Halitosis: Causes, Treatment, and Prevention

What is Halitosis?

About 50% of adults have bad breath at some point in their lives.¹ The odor typically resolves with oral health changes like brushing and using mouthwash after eating. 

Halitosis (chronic bad breath) is an oral health problem that causes persistent bad breath. It is different from the “morning breath” many people experience temporarily.  

Daily brushing, chewing gum, mints, and mouthwash typically won’t improve the odor halitosis causes. This condition can also indicate a more serious problem like cavities or gum disease. 

If you have bad breath, try improving your dental hygiene and the foods you eat. If these lifestyle changes don’t help, you may have halitosis. Schedule an appointment with your dentist to determine the root cause.

What Causes Halitosis?

If nothing eliminates your bad breath, it may be an indication of something else happening in your body.

Mouth, Nose, and Throat Infections

Nose, sinus, and throat infections can lead to postnasal drip, causing bad breath. When you’re fighting a sinus infection, your body may produce more mucus. Bacteria feed on mucus, making your mouth odor worse.

Oral Health Issues

Cavities, malocclusion, and periodontal disease (advanced gum disease) can contribute to bad breath. Holes in teeth and deep pockets between the gums give bad breath-causing bacteria a place to hide. 

Bacteria is challenging to remove from deep periodontal pockets. Normal toothbrushes and floss aren’t effective at removing plaque from these areas. 

Instead, you need to visit a general dentist or periodontist for a professional deep cleaning. This treatment helps prevent gum disease from progressing.  

Dry Mouth

If you have a dry mouth, you don’t have enough saliva to maintain your dental health, potentially causing halitosis. Health conditions, medications, tobacco, alcohol, caffeine, and mouth breathing can cause dry mouth. 

Saliva is an integral part of your dental health. Saliva contains disease-fighting substances that protect against infections and cavities. It also helps break down food and rinse out any leftover food particles. 

Side Effects of Tobacco Products

Tobacco products significantly worsen bad breath. They have a strong odor that lingers in your mouth. Smokers are also more likely to develop dry mouth and gum disease than nonsmokers.

Poor Oral Hygiene

If you don’t have good dental hygiene, you are more vulnerable to bad breath, which can lead to bacteria buildup, cavities, gum disease, and other infections.

Brushing your teeth twice a day and flossing daily helps remove bad breath-causing bacteria. Waterpiks can also improve oral health.

Other Chronic Conditions

Sometimes halitosis is a sign of another health problem. For example, conditions like diabetes, liver disease, kidney disease, and gastric reflux can contribute to chronic bad breath.

Other Causes of Bad Breath 

Other causes of bad breath not necessarily linked to halitosis include: 

Certain Foods

Diet is a significant factor that contributes to breath and overall dental health. The foods you eat absorb into your bloodstream, and some can leave a bad odor in your mouth. Onions and garlic, for example, can lead to bad breath.

Odor-Causing Bacteria

Odor-causing bacteria on the tongue can react with amino acids to produce volatile sulfur compounds. These sulfur compounds can be particularly smelly, causing bad breath.

Other Symptoms of Bad Breath 

The main symptom of halitosis is bad breath. However, chronic bad breath can also cause a bad taste in the mouth. 

Symptoms vary depending on what is causing the halitosis. If you have poor dental hygiene, you might develop a toothache, indicating a cavity. If a recent infection is causing your bad breath, additional symptoms may include a runny nose or other flu-like symptoms.

Bad breath is often worse in the morning. It can also seem worse after smoking, drinking coffee, or eating certain foods like garlic.

How to Manage and Treat Halitosis

Getting a diagnosis and treatment recommendations from a dentist is the first step in eliminating and treating halitosis.

Diagnosis

If you notice persistent bad breath, first pay attention to the foods you eat. You should also improve your dental hygiene if needed. This means brushing twice a day with fluoride toothpaste, flossing at least once a day, and rinsing with mouthwash. If your bad breath persists, see a dentist.

