Bad Breath

Bad BreathBad breath or halitosis is a condition estimated to affect 50 to 60% of the population1 Up to 90% of cases originate from sources in the mouth, including poor oral hygiene, periodontal disease, tooth decay, coating on the tongue, impacted food, dry mouth, faulty dental restorations, and throat infections2. The other 10% are due to systemic disorders, such as lung infections, liver or kidney disease, diabetes, or peptic ulcers3.

In most cases, bad breath can be traced to sulfur gases (hydrogen
sulfide and methyl mercaptan) produced by bacteria in the mouth4. These gases are damaging to the tissues in the mouth and are a sign of periodontal disease5. As periodontal disease progresses, so does the halitosis, as bacteria accumulate in the gum pockets around the teeth.

Eliminating periodontal disease and maintaining good oral hygiene is essential to controlling bad breath. Brushing and flossing daily will not only remove trapped food particles that begin to rot if left in the mouth, but they also reduce the sulfide gas forming bacteria responsible for periodontal disease. Scraping or brushing the tongue will also aid in controlling bad breath.

  1. Bollen CM, Rompen EH, Demanez JP. Halitosis: a multidisciplinary problem. Rev Med Liege 1999;54:32-6.
  2. Meningaud JP, Bado F, Favre E, et al. Halitosis in 1999. Rev Stomatol Chir Maxillofac 1999;100:240-4. Spielman AI, Bivona P, Rifkin BR. Halitosis. A common oral problem. NY State Dent J 1996;62:36-42. Touyz LZ. Oral malodor-a review. J Can Dent Assoc 1993;59:607-10.
  3. Tiomny E, Arber N, Moshkowitz M, et al. Halitosis and Helicobacter pylori. A possible link? J Clin Gastroenterol 1992;15:236-7. Ierardi E, Amoruso A, La Notte T, et al. Halitosis and Helicobacter pylori: a possible relationship. Dig Dis Sci 1998;43:2733-7. Lorber B. “Bad breath”: presenting manifestation of anaerobic pulmonary infection. Am Rev Respir Dis 1975;112:875-7. Touyz LZ. Oral malodor-a review. J Can Dent Assoc 1993;59:607-10. Durham TM, Malloy T, Hodges ED. Halitosis: knowing when “bad breath” signals systems disease. Geriatrics 1993;48:55-9.
  4. Reiss M, Reiss G. Bad breath-etiological, diagnostic and therapeutic problems. Wien Med Wochenshchr 2000;150:98-100 [in German]. Tonzetich J. Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol 1977;48:13-20.
  5. Ratcliff PA, Johnson PW. The relationship between oral malodor, gingivitis, and periodontitis. A review. J Periodontol 1999;7:485-9. Waler SM. Bad breath from the oral cavity. Tidsskr Nor Laegeforen 1997;117:1618-21.