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Bad breath

Bad Breath


Bad breath



Ever been turned off by bad breath? Well, you are not alone. In fact, we can’t think of anyone who isn’t turned off by bad breath. The problem, of course, is that we can’t tell whether we ourselves have bad breath. So we don’t know whether a promising prospective date/spouse/partner is turning their backs on us because of our stinky breath.


Anyhoo, here’s a blind item about a celebrity who apparently needs some halitosis treatment:

StarMagazine – Which hunky actor is a real stinker? His girlfriend has refused his kisses because of his seriously bad breath. Maybe that’s the reason they’re constantly on and off.

Any idea who the guy is? None? Well, it could be anyone in Hollywood. Celebrities, after all, are just like us. They may make millions but they too can stink.

You lean over to whisper something to your friend and you can tell by the look on your friend's face that something is up. Could it be your breath? Maybe you shouldn't have put extra onions on your hamburger at lunch. What's a kid with smelly breath to do?

The good news is that bad breath happens to everyone once in a while. Let's find out how to detect it, prevent it, and even treat it.

What's That Smell?

Bad breath is the common name for the medical condition known as halitosis (say: hal-uh-toe-sis). Many different things can cause halitosis — from not brushing your teeth to certain medical conditions.

Sometimes, a person's bad breath can blow you away — and he or she may not realize there's a problem. There are tactful (nice) ways of letting someone know about bad breath. You could offer mints or sugarless gum without having to say anything.

If you need to tell a friend he or she has bad breath, you could say that you understand foods can cause bad breath because you've had it before yourself. By letting someone know that bad breath isn't something unusual, you'll make your friend feel more comfortable and less embarrassed about accepting your piece of chewing gum.

If you suspect your own breath is foul, ask someone who will give you an honest answer without making fun of you. (Just don't ask your brother or sister — they just might tell you your breath stinks even when it doesn't!)


What Causes Bad Breath?

Here are three common causes of bad breath:

  1. foods and drinks, such as garlic, onions, cheese, orange juice, and soda
  2. poor dental hygiene (say: hi-jeen), meaning not brushing and flossing regularly
  3. smoking and other tobacco use

Poor oral hygiene leads to bad breath because when food particles are left in your mouth, they can rot and start to smell. The food bits may begin to collect bacteria, which can be smelly, too.

Not brushing your teeth regularly will let plaque (a sticky, colorless film) build up on your teeth. Plaque is a great place for bacteria to live and yet another reason why breath can turn foul.

Preventing Smelly Breath

So what's a kid to do? Don't smoke or use tobacco products, of course. And take care of your mouth by brushing your teeth at least twice a day and flossing once a day. Brush your tongue, too, because bacteria can grow there. Flossing once a day helps get rid of particles wedged between your teeth. Also, visit your dentist twice a year for regular checkups and cleanings.

Not only will you get a thorough cleaning, the dentist will look around your mouth for any potential problems, including those that can affect breath. For example, gum disease, also known asperiodontal (say: per-ee-uh-don-tul) disease, can cause bad breath and damage your teeth.

If you're concerned about bad breath, tell your doctor or dentist. But don't be surprised if he or she leans in and take a big whiff! Smell is one way doctors and dentists can help figure out what's causing the problem. The way a person's breath smells can be a clue to what's wrong. For instance, if someone has uncontrolleddiabetes, his or her breath might smell like acetone (the same stuff that's in nail polish remover).

If you have bad breath all the time and the reason can't be determined by your dentist, he or she may refer you to a doctor to make sure no other medical condition could be causing it. Sometimes sinus problems, and rarely liver or kidney problems, can cause bad breath.

Usually, there's a less complicated reason for bad breath — like what you had for lunch. So keep up with your brushing and flossing and you should be breathing easy — and odor free!

Bad breath: Testing yourself. / Causes. / Treatments and cures.


Having bad breath (also called "halitosis") doesn't have to be an insurmountable problem. In fact, with just a little basic understanding of its fundamental cause and associated risk factors, developing aneffective plan for its treatment becomes relatively simple.

Our pages describe how to test yourself for bad breath (or, for some, denture breath). We then discuss the various cures. Most notably this involves effective tongue cleaning. But it can also involve the use of mouthwashes, mints or lozenges or some simple common-sense tips.

FYI – Bad breath and halitosis are the same thing. Halitosis is derived from the Latin word "halitus," which means breath, and the Greek suffix "osis," which means condition.

Do you have bad breath?

