, it is referred to as tartar (calculus). Tartar holds bacteria that can irritate the gums and lead to 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, the common cold, influenza (flu), tonsil stones (tonsilloliths), thrush, bronchitis, postnasal drip, diabetes, acid reflux (gastroesophageal reflux disease or GERD), lactose intolerance, other stomach or digestion 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.
• Allergies: Many medications used to treat allergies can cause dry mouth, another cause of halitosis. In addition, post-nasal drip is a common allergy symptom that can result in bad breath. Sinus congestion due to allergies can also cause people to breathe from their mouths, causing dry 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 to treat allergies 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 odor-causing 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.