Causes of Bad Breath

Posted by Dr. Elizabeth Perez on Aug 3 2019, 12:57 AM

Where Bad Breath Come From

Chronic bad breath or as dentists call it, halitosis, is a common disorder with a broad range of causes including infections, smoking, and poor dental hygiene. However, the leading cause of bad breath is the reaction between the bacteria living in our mouths and the food we eat, which produces the foul odors.

There are many ways to diagnose halitosis, but putting our hands on the cause is not always easy. There are also many ways to treat it, and many patients do strive to diagnose and address this stigmatizing disorder.

The bacteria can hide in many places inside your mouth:

  • The space between your gum and your teeth (if we have gum disease)
  • Between the teeth.
  • Decayed teeth.
  • Under unclean and ill-fitting crowns, fillings, dentures, or braces.
  • Removable dental appliances.

The bacteria can also hide in tongue coating, which is one of the largest contributors to bad breath. It is where the odor-producing bacteria “feast” on food remnants and exfoliated cells.

Chronic bad breath is a serious condition, as it can lead to social isolation, stress, and depression. Bad breath patients are 60% more likely to suffer from stress than non-patients. Furthermore, 57% of patients report feelings of depression because of this problem.

Not only that, but chronic bad breath can also be the sign of an underlying systemic disease. Though it is rare, there have been cases of suicide due to the problem.

What You Need to Know About Bad Breath

Halitosis (halitus: smell; osis: chronic dysfunction) refers to a medical condition where the patient suffers from a smelly mouth on a regular basis, which can last for years. A distant cousin of Halitosis is pseudohalitosis and halitophobia, when the patient believes that the unpleasant mouth odor is present but the people around the victim around don’t notice it.

Bad breath or fetor oris is a common problem with studies by The Journal of the American Dental Association confirming that 15-30% of the population suffer from it.

A host of other disease may cause bad breath including gum disease, tongue coating, or respiratory tract infections. Also, dietary choices, hygienic habits, and a dry mouth could stimulate bad breath.

According to the Journal of Dental Health/Oral Disorders & Therapy, Middle Ear Infections (including tonsillitis and/or post-nasal drip) cause 10% of the odors. Another 5% are caused by different medical conditions and disorders including diabetes, hepatitis or uremia.

Bad Breath: Diagnose and Treatment

There are several methods dentists use to diagnose bad breath.

1.      The Organoleptic Method: The most common diagnostic method, which is simply smelling the patient’s exhaled air.

2.      The BANA test: Another easy method, which constitutes the separate detection of each odor produced by the bacteria that lives in the plaque and the back of the tongue.

3.      The Halimeter: A device that assess the severity of bad breath by measuring the quantity of odors in the exhaled air.

4.      Gas Chromatography: An expensive but accurate method which separately measures the amount of each volatile sulfur compound in the exhaled air.

90% of bad breath cases are treatable, with most dentists focusing on attacking the root cause rather than covering it. Furthermore, it consists of maintaining lifelong meticulous oral hygiene, using proper oral mouthwashes and chewing gums.  In fact, Americans spent about 1.49 billion U.S dollars on mouthwash and dental rinse in 2015.

Surgical intervention can be used as a last resort to treat severe bad breath cases, but is typically only necessary less than 3% of the time.


Bad breath carries a certain social stigma across different cultures, from Britain to Saudi Arabia. It is a big taboo that people don’t talk about with close relatives, friends or social and professional contacts, even though it bothers them.

Thus, many myths are circulated about halitosis. We can conclude that you don’t need to worry about bad breath originating from stomach and intestine activities.

Foods such as onions, garlic, and cauliflower can be disregarded as a source of bad breath, but these are just temporary.

You can’t smell your own bad breath, no matter how hard you pretend you can. Only others can smell it.

Tongue cleaning alone can’t solve the bad breath problem, you will need a comprehensive oral hygiene regimen to eliminate halitosis.

Furthermore, mouthwash, mints, gums are sufficient for bad breath treatment. It can only cover the foul odor with a stronger, pleasant odor. The exception is chlorhexidine mouthwashes and those that contain a combination of cetylpyridinium chloride and zinc.

As for halitophobia patients there is no real “cure” for them. Perhaps they should turn to psychology for help!

If you are experiencing recurring challenges dealing with bad breath or perhaps you just are looking to improve your oral health, we encourage you to contact our dentist in Brandon, FL.   With nearly two decades of dental experience, Dr. Elizabeth Perez is well equipped to treat patients with halitosis and can help you restore good breath along with great confidence!

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