Halitosis: Causes, Symptoms, and Treatments

What is Halitosis?

Halitosis, more commonly known as bad breath, can cause a lot of anxiety. We spend a lot of money on breath mints, gum, mouthwash, and other items in the effort to combat bad breath, but these temporary fixes do not address the root of the problem.

Practicing good oral hygiene by brushing your teeth at least twice per day, and flossing at least once per day, is usually enough to combat bad breath. However, if your halitosis persists you should consider booking a dentist appointment.

Halitosis Symptoms

The main symptom of halitosis is an unpleasant odour that lingers on your beath. To determine if you have bad breath you can smell your breath for yourself, or ask a close friend or family member to assess how odorous your breath is.

Halitosis Causes

Halitosis is a multifaceted condition that can be caused by a variety of factors. Some cases of halitosis are temporary and result from eating odorous foods. However, according to the Canadian Dental Association as many as 85% of halitosis cases are caused by oral cavities.

Other causes of halitosis include:

Oral Pathology

Oral pathology refers to diseases and other problems originating in your mouth and jawbone. Oral pathology conditions that cause halitosis can include:

Food remnants and epithelial cells forming a coating that sticks to your tongue. This coating can be difficult to remove, and as a result, the food particles degrade and cause unpleasant odours.
Reduced salivary flow during sleep, which causes odours.
Poor oral hygiene, resulting in food and other particulates being left on the teeth and gums. This results in halitosis, plaque and tartar buildup, and gum diseases.
Insufficient denture cleaning, which allows food and other particles to build up on the surface of your dentures, where they break down and cause odours.
Gum diseases, including gingivitis and periodontitis.
Stomatitis (inflammation and soreness in the mouth), tooth extraction wounds, crowded teeth, recurrent oral ulcers, pericoronitis (swollen tissue around the wisdom teeth), and implantitis (swollen tissue around dental implants).

Gastrointestinal Pathology

Halitosis can be caused by a variety of gastrointestinal issues, including:

Intestinal obstructions
Stomach infections. Infections that are the result of H. pylori bacteria may also cause halitosis, but there is currently no research to support a strong correlation.

ENT (Ear, Nose, and Throat) and Pulmonary Pathology

ENT and pulmonary pathology refer to diseases of the ears, nose, throat and pulmonary systems. According to the Canadian Dental Association diseases and other problems with these systems account for as many as 10% of all halitosis cases. These halitosis cases can result from:

Acute tonsillitis. The same bacteria that causes tonsillitis can cause halitosis.
Post-nasal drip, foreign bodies in the nasal passage, and atrophic rhinitis. Malfunctioning mucus glands can contribute to the development of halitosis.
Acute bacterial rhinosinusitis, a respiratory infection caused by bacteria.
Bronchiectasis, lung abscesses, and endobronchial chronic disorders.

Metabolic Disorders

Halitosis can be a side effect of some metabolic disorders, including:

Diabetes mellitus and ketoacidosis (both of which are types of diabetes), which can produce a sweet-smelling odour.
Trimethylaminuria, a condition that prevents the body from breaking down trimethylamine and causes the breath to take on a fishy odour.
Kidney failure, and cirrhosis of the liver.

Hepathology and Endocrinology

Halitosis can be a side effect of liver diseases and problems.

Tyrosinemia, which is a hereditary disease, can cause halitosis with a cabbage-like odour.
Reduced liver function can also cause your breath to take on a sweet odour similar to excrement.

Certain Medications

Halitosis can be a side effect of some medications.

Medications that cause dry mouth can lead to halitosis.
Bisphosphonates, a class of medications used to treat osteoporosis-related bone loss, can cause halitosis.

Halitosis Treatments

Though halitosis can be caused by a wide variety of factors there are a number of ways to treat or manage the condition both at home and at the dentist’s office.

Treating Halitosis at Home

Depending on the cause of your halitosis you may be able to treat it effectively on your own. Home treatments for halitosis can include:

Practising good oral hygiene. Ensuring you are flossing your teeth at least once per day, and brushing at least twice per day with a fluoride toothpaste, to ensure that all food particles, plaque, and other particulates are removed from your teeth and gums. You may also want to select a toothpaste that contains zinc or triclosan.
Adding tongue scraping to your normal oral hygiene routine, so that you can remove food and other particles from your tongue before they cause unpleasant odours.
Watching what you are eating and drinking, and avoiding odorous foods such as onions, and garlic.
Drinking lots of water to ensure your mouth stays hydrated.
Rinsing your mouth with an antiseptic mouthwash at least once per day.
Skip the after-dinner mints and choose sugarless gum instead. The bacteria in our mouths love sugar, which they use to produce acid. This, in turn, can cause a variety of conditions including halitosis, gum diseases, and tooth decay.
Staying away from tobacco. Smoking causes a large variety of serious health problems such as cancer. It can also cause halitosis and damage your gums.

Treating Halitosis at the Dentist’s Office

If you are finding that your halitosis persists even after you have tried at home remedies it is time to make an appointment with both your dentist and your doctor.

Halitosis can be caused by cavities, gum disease, and a variety of other medical problems, and may be a sign that there is a more serious problem afoot. Your dentist and your doctor are better equipped to help you diagnose the root causes of your halitosis, and will be able to rule out any serious problems that may be contributing factors.