Bad breath (halitosis) is a condition many people experience at some point in life; most causes are found in the mouth (Quirynen et al., 2019). This article is meant to inform patients from around Bahçelievler; an examination is needed for personal diagnosis.

Common causes

• Coating on the tongue: Bacteria can produce volatile sulfur compounds (Tonzetich, 1971).
• Gum disease and calculus
• Decay, ill-fitting fillings or dentures and inadequate interdental cleaning
• Dry mouth and smoking
• Causes outside the mouth (require a doctor’s evaluation)

What can be done?

Regular brushing, floss/interdental cleaning and tongue cleaning are the basic steps. If there is calculus and gum inflammation, professional cleaning and periodontal treatment are needed. The place of mouthwashes is determined by the dentist’s advice; if a cause outside the mouth is suspected, referral to the relevant specialist is made.

The source of odor is mostly in the mouth

In patients presenting with bad breath, most causes are in the mouth: tongue coating, gum disease, calculus, decay and inadequate interdental cleaning are the main culprits (Quirynen et al., 2019). When bacteria break down proteins they form volatile sulfur compounds, which are the basis of the odor (Tonzetich, 1971).

The importance of tongue cleaning

The coating at the back of the tongue is a suitable environment for bacteria. Gently cleaning from back to front with a tongue cleaner or soft brush can be part of daily care; however, pressing too hard can cause gag reflex and tissue irritation. Tongue cleaning should be considered together with toothbrushing and interdental cleaning.

Relationship with gum disease

Inflamed gum pockets can increase odor formation. For this reason a periodontal examination is important in people with persistent bad breath (see bleeding gums and dental scaling). Calculus removal and, if needed, deep cleaning contribute to managing the complaint in many cases; still, results vary from person to person.

Causes outside the mouth and referral

Rarely, the cause of the odor can be outside the mouth (nose, throat or systemic causes). If the complaint persists despite oral care and the dentist finds no obvious cause in the mouth, referral to the relevant specialty is made. If you do not notice the odor yourself but are worried, this should be evaluated separately, because a person’s perception does not always match measurable odor (Quirynen et al., 2019).

Frequently asked questions

Can’t I notice my own bad breath?

People find it hard to perceive their own odor; someone you trust or a dentist’s evaluation can help.

Are gum or mints a permanent solution?

They give temporary masking; treatment aimed at the cause is needed.

Which specialist should I see?

First a dentist/periodontist; if needed you will be referred to the relevant medical specialty.

Does bad breath come from my stomach?

In most cases the source is in the mouth; causes outside the mouth are less common and are evaluated separately by a doctor.

Does going hungry affect bad breath?

Reduced saliva and eating patterns can temporarily affect the odor.

Is mouthwash alone a solution?

No; without removing the cause, mouthwash has only a temporary effect.

For your gum health you can book an appointment or browse the other articles in our Dental Health section. You can reach us from Bahçelievler, Bakırköy, Güngören, Haznedar, İlkyuva and Basınsitesi.

References

• Tonzetich, J. (1971). Direct gas chromatographic analysis of sulphur compounds in mouth air in man. Archives of Oral Biology, 16(6), 587–597. PubMed ↗
• Quirynen, M., Laleman, I., De Geest, S., De Hous, C., Dekeyser, C., & Teughels, W. (2019). Breath malodor (Chapter 49). In M. G. Newman, H. H. Takei, P. R. Klokkevold, & F. A. Carranza (Eds.), Newman and Carranza’s clinical periodontology (13th ed., pp. 521–530). Elsevier.

Note: Book chapter references follow the page ranges of the publisher’s edition; article links open the matching PubMed record.

This article is for information only and is not medical advice. See your dentist for diagnosis and treatment; no outcome is guaranteed.

This page was reviewed by Dr. Dt. Mehmet Fuat Bozaba, periodontist.