Bad Breath Halitosis

Authored by Dr Mary Harding, 06 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Helen Huins, 06 Jul 2017

Halitosis is the medical name for bad breath. It describes an unpleasant smell in the breath which is detectable by other people.

Bad breath is something we're probably all a little paranoid about. It's dead embarrassing and we all know we probably won't necessarily be aware of it ourselves, and our friends are likely to be too kind to mention it. So we find ourselves breathing into our cupped hands and having a sniff to check.

How will I know if I have it?

Unfortunately the breathing-into-your-hand technique may not work awfully well as we get used to our own odours so can't really smell them. Like the way that people with pets aren't aware their house reeks of cat or dog. Or the way you can't smell your own perfume on yourself. So you may have to rely on other people telling you. You could ask a close friend or family member if they have noticed anything. Or ask your dentist when you have your regular check-up. Your doctor would have a sniff for you if asked about it.

What is normal?

It's perfectly normal to have dog breath in the mornings. Your saliva stagnates in your mouth overnight, but once you are salivating again normally with breakfast, this improves. We all know our breath reeks after eating lots of garlic in particular, but also if lots of onions, spices or alcohol have gone down the hatch. Smokers tend to have an ashtray type of breath. But outside of these situations, if you have bad breath, there may be a problem causing it.

Read more about the symptom of bad breath, how common it is, and the types that exist.

What is the reason for bad breath?

Most of the time, it comes from a problem in your mouth. Which stands to reason, given that's the last place your breath came from. And it's usually down to a problem with your teeth and your oral hygiene regime. It may be due to gum or teeth problems, food particles festering between your teeth, or germs on your tongue. Occasionally it's from a problem at the back of your mouth in your tonsils. (Often parents are aware their kids have tonsillitis because of the way their breath stinks.)

Learn more about problems in the mouth which cause bad breath.

In some people it can come from other sources. Problems in the nose or reflux of acid from the stomach may cause bad breath. Some medicines may cause it, as may certain diets. Some illnesses can cause typical odours in the breath. Learn more about the causes of bad breath.

Will I need any tests?

Not usually. Your doctor or dentist may establish if your bad breath is coming from your nose or mouth, by asking you to breathe out of each in turn. A thorough dental examination will check for the majority of causes of bad breath, and then the dentist will be able to advise accordingly. Only if no cause is found will you need further tests. This might include a camera examination of your nose or gullet and stomach, or tests for acid reflux.

Read more about investigating bad breath.

How can I smell sweet again?

The most important way to sort out bad breath is to take a good look at your teeth-cleaning routines. It may be worth visiting your dental hygienist to get some advice. You should be cleaning your teeth for at least two minutes twice a day, ideally with an electric toothbrush. You should also clean your tongue each day. Clean between your teeth each day with dental floss or interdental brushes. Consider using a mouth wash once or twice a day.

If you smoke, consider quitting. Have a think about the things in your diet which might be making it worse. If there is a medical cause, such as acid reflux, your doctor should be able to help you with that.

Discover more about the treatment of bad breath.

How can I avoid having bad breath?

Good oral hygiene usually prevents bad breath. Essentially this just means brushing your teeth regularly and effectively. Stopping smoking, if you are a smoker, also helps.

Learn about good oral hygiene and preventing bad breath.

Further reading and references

  • Kapoor U, Sharma G, Juneja M, et al; Halitosis: Current concepts on etiology, diagnosis and management. Eur J Dent. 2016 Apr-Jun10(2):292-300. doi: 10.4103/1305-7456.178294.

  • Halitosis; NICE CKS, November 2014 (UK access only)

  • Bollen CM, Beikler T; Halitosis: the multidisciplinary approach. Int J Oral Sci. 2012 Jun4(2):55-63.

  • Yaacob M, Worthington HV, Deacon SA, et al; Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev. 2014 Jun 17(6):CD002281. doi: 10.1002/14651858.CD002281.pub3.

  • Poklepovic T, Worthington HV, Johnson TM, et al; Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev. 2013 Dec 18(12):CD009857. doi: 10.1002/14651858.CD009857.pub2.

  • Kuo YW, Yen M, Fetzer S, et al; Toothbrushing versus toothbrushing plus tongue cleaning in reducing halitosis and tongue coating: a systematic review and meta-analysis. Nurs Res. 2013 Nov-Dec62(6):422-9. doi: 10.1097/NNR.0b013e3182a53b3a.

  • Porter SR, Scully C; Oral malodour (halitosis). BMJ. 2006 Sep 23333(7569):632-5.

  • Fedorowicz Z, Aljufairi H, Nasser M, et al; Mouthrinses for the treatment of halitosis. Cochrane Database Syst Rev. 2008 Oct 8(4):CD006701.

  • Phillips IR, Shephard EA; Trimethylaminuria, University of Washington, 2007 (updated 2011)

  • Reidy JT, McHugh EE, Stassen LF; A review of the role of alcohol in the pathogenesis of oral cancer and the link between alcohol-containing mouthrinses and oral cancer. J Ir Dent Assoc. 2011 Aug-Sep57(4):200-2.

Hi,I wasn't sure where to put this duscussion.I've had bad breath (especially horrendous morning breath) for as long as I can remember. Probably for a good 10 years or so? (I'm 29)I've also...

mike666
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