How is your breath? Not sure? No doubt each of us has, at some point, unwittingly had bad breath (halitosis) only to be subsequently embarrassed by the reactions of others in response to it.

For any individual, the exact status of their own breath can be difficult to ascertain. The reason for this lies in the fact that the oral cavity is connected to our nose by way of an opening which lies in the back of our mouth (in the region of our soft palate). Since noses tend to filter out and ignore background odors, it filters out and ignores the quality of our own breath. This means that it is quite possible for a person to have bad breath, yet not be aware of it.

How can you tell if you have a breath problem?

If our noses can't reliably help us judge the quality of our own breath, how can we determine if we do have bad breath? One solution is to ask the opinion of a spouse or significant other. If you don't feel you can ask them, ask your dentist or hygienist at your next dental appointment, after all, evaluating oral conditions is part of their job. If you find this type of question too personal to ask an adult, don't overlook asking a child. As we all know, sometimes the least inhibited and most honest responses come from children.

Symptoms: How can a person can test the quality of their own breath?

There are ways you can objectively smell your own breath. However, you have to take a slightly indirect route.

Try this technique. Lick your wrist, wait about five seconds while the saliva dries somewhat, and then smell it. What do you think?

That's the way you smell. Or, more precisely, that's the way the end of your tongue smells (your tongue's "anterior" portion). How was it? Did you pass this first check?

Now try this second experiment. It will check the odor associated with the back portion of your tongue (your tongue's "posterior" aspect).

Take a spoon, turn it upside down, and use it to scrape the very back portion of your tongue. (Don't be surprised if you find you have an active gag reflex.) Take a look at the material that has been scrapped off, usually it's a thick whitish material. Now, take a whiff of it. Not so bad? Pretty nasty? This smell, as opposed to the sampling from the anterior portion of your tongue, is probably the way your breath smells to others.

You now know. The fundamental cause of bad breath is…

Just as your experimentation has suggested, for most people the fundamental cause of bad breath is the whitish coating that covers the surface of the posterior portion of their tongue. More accurately, bad breath is caused by the bacteria that live in this coating. (The second most common fundamental cause of bad breath is bacteria that accumulate elsewhere in a person's mouth.)

The remainder of the text on this page describes the various methods by which dental researchers attempt to quantify bad breath. If you're interested in this topic of course please read on, otherwise you may want to skip to our next page which continues on with our discussion about causes of halitosis.

Bad Breath

How dental researchers test for the presence of halitosis.

   ( Related page: How academic researchers and dental professionals categorize types of bad breath. )

Before a dental researcher can evaluate the effectiveness of a cure for bad breath they must first have a way to quantify the person's level of malodor, both initially and after the cure they are studying has been administered. Some of the different methods researchers use to measure bad breath are discussed below.

A) Organoleptic testing for bad breath.

Judging a person's breath by way of organoleptic testing simply means that the researcher performing the breath evaluation has used their sense of smell (their nose) as the means for making a determination. Historically this method of breath testing has been a frequent choice among dental researchers. Noses are readily available, inexpensive to obtain and operate, and to their credit, noses can detect up to 10,000 different smells.

One of the problems associated with using organoleptic testing is that this technique is not totally objective. Another is that factors other than just breath odors can and do influence organoleptic evaluations. As examples, research has shown that factors such as hunger, menstrual cycle, head position, and the degree of attentiveness and expectation can each influence a judge's interpretation of what they smell. Additionally, consumption or use of coffee, tea, juice, tobacco products and scented cosmetics by subjects prior to their evaluation can influence the testing.

As for quantifying the organoleptic measurement itself, what exactly does constitute a weak, strong, or average level of bad breath? Will each judge participating in the research be able to make equivalent comparisons? Complicating things even more, as we all know, when we are repeatedly exposed to a bad odor our sense of smell acclimates to the odor and therefore loses much of its sensitivity. Breath malodor that seems exceedingly objectionable at the beginning of testing may seem quite less so as the evaluation continues.

B) Evaluating bad breath with gas chromatography.

A number of scientific fields utilize gas chromatographs to identify compounds found in the samples they are studying. Likewise, gas chromatographs have been employed by dentists conducting halitosis studies and have provided a means by which a researcher can definitively quantify the precise levels of various compounds present in someone's breath. It is considered to be the "gold standard" for measuring breath malodor.

While gas chromatography is probably the best way to test for the compounds associated with bad breath, it has not been widely utilized in research studies for several reasons. Gas chromatographs are relatively expensive and require personnel with special training to operate them. The equipment is not portable and a significant amount of time is needed to make each breath measurement.

C) Using Halimeters to quantify halitosis.

A specialized type of sulfide monitor (termed a Halimeter) has been developed and it provides a means by which a tester can quantify certain aspects of a person's breath. These machines, first introduced in 1991, measure levels of sulfide gases. Some sulfides, such as hydrogen sulfide and methyl mercaptan (collectively referred to in dental literature as volatile sulfur compounds or "VSC's"), are known to be causative agents of bad breath. A Halimeter's reading showing a high level of sulfides in a person's breath suggests that a corresponding high level of VSC's are present, although the apparatus does not test for individual types of VSC's specifically.

Since a Halimeter tests for a fewer number of compounds (sulfides only) than gas chromatographs, and in fact test for no individual compounds at all but instead just sulfides as a class, Halimeters provide for a less definitive evaluation of a person's breath malodor than gas chromatographs. Additionally, compounds such as ethanol (alcohol) and essential oils (both of which are frequently found in mouthwashes) interfere with a Halimeter's ability to make a measurement. The advantages of using a Halimeter for a study rather than a gas chromatograph are that a Halimeter requires no special training to use, is portable, breath measurements can be made quickly and the apparatus itself is comparatively inexpensive.

D) The BANA test.

Some of the bacteria that cause periodontal disease (gum disease) produce waste products that are quite odiferous and as a result contribute to a person's breath problems. The presence of some of these types of bacteria can be tested for by way of performing a BANA test.

The bacteria in question have the characteristic of being able to produce an enzyme that degrades the compound benzoyl-D, L-arginine-naphthylamide (abbreviated BANA). When a sample of a patient's saliva that contains these bacteria is placed in with the BANA testing compound they cause it to break down, thus creating a color change in the testing medium.

E) Utilizing chemiluminescence to detect bad breath.

One of the more recently developed methods of testing for the presence of compounds associated with bad breath relies on the principle of chemiluminescence. This type of testing was first introduced in 1999. When a sample containing sulfur compounds (such as VSC's, the types of compounds which cause bad breath) is mixed in with the test's mercury compound, the resulting reaction causes fluorescence. The strength of chemiluminescence methodology is that it can provide better selectivity and sensitivity when measuring low levels of sulfur compounds, as compared to testing with a Halimeter.


Bad breath is usually caused by oral bacteria.

The most common cause of halitosis is the anaerobic bacteria that live in a person's mouth.

For the majority of people (85 to 90% of those who have bad breath[halitosis]), the single most frequent cause of breath odor problems is bacteria that live in their mouth.

Some oral bacteria excrete odiferous waste products.

Bacteria, just like humans, consume food and excreting waste. The waste products produced by some oral bacteria are sulfur compounds. And it is these sulfur compounds that usually lie at the root of a person's breath problems.

Have you ever smelled a rotten egg? The stench associated with rotten eggs is caused by the sulfur compound hydrogen sulfide. The stinky smell emanating from feed lots and barnyards is one created by the sulfur compound methyl mercaptan. The odor you associate with the ocean is in part due to the presence of dimethyl sulfide. And each of these types of sulfur compounds is also excreted as a waste product by the bacteria that live in our mouths.

Bad breath is caused by "volatile sulfur compounds."

Dentists refer to the sulfur compounds excreted by oral bacteria as waste as "volatile sulfur compounds" (VSC's). The term "volatile" simply describes the fact that these compounds evaporate readily, even at normal temperatures. The extreme volatility of VSC's explains how these compounds have the ability to offend those around us, instantly.

While volatile sulfur compounds are the principle causative agents of bad breath, the bacteria that live in our mouth produce other waste products too. Some of these have their own unique and unpleasant smell. A few of these waste byproducts are:

  • Cadaverine – the smell we associate with corpses.
  • Putrescine – the compound responsible for much of the foul odor produced by decaying meat.
  • Skatole – the characteristic smell of human fecal matter.
  • Isovaleric Acid – the smell of sweaty feet.

How surprised you must be to discover that this wonderful mix of compounds emanates from the mouths of humans. And no one is an exception. Everyone has some amount of these unpleasant compounds in their breath. Fortunately, however, at low levels these odorous compounds cannot be detected by the human nose. It's only when the amount of these compounds becomes elevated that others can detect our "bad" breath.

Bad breath is caused by waste products produced by anaerobic oral bacteria.

Most of the compounds that cause bad breath (hydrogen sulfide, methyl mercaptan, cadaverine, putrescine, skatole) are the waste products of anaerobic bacteria (more specifically Gram-negative anaerobic bacteria). The term "anaerobic" describes the fact that these types of bacteria grow best in environments that are devoid of oxygen.

A person's mouth can be home for hundreds of different species of bacteria. And on going in our mouth, at all times, is a constant battle for living space between the types of bacteria which do create waste products that cause bad breath and those that don't. And it is the precise balance between the relative numbers of these two different types of bacteria that will ultimately determine the quality of a person's breath.

Dental plaque accumulation (the whitish film that forms on teeth both above and below the gum line and also on the tongue) can tip the scales in favor of the odor causing bacteria. You might be surprised to learn that a layer of plaque as thin as 0.1 to 0.2 millimeters (about the same thickness as a dollar bill) can be oxygen depleted, thus creating the precise type of environment in which anaerobic bacteria will flourish.

So, as more and more plaque builds up in a person's mouth the bacteria that cause bad breath gain available living space and proliferate, thus increasing the level of odor causing compounds that escape with each breath that is exhaled.

What is the food source for the anaerobic bacteria that cause bad breath?

Most of the volitile sulfur compounds that cause bad breath are waste products created by anaerobic bacteria as they digest proteins. This means that as we consume food items such as meat and fish, the bacteria that live in our mouths are getting a meal too and subsequently producing the waste products that cause our bad breath.

Even without an obvious protein source, like just having eaten a cheeseburger, it's not hard for the anaerobic bacteria that live in our mouths to find a meal. There are always protein food sources floating around in our mouths such as dead skin cells or one of the many protein compounds found in saliva. And then also, especially for those who are not diligent with brushing and flossing, there is always the leftover food debris from yesterday's meal, and the meal before that, and the one before that….

High protein foods.

Meat, fish and seafood, eggs, and dairy foods (milk, cheeses, and yogurt) are all obvious examples of foods high in protein. Most of us get about two thirds of our needed protein from eating them. Other protein sources include cereal grains (and cereal grain products), nuts, and the seeds from pod bearing plants (peas, beans, and lentils). The ingredients found in many of our favorite deserts (especiallycakes and pies) can make these food items surprisingly high protein sources.

Where do the bacteria that cause bad breath live?

For most of us the bacteria that cause our bad breath live on the surface of our tongue. There can be, however, other locations (which are typically secondary in nature) that harbor these culprit bacteria as well.

Bad breath source: Bacteria that live on a person's tongue.

Plaque accumulation on the posterior tongue surface.

Think back to the breath testing experiments described at the beginning of this topic. While the smell emanating from the anterior portion of a person's tongue can be unpleasant, it usually it isn't the source of their breath problems. The most common odor-producing region of the tongue is the posterior (back) portion.

Go to a mirror, stick your tongue out and take a look at it. With many people, you can actually see a whitish coating on the tongue's surface. The further back (toward the throat) you look, the whiter this layer usually appears. This is dental plaque and it is chocked full of the types of anaerobic bacteria that cause bad breath.Tongue surfaces can be deeply grooved or furrowed.

The type of surface texture found on a person's tongue will influence the amount of coating that it tends to accumulate. People whose tongues are deeply grooved or furrowed will be more likely to accumulate a bacterial laden coating, as opposed to those who have a smoother tongue surface.

It only takes a coating that has a thickness of 0.1 to 0.2 millimeters (about the same thickness as a dollar bill) to provide an environment depleted of oxygen. This type of environment is referred to as "anaerobic" and it is precisely the type of environment in which the bacteria that cause bad breath will flourish.Reducing the amount of tongue coating will reduce bad breath.

Research has shown that there is a direct correlation between the amount of coating that exists on a person's tongue and the total number of anaerobic bacteria that are present. And as you can probably guess, when the anaerobic bacterial count on a person's tongue is reduced there is usually a direct correlation, an improvement, in the odor emanating from their mouth.

Bad breath source: Bacteria that live at and below a person's gum line.

Bacteria which cause bad breath can accumulate underneath the gum line.

The type of bacteria that cause bad breath can find a suitable home in places other than just on the surface of a person's tongue. When you floss you may have noticed that at times you have dredged up a foul taste or odor. Maybe this odor is more noticeable as you floss between the teeth that are relatively further toward the back of your mouth. These locations are places where the bacteria that cause bad breath often find a cozy home. The taste and smell you get when flossing these locations is evidence of this.Periodontal pockets harboring bad breath producing bacteria.

Even in a relatively healthy mouth, bacteria can and do find anaerobic (oxygen deprived) environments in which to live underneath the gum line, both around and in between teeth. These anaerobic environments are, however, even more numerous and available in the mouths of people who have experienced periodontal disease ("gum disease").

This is because periodontal disease can cause damage to the bone that surrounds a person's teeth. This bone destruction leads to the formation of deep spaces that lie between the teeth and gums (termed "periodontal pockets"). The deep recesses of periodontal pockets can be difficult, if not impossible, to clean effectively. This makes them an ideal anaerobic environment for the types of bacteria that cause bad breath.




Bad breath: Causes and risk factors.

Conditions and circumstances that cause or place a person at risk for having halitosis.

In most cases bad breath (halitosis) is caused by the presence of oral bacteria. There can be, however, other factors that influence the odor associated with one's breath and, in fact, the quality of a person's breath will ultimately depend on a number of different variables.

The next portion of our discussion details some of these specific risk factors and conditions. When reading this information you should take notice of the fact that many of the items we list directly relate to:

  • Oral bacteria.
  • Conditions which promote the growth of oral bacteria.
  • Not cleaning, or not being able to clean, those areas where oral bacteria reside.

Later on our pages will describe in greater detail how bacteria cause mouth odors and outline methods for cleaning these bacteria away. Right now however, at this point in our discussion, just realize that anything that promotes the growth of oral bacterial will most likely heighten a person's problems with bad breath too.

How do foods cause bad breath?

Everyone knows that certain foods have a reputation for causing bad breath. Two of the most notorious ones are garlic and onions.

When we eat our digestive system breaks the food we have consumed down in to its component molecules, some of which have very unpleasant and characteristic odors. As these molecules are created they are absorbed into our circulatory system so they can subsequently be distributed throughout the remainder of our body as nourishment.

As our blood travels through our lungs some of these molecules will be released into them. As a result, as we exhale our breath will contain some of these offending molecules, thus producing breath malodor.

While this type of bad breath can be annoying or embarrassing, this is not the type of breath problem we discuss on the subsequent pages of this topic. Bad breath caused by the consumption of certain foods will resolve on its own in a day or so as your body completes the process of breaking down and utilizing, or else excreting, the offending molecules. You can control this type of breath problem simply by avoiding or minimizing your consumption of these foods.

Why is smoking a risk factor for halitosis?

You are probably familiar with people who have "smoker's breath." While even though the precise odor associated with smoking depends on a number of factors, a great part of it is directly related to the tar, nicotine, and other foul smelling substances derived from tobacco's smoke that accumulates on a person's teeth and oral soft tissues (tongue, cheeks, gums,…).

Once again, while this type of breath malodor can be a problem, this is not the precise type of bad breath we address on the pages of this topic. Short of quitting smoking there is no effective way to totally eliminate smoker's breath, although immaculate oral hygiene can help to minimize it.

Bad breath.

As a contributing risk factor, the act of smoking does have a drying effect on oral tissues. Decreased moisture in the mouth limits the washing and buffering effect of saliva on oral bacteria and their waste products, thus aggravating a person's problems with bad breath. More information about breath problems associated with dry mouth conditionsis discussed just below.

It is also known that people who smoke are at greater risk for having problems with periodontal disease ("gum disease") than people who do not smoke. Gum disease, as it relates to bad breath, is discussed in more detail below.

Why is having a dry mouth (xerostomia) a risk factor for bad breath?

Even if you don't have much of a problem with bad breath you have probably noticed that your breath is least pleasant in the morning when you first wake up. This is because during the night a person's mouth dries up somewhat, due to the human body's natural tendency to reduce salivary flow when a person sleeps. This same souring effect is sometimes noticed by teachers, lawyers, and anyone else whose mouth has become dry after having to speak for a prolonged period of time. Additionally, people who breathe through their mouth, are fasting, or else are under stress can find that they have comparatively dry mouths and therefore persistent problems with breath odors.

One explanation for this phenomenon is that the moisture found in our mouth helps to cleanse it. The presence of oral fluids encourages us to swallow. With each swallow we take we wash away bacteria, as well as the food and debris on which they feed. This same moisture also dilutes and washes away the waste products that oral bacteria produce.

Additionally, saliva is a very special form of mouth moisture. It's the body's natural mouth rinse. Beyond the washing and diluting effect that any oral moisture can provide, saliva has the added benefit that it contains compounds that can kill bacteria and buffer their waste products. So, when our mouth becomes dry, all of the benefits provided by each source of oral moisture are minimized. The net result is that the conditions for bacterial growth are enhanced while the neutralization of bacterial waste products is reduced.

