Halitosis: what it is, possible causes, symptoms, types, what to do and remedies

Halitosis: what it is, possible causes, symptoms, types, what to do and remedies

Bad breath or bad breath is a very common condition and often causes discomfort in both adults and children. However, even if its main cause lies in poor oral hygiene, in most cases, some specific situations can hide underlying conditions that must be eliminated as soon as possible, which is why it is important to learn to recognize and differentiate them.

Fortunately, it is a disorder that can be treated. Then find out the causes and remedies for bad breath.

Halitosis or bad breath: what is it?

Halitosis, commonly known as bad breath, is a condition in which the breath gives off an unpleasant odor. It can be temporary or chronic and create a certain embarrassment for those who suffer from it, especially on a social level.

It is a condition described since ancient times because it could even be considered a possible cause of divorce for a couple. It is a frequent reason for medical consultation because it affects communication and interpersonal relationships.

The prevalence is not known, but some studies estimate it at 30-50% among the reasons for presentation to the dentist, in the European Union as well as in the United States.

In most cases, it occurs due to inadequate oral hygiene, but it can have other origins that still need to be investigated. Usually, with treatment of the cause, the symptom disappears.

Halitosis: causes

The causes of bad breath or bad breath can vary, but are often associated with poor oral hygiene or dental problems, such as tooth decay. Therefore, bad breath can be caused by:

  • Bacterial plaque and tooth decay: both aspects that can be the cause of bad breath. Bacteria that accumulate in the mouth can produce chemical compounds that cause the unpleasant odor.
  • Gum disease: it can be determined by gum diseases such as gingivitis or periodontitis. These conditions can cause inflammation and infection of the gum tissues, producing unpleasant odors.
  • White tongue: A tongue covered in a whitish layer can retain bacteria and food debris that contribute to bad breath.
  • Oral infections: Infections such as those of the maxillary sinus, tonsils or in the oral cavity can cause bad breath.
  • Dry mouth: Reduced saliva production can cause bad breath. Saliva plays an important role in washing out bacteria and neutralizing acids in the mouth.
  • Indigestion: Certain gastrointestinal conditions, such as acid reflux or chronic heartburn, can contribute to bad breath.
  • Diet: Certain foods, such as garlic, onions, or strong spices, can temporarily cause bad breath due to odorous compounds being metabolized and released into the bloodstream. But even a regime in which large amounts of protein and excess sugar predominate favors bad breath, as do diets based on a low carbohydrate content (typical smell of metabolic ketosis).
  • Smoking: Bad breath is just one of the symptoms of tobacco. Teeth can also become stained and there is a higher risk of gum disease and tartar deposits. At the same time, tobacco can affect the perception of smell, which is why smokers may often be unaware of the smell on their breath.
  • Medications: Some components of chemotherapy, some tranquilizers, and vitamin supplements can increase the risk of bad breath. Furthermore, antihistamines, antihypertensives and antibiotics dry out the oral mucosa, favoring the appearance of bad odours.
  • Deficiency of some vitamins – unpleasant odor can also appear against the background of diseases caused by a lack of nutrients. For example, vitamin C deficiency causes gingivitis and vitamin A deficiency can lead to the formation of dental tartar.

Importantly, bad breath can also be a sign of underlying medical conditions, such as respiratory infections, diabetes, liver or kidney problems. So, if bad breath persists despite good oral hygiene, a visit to the dentist or doctor would be necessary to rule out other potential causes.

To combat bad breath, it’s important to maintain good oral hygiene, which includes brushing your teeth at least twice a day, flossing your teeth, and using mouthwashes. It is also advisable to have regular dental checkups and to eat a healthy and balanced diet. In some cases, specific treatment of the underlying dental or gum conditions may be needed to resolve the bad breath.

Remedies for bad breath

What are the remedies for bad breath? There are several treatments to reduce or prevent bad breath, as long as there is no reason associated with ailment or disease. In these cases, the treatment will be targeted and adequate to resolve the underlying cause. In this case, the doctor will prescribe the most suitable therapy.

Here are some remedies to combat bad breath.

  • Maintain good oral hygiene: brush your teeth at least twice a day, using a toothpaste that contains fluoride. Be sure to brush your tongue as well, as it can be a breeding ground for bad breath-causing bacteria.
  • Use dental floss to remove food debris from hard-to-reach areas. The use of an interdental brush can also be used to better clean the interdental space.
  • Clean or scrape your tongue: Use a tongue scraper or an inverted teaspoon to gently clean your tongue. This helps remove bacteria and food debris that can cause bad breath.
  • Use an antibacterial mouthwash: such as cetylpyridinium chloride or tea tree oil. These products can help reduce the bacteria responsible for bad breath.
  • Keep your mouth hydrated: Drink enough water, even 2 liters a day, to keep your mouth hydrated. The production of saliva helps fight bacteria and reduce bad breath. You can also suck on candy or chew sugarless gum to stimulate saliva production.
  • Avoid spicy foods: such as garlic, onion, strong spices, coffee and alcohol. Also limit your consumption of sugary foods, as sugar can promote bacterial growth. Schedule regular dental checkups: Regular dental checkups are helpful in identifying and treating any dental or gum problems that may be contributing to bad breath.
  • Quit smoking: If you are a smoker, try to quit. Smoking can contribute to bad breath and compromise overall oral health.
  • If you wear dentures, they must be properly sanitized. Remove them at each meal, if mobile, and wash them with dish soap or practical effervescent tablets by dipping them in a glass of water.
  • Change your toothbrush every 3-4 months, or more often if the bristles become dull or lose their original shape.
  • Have a dental check-up for an examination of your teeth and a deep cleaning 1-2 times a year.

Bad breath in children

Bad breath in children is commonly caused by: poor oral hygