Bad breath is a persistent, unpleasant odour in exhaled breath. In simple words, bad breath is when your breath has a bad smell/odour. It's also known as halitosis. This odour can occur from time to time, or it can be long-lasting, depending on the cause.
Millions of bacteria live in your mouth, particularly on the back of the tongue. Bad breath usually happens due to these bacteria that naturally live in your mouth.
The saliva (an extracellular, watery fluid produced in your mouth for chewing food and for digestion) in your mouth provides moist conditions for these bacteria to grow. Additionally, every time you eat, bacteria feed on the food left in your mouth and can leave a foul-smelling waste product behind, resulting in bad breath.
In most cases, the primary cause of bad breath is poor oral hygiene. Bad breath can cause significant worry, embarrassment, and anxiety but it is relatively easy to treat and prevent.
Remember, some types of bad breath are considered to be fairly normal. They usually are not health concerns. One example is "morning mouth." This occurs because of changes in your mouth while you sleep. During the day, saliva washes away decaying food and odours.
Your body makes less saliva at night. Your mouth becomes dry, and dead cells stick to your tongue and to the inside of your cheeks. When bacteria use these cells for food, they produce a foul odour. Besides this, there are various other causes of bad breath.
What Causes Bad Breath?
1. Poor dental hygiene. Infrequent or improper brushing and flossing (the process of removing plaque and food particles between your teeth using a thin, waxy cord called a floss) allows bits of food that are stuck between the teeth to decay inside your mouth. Bacteria in your mouth can feed on these food remnants and result in bad breath.
Poor oral hygiene can eventually lead to periodontal diseases, which can also be a cause of bad breath. Periodontal disease, also called gum disease, is a serious gum infection that damages the soft tissue and bones that support your teeth.
2. Infections in your mouth. Mouth infections can be caused by either a cavity in your tooth or by a gum disease/infection. Cavities are damaged areas of a tooth that develop into holes. When left untreated, bacteria stick and accumulate in these pockets and can cause bad breath.
3. Respiratory tract infections (RTIs). RTIs are infectious diseases that can affect your throat, sinuses (hollow spaces in your skull and face bones), or airways. The most common symptom of RTIs is nasal secretion.
Nasal secretion, also known as nasal discharge, happens when mucus (a slimy and slippery fluid) is drained out from your nose. Nasal secretions can sometimes drain into your mouth and result in bad breath.
4. Dry mouth (xerostomia). If your mouth is dry, you might not be making enough saliva. Saliva is important to wash out bacteria and to clean your mouth.
A dry mouth can be caused by salivary gland (gland that produces saliva in your mouth) problems, medicines, or "mouth breathing." A large number of prescriptions and over-the-counter medicines can cause a dry mouth.
5. Illnesses. Illnesses like cancers, liver failure, and other metabolic diseases (disorders resulting from abnormal chemical reactions in your body) can cause halitosis, due to the specific mixes of chemicals that they produce.
6. Psychiatric illness. Some people may believe they have bad breath, but others do not notice it. This is referred to as "pseudohalitosis." Pseudohalitosis is a situation in which patients complain of oral malodour even though they do not have an offensive odour.
7. External sources. Foods such as garlic and onions that have a strong odour can cause bad breath when their particles stick between your teeth. Similarly, drinking too much coffee can be a cause of bad breath due to its intense flavour.
Other external sources of bad breath include cigarette smoking and chewing tobacco. The smell of cigarette smoke and tobacco products tends to linger in your mouth, causing bad breath. Smoking also dries out your mouth, one of the most common reasons for halitosis.
Symptoms of Bad Breath
You may not always know that you have bad breath. That's because odour-detecting cells in your nose eventually get used to the smell. Other people may notice and react by stepping away from you or by making a face, as you speak.
The symptoms depend on the underlying cause of bad breath:
1. Symptoms if the cause is infections in your mouth:
Red or swollen gums that may bleed easily, especially after brushing or flossing
Pus between teeth or a pocket of pus (abscess) at the base of a tooth
Loose teeth or a change in how a denture (a removable plate or frame holding one or more artificial teeth) fits
Painful, open sores on your tongue or gums
2. Symptoms in case of respiratory tract infections (RTIs):
Sore throat
Swollen lymph nodes ("swollen glands") in your neck
Fever
Stuffy nose
A greenish or yellowish discharge from the nose
A cough that produces mucus
3. Symptoms if dry mouth is the cause:
Difficulty swallowing dry foods
Difficulty speaking for a long time because of mouth dryness
Burning in the mouth
An unusually high number of cavities
Dry eyes (in Sjögren's syndrome, an auto-immune disorder that affects your eyes and the salivary glands in your mouth)
Diagnosis of Bad Breath
A dentist or physician may notice bad breath during an office visit. Sometimes, the smell of the patient's breath may suggest a likely cause for the problem. For example, "fruity" breath may be a sign of uncontrolled diabetes (a chronic condition in which there is excess sugar in your blood). A urine-like smell, especially in a person who is at high risk of kidney disease, can sometimes indicate kidney failure.
Your dentist will review your medical history for conditions that can cause bad breath and for medicines that can cause dry mouth. Your dentist will also ask you about your diet, personal habits (smoking, chewing tobacco), and any other symptoms. He or she will ask who noticed the bad breath and when.
Your dentist will examine your teeth, gums, mouth, and salivary glands. He or she will feel your head and neck and will evaluate your breath when you exhale from your nose and from your mouth.
Your dentist may refer you to your family physician if an illness is the most likely cause of your bad breath. In severe cases of gum disease, your dentist may suggest that you see a periodontist (a dentist who specializes in gum problems).
You will need diagnostic tests if the doctor suspects a lung infection, diabetes, kidney disease, liver disease, etc. You may get blood tests, urine tests, X-rays of the chest or sinuses, or other tests.
How Long Will Your Bad Breath Last?
How long bad breath lasts depends on its cause. For example, when the problem results from poor dental hygiene, proper dental care will begin to freshen your mouth right away. You'll have even better results after a few days of regular brushing and flossing.
Periodontal disease and tooth abscess also respond quickly to proper dental treatment.
Bad breath caused by chronic sinusitis may keep coming back, especially if it is caused by a structural abnormality of the sinuses.
Bad breath that results from an illness may be a long-term problem. It can often be controlled with proper medical care.
How Can You Prevent or Keep Bad Breath Away?
Bad breath caused by dental problems can be prevented easily with proper home and professional care.
Brush and floss your teeth, and clean your tongue and gums daily.
Rinse your mouth with a mouthwash approved by the regulatory bodies. Mouthwash, also called oral rinse, is a liquid product used to rinse your teeth, gums, and mouth. It usually contains an antiseptic to kill any harmful bacteria in your mouth.
Visit your dentist regularly (at least twice a year) for an exam and tooth cleaning.
You also can combat bad breath by following these tips:
Drinking plenty of water every day helps your body make saliva. An occasional swish of the mouth with water can loosen bits of food.
Eating sugar-free gum or sugar-free breath mints can help you keep your breath fresh and prevent plaque from forming. But be aware that consuming large amounts of sugar-free gum and/or mints that contain sorbitol (a kind of sugar alcohol) may cause side effects. These can include diarrhoea and bloating.
When To Call Your Doctor
Call your dentist promptly if you have bad breath with loose teeth or painful, swollen gums that bleed easily. Also, call your doctor if you have bad breath along with any of the following symptoms:
Fever
Sore throat
Postnasal drip (secretions from your nose that drain down into the throat)
Discoloured nasal discharge
Cough that produces mucus
Even if you have none of these symptoms, call your dentist or physician if your bad breath continues despite a good diet and proper dental hygiene.
The outlook for fresh breath is usually excellent if you stick to your dentist's or physician's treatment plan. Eat healthy food, drink a lot of water, and follow proper oral hygiene practices to keep bad breath away.
Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.