Some people have chronically dry mouths. This condition is termed "xerostomia." Xerostomia can be a side effect of the medication a person is taking. Antihistamines (allergy and cold medications), antidepressants, blood pressure agents, diuretics, narcotics, or anti-anxiety medications are each known to produce xerostomia.

Another contributing factor associated with xerostomia is a person's age. It is commonplace that as people age they find that chronic mouth dryness becomes more and more of a problem. With age our salivary glands tend to work less effectively and the composition of the saliva that they produce changes too. Both of these factors create a situation where the effects of salivary cleansing and buffering are reduced.

A factor that compounds the problems associated with mouth dryness is that people who suffer from xerostomia are more at risk for having periodontal disease ("gum disease"). As discussed in our next section, periodontal disease is a causative factor for bad breath.

How does periodontal disease (gum disease) cause bad breath?

Periodontal disease, often just called "gum disease," can be the source of a person's breath problems. Ask any dentist, the odor coming from the mouth of a person with active gum disease can be so distinctive that a dentist will often correctly anticipate the presence of gum problems even before they begin their examination of the patient.

Periodontal pockets harboring bad breath producing bacteria.

Periodontal disease is the second most common (fundamental) cause of bad breath. Since periodontal disease is typically more of a problem for people over the age of 35 or so, the older we get the more likely that the source of our bad breath is related to conditions associated with the health of our gums.

Periodontal disease is a bacterial infection located in the tissues that surround a person's teeth. Advanced forms of periodontal disease typically result in serious damage to the bone that holds teeth in place. As this bone damage occurs, deep spaces form between the teeth and gums (termed "periodontal pockets"). These pockets provide an ideal location for bacteria to live in.

In many cases it is waste products coming from the bacteria that reside in these periodontal pockets, pockets which are often so deep that a person cannot effectively cleanse them, that is the cause of a person's bad breath. In addition, researchers have found that the amount of coating (as measured by weight) that is present on the tongues of people with periodontitis is greater than those in control groups. They have also found that the level of volitile sulfur compounds coming from this coating is four times greater than in people who do not have periodontal disease.

Source of post-nasal drip.

How can sinus conditions promote bad breath?

Sinus conditions can have an effect on the quality of a person's breath. Upper respiratory infections and allergies can create postnasal drip that deposits onto the back portion of a person's tongue (by way of the oral-nasal pathway found in the area of a person's soft palate). This discharge often has a foul taste and smell. What's worse, oral bacteria will feed upon this discharge and create their own smelly waste products thus adding to the problems the person is having with bad breath.

As a compounding factor, people with sinus conditions will often have stuffed up noses and therefore will have a need to breathe through their mouth. The drying effect of mouth breathing can create an environment that promotes bad breath. Additionally, sinus sufferers are likely to be taking antihistamines, a type of medicine that is known to create mouth dryness.

Can untreated medical conditions cause bad breath?

Although the most common source of breath odors is related to the accumulation of bacteria in the mouth, certain medical conditions can be the cause of a person's breath odors. If a person's bad breath persists after they have consulted with their dentist and tried the usual simple solutions, then a consultation with a medical doctor may be indicated. Your doctor will of course know what types of conditions to look for but, in general, they will look for problems associated with the respiratory (pulmonary or bronchial), hepatic (liver), renal (kidney), and gastrointestinal (stomach and intestine) systems.

X-ray of a decayed tooth with an abscess.

What types of dental conditions can cause bad breath?

There can be some types of untreated dental pathology that can contribute the problems a person is having with their breath. Any active infections in a person's mouth, such as those associated with abscessed teeth or a partially erupted wisdom tooth, can cause bad breath. Teeth having extensive untreated decay can trap enough debris and bacteria that they become the source of foul odors. Your dentist can identify and treat these problem dental conditions if they exist.

Can bad breath be caused by dentures?

Dentures (complete dentures, full dentures, partial dentures, etc…) can have a big influence on the quality of a person's breath. If you have dentures try this test to see if they might be the source of your breath malodor:

Remove your dentures and place them in a baggie. Seal the baggie shut and let it sit for about four or five minutes. Now, crack the baggie open and take a whiff. For better or worse, the odor you smell is representative of what your breath smells like to others.

While the most common cause of breath malodor is that caused by the accumulation of bacteria either on a person's tongue or on and around their teeth (periodontal disease), bacteria can and do accumulate on the surface of dentures and this can be the source of bad breath for some. 