Dentists diagnose halitosis by reviewing your medical history and performing a mouth exam. The dentist will check your entire mouth for any signs of infection. If the dentist cannot determine the cause of the bad breath, they will refer you to a specialist.

Professional Treatments

Below are four causes of halitosis and their treatments: 

1. Periodontal Disease

Advanced gum disease can be treated by your dentist or another oral specialist, like a periodontist. Periodontal cleanings remove tartar, plaque, and bacteria above and below the gum line. 

2. Poor Oral Hygiene

If poor dental care is causing halitosis, your dentist will also recommend ways to maintain good oral hygiene and reduce bad breath at home. 

3. Plaque Buildup

If you have extensive plaque buildup, your dentist or periodontist may suggest an antibacterial mouthwash. You should also brush your tongue daily to remove bacteria. 

4. Health Conditions

Some underlying medical conditions can cause halitosis. Diagnosis and treatment of these conditions may be the only cure for your bad breath. For example, having a doctor treat gastroesophageal reflux disease (GERD) can stop oral malodor and clear up your halitosis.

Home Remedies

You can try several home remedies for bad breath. These include:

• Practicing good dental hygiene — this includes brushing your teeth twice a day with fluoride toothpaste, brushing your tongue, flossing daily, and rinsing with mouthwash that contains zinc and chlorhexidine.¹
• Eating parsley — chew on parsley leaves after a meal. Parsley, which contains chlorophyll, may mask the odor of bad breath temporarily.²
• Drinking pineapple juice — anecdotal evidence suggests that drinking pineapple juice after a meal can help fight unpleasant oral odors. Just make sure you rinse your mouth afterward.³
• Drinking water — dry mouth is one of the causes of halitosis, so staying hydrated can help eliminate bad breath by combatting a dry mouth.⁴
• Using homemade mouthwash — homemade mouthwash that contains baking soda or vinegar helps kill bacteria in the mouth, potentially reducing bad breath.⁵
• Eating yogurt — the healthy bacteria in yogurt, particularly Greek yogurt, can eliminate harmful bacteria in the mouth and reduce bad breath.⁶
• Drinking milk — milk can reduce the “garlicky” smell of breath.⁷
• Drinking green tea — green tea has disinfectant and deodorizing properties that can improve bad breath.⁸
• Taking zinc — zinc salts (commonly found in mouthwash) help fight bad breath.⁹
• Taking vitamin C — fruits like oranges and strawberries are high in vitamin C and help improve saliva production, reducing dry mouth and bad breath.¹⁰

These remedies are not proven to work for everyone. If bad breath persists, see your dentist.

Preventing Bad Breath

You can prevent bad breath odor by following these tips: 

Practice Good Oral Hygiene

This includes:

• Brushing your teeth twice a day (with fluoride) and flossing at least once a day. Dentists recommend flossing before you brush to loosen any debris between your teeth. 
• Brushing your whole mouth, tongue, cheeks, and the roof of the mouth. Also, gently brush or scrape your tongue. Your tongue harbors bacteria.
• Rinsing with mouthwash after you brush and floss your teeth (before bed). 
• If you have dentures, a retainer, or a mouth guard, brush it every night before placing it in your mouth.
• Quit smoking to lower your risk of gum disease and prevent dry mouth.

Eat a Healthy Diet

Eating healthy foods that stimulate saliva production is an effective way to prevent bad breath. Carrots and apples are two examples. They require intense chewing, which increases saliva content. This, in turn, can help prevent bad breath and dry mouth.

You can also chew sugarless gum or suck on hard candy to keep your saliva flowing. If you still have dry mouth, talk to your dentist. They may give you artificial saliva.

Visit Your Dentist Regularly

Visit your dentist twice a year for a professional teeth cleaning and dental exam. These visits are essential for preventing oral health conditions and treating any issues early.