Halitosis (Bad Breath)

halitosisHalitosis is a condition where a person suffers from oral malodor or bad breath. It reduces a person’s self confidence and can cause embarrassment to the sufferer while communicating with other people. As a result, the affected person avoids social interactions and could be psychologically affected.

Halitosis or bad breath is caused by diseases affecting the mouth and sometimes nose or throat. Bacteria present in the mouth act on food particles, saliva, cells or blood in the mouth to produce halitosis. Some causes of halitosis include:-

► Poor oral hygiene: Poor oral hygiene leads to accumulation of food and plaque in the mouth. This result in inflammation of gums called gingivitis and of the tissues surrounding the teeth called periodontitis. Both gingivitis and periodontitis can cause halitosis. A particular type of gingivitis called Vincent’s disease or trench mouth causes very bad halitosis. Besides, dental caries also lead to oral malodor.

► Dry mouth or Xerostomia: Dryness of mouth could occur in various conditions like Sjogren’s syndrome.

► Mouth ulcers: Bacteria can grow on the tissue debris and blood of mouth ulcers and cause bad breath.

► Dentures: Dentures may increase tongue coat deposits and lead to halitosis.

► Morning halitosis: Halitosis that occurs when one wakes up from sleep is called “morning halitosis.” This could occur due to a nose or throat infection or due to hot, dry surroundings.

► Food and addictions: Foods like garlic, onions and spices result in transient bad breath. Tobacco, alcohol and betel nut could also cause halitosis.

► Respiratory tract infections: Infections of the upper respiratory tract like rhinitis, sinusitis and tonsillitis as well as lung infections like bronchiectasis can result in halitosis.

► Cancer: Cancer of the mouth as well as of the lungs can lead to bad breath.

► Gastroesophageal reflux disease: In gastroesophageal reflux disease, the stomach contents move back into the esophagus and damage the lining of the esophagus. Bacteria grow on these damaged portions and cause halitosis.

► Other conditions: Conditions like fever, diabetes, liver and kidney failure result in halitosis.


Halitosis is diagnosed by history and examination. Improving oral hygiene often helps to cure the condition.

Though some tests like the organoleptic procedure, gas chromatography (GC) and sulphide monitoring are available to test what the malodor is due to, they are expensive and usually not practical to be carried out.

Some patients suffer from halitophobia. These patients have the delusion that they suffer from bad breath when it is not actually present. They get obsessed with cleaning their mouth repeatedly with mouthwashes and keep using chewing gums and mints. They also try to keep their distance from others and avoid social interactions. These patients require psychological support.

-Dr.Bhavani Sagar Surampally


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