Curing bad breath: How dentists treat bad breath.

What approach makes sense for treating halitosis?

Since the most common cause of bad breath is the odorous waste products (volatile sulfur compounds) created by anaerobic oral bacteria, the most important message a dentist can convey to their patients is that they must clean their mouth in a manner which helps to:

  • Minimize the amount of food available to these bacteria.
  • Minimize the total number of these bacteria that exist.
  • Minimize the availability of the types of environments in which these bacteria prefer to live.
  • Make any environment in which these bacteria do live less hospitable.

On a second front the patient can:

  • Use products that help to neutralize volatile sulfur compounds.

Minimize the food supply available to the bacteria that cause halitosis.

The volatile sulfur compounds that cause bad breath are actually waste byproducts created by anaerobic oral bacteria when they digest proteins. This would imply that those persons who maintain a vegetarian diet (a diet composed mostly of fruits and vegetables) should have fewer breath problems, as compared to people who have diets that are high in protein rich foods such as meat.

It is important for a person to clean their mouth thoroughly after eating, and especially after eating foods that are high in protein content. This is because even after we have finished a meal minute particles of food still remain in our mouth. Much of this food debris ends up lodged between our teeth and incorporated into the coating found on the posterior part of our tongue. Since these are precisely the same locations in which the anaerobic bacteria that cause bad breath live, if a person does not clean their mouth thoroughly a food supply is provided for these bacteria over an extended period of time.

How cleaning your teeth and gums can help to cure bad breath.

Bacteria which cause bad breath can accumulate underneath the gum line.

Some of the oral bacteria that create the waste products that are responsible for causing bad breath live in the dental plaque that accumulates on and around a person's teeth, both at and below the gum line. Thorough brushing and flossing technique is needed so to effectively remove this plaque and also any food debris that is left in the person's mouth after eating that could serve as a food supply by these bacteria.

Take notice of the fact that we have used the term "brushing and flossing" here. It is not realistic to think that a mouth odor emanating from the areas around the teeth can be diminished unless flossing is an integral part of a person's daily cleaning routine.

Make an appointment with your dentist.

If your bad breath problem persists, even after a period of following all of the tips and suggestions we make on this topic's pages, you should schedule an examination and cleaning appointment with your dentist so you can discuss your problems with them. During this visit the following can be accomplished:Tartar is removed during dental cleanings.

1) Sometimes effective brushing and flossing technique can be difficult to learn. After examining you your dentist can provide you with instructions, tips, and pointers that will be helpful for your specific situation.

2) Tartar (dental calculus) accumulation can interfere with effective brushing and flossing. Your dental cleaning will remove this debris from your teeth.Periodontal pockets harboring bad breath producing bacteria.

3) A part of your dentist's examination will include a periodontal evaluation. Periodontal disease ("gum disease") can cause significant damage to your gums and the bone that lies underneath them. This damage can result in the creation of deep spaces between your teeth and gums called "periodontal pockets." These pockets are often impossible for you to clean effectively and therefore make an ideal environment for the bacteria that cause bad breath to live. If a periodontal problem is found your dentist can outline the treatment that will be needed to get this condition under control.

4) During your examination your dentist will check to see if there are any untreated dental conditions that could be causing or aggravating your breath problems.

5) Your dentist can help to determine if it is unlikely that oral conditions are the cause of your bad breath and that a referral to a doctor for a medical evaluation is indicated.





Treating and preventing halitosis: A brief overview.

Curing your halitosis might be much simpler than you expect.

Research has shown that most cases of bad breath (over of 85%) can be directly attributed to factors originating in a person's mouth. Once a person understands this fact and a few basic details associated with it, the treatment, as well as the prevention, of their breath malodor problem can become a pretty straightforward affair.

Bad breath is caused by oral bacteria.

Every human mouth harbors a number of different types of bacteria. One of these is the "anaerobic" bacteria. The term anaerobic refers to the fact that these bacteria prefer to live in environments that are devoid of oxygen.

Due to this characteristic anaerobic bacteria are typically found in the greatest numbers in the hidden recesses of the mouth such as the deep grooves of the tongue, the spaces between teeth, and those spaces (pockets) that lie between teeth and their surrounding gum tissue. They are also typically found in thick debris films such as the one that often covers the posterior portion of a person's tongue.

Breath malodor is due to the presence of volatile sulfur compounds (VSC's).

When the anaerobic bacteria that live in our mouth consume and digest their meals (which includes food particles and debris leftover from the meals that we have consumed) they, in turn, create foul smelling byproducts called volatile sulfur compounds (VSC's). When we exhale these VSC's (some of which are the very same compounds that are responsible for the smell of sweaty feet, decaying meat and rotten eggs) they become incorporated into our breath and taint its quality.

We present more detailed information about the causes of and treatments for halitosis on the pages of our topic "Bad Breath." ]

What is the best treatment for bad breath?

Just knowing the few facts mentioned above should make it obvious as to which approaches are best for treating bad breath. And in reality, for most people armed with these facts, the treatment of their halitosis should be a fairly straightforward affair and one that can be mounted on a few different fronts. The remainder of this page lists the typical solutions dental professionals use when treating their patient's breath problems.The posterior portion of the tongue is usually the region that harbors the bacteria that cause bad breath.

1) Tongue cleaning.

Treatment rationale: The first step every person should always take when making an attempt to improve the quality of their breath is to initiate proper tongue cleaning. Large numbers of anaerobic bacteria (the type of bacteria that produce the VCS's that cause bad breath) typically reside on the back-most portion of the topside of a breath sufferer's tongue. If these bacteria are removed, or at least a significant number of them, a person will experience an improvement in the quality of their breath. In many instances the initiation of an effective tongue-cleaning regimen will be the only treatment that is needed.

A person can clean their tongue by either brushing or scraping its top, rear-most surface. We discuss tongue cleaning and its importance in treating bad breath in greater detail on our "Tongue Cleaning" page.

2) Allow your dentist to perform a dental cleaning and periodontal health evaluation.

Dental cleanings can help to cleanse those areas that harbor the bacteria that cause halitosis.

Treatment rationale: The bacteria that cause bad breath can also be harbored in the spaces (pockets) that lie between the teeth and gums. These recesses can be difficult to access and adequately cleanse, especially in those cases where debris (tartar) has formed in them. Allowing your dentist to perform routine dental cleanings on the periodic basis that they recommend can be vitally important in maintaining the health of these regions and minimizing the number of bacteria that find refuge in them. It also provides your dentist with an opportunity to evaluate the overall health of your gums (periodontal health) and to determine if it is possible that gum disease and the bacteria that cause it play a significant role in the creation of your breath malodor. You can find more information about the link between periodontal disease (gum disease) and bad breath on this page.

3) Minimize the food supply available to oral anaerobic bacteria.

Treatment rationale: The smelly volatile sulfur compounds that are the cause of bad breath are actually the metabolites that are produced by anaerobic bacteria as they digest proteins. This fact would suggest that by reducing the amount of protein-rich food remnants that are available to these bacteria a person could improve the quality of their breath.

A person could choose to limit their intake of protein-rich foods and this might help to alleviate their breath problems but, of course, the need to maintain a healthy diet is important. A better focus would be to take those steps that help to insure more effective oral cleansing (brushing, flossing, tongue scraping and rinsing) is performed, especially after eating meals or snacks that are rich in protein. I also might be prudent to avoid protein-rich foods during those time periods when thorough oral cleaning will not be a possibility.

4) Keep your mouth well hydrated.

Treatment rationale: Maintaining adequate oral moisture can play a valuable role in treating halitosis. It can serve to wash away the bacteria that cause bad breath, minimize the amount of food that is available to them as well as dilute and wash away the smelly VCS's that they produce. Evidence that an absence of oral moisture can play a role in causing bad breath is easy to find. "morning breath" is caused by the dry-mouth conditions that exist due to the reduction in salivary flow that takes place when we sleep. People who give lectures or have reason to talk at length may notice that the quality of their breath becomes offensive after extended periods of speaking due to the drying effect it has on their mouth.

Maintaining proper oral moisture should be accomplished using a number of different methods. A person should drink plenty of water each day. This will obviously provide an immediate benefit but doing so will also help to insure adequate body hydration so proper salivary output is produced. Rinsing with water often will help to hydrate oral tissues as well as dislodge, dilute and remove bacteria, food debris and VSC's. Oral moisture can also be maximized by stimulating salivary flow by way of chewing on an item such as sugar-free chewing gum or a sugar-free mint.

5) Use a mouthwash.

Treatment rationale: Mouthwashes that have antibacterial properties or else the capability to neutralize volatile sulfur compounds (VSC's) can contribute to the treatment of bad breath. A mouth rinse on its own, however, cannot be expected to be an effective treatment for halitosis. Any mouthwash must be utilized in conjunction with a regimen of improved tongue cleaning, tooth brushingand flossing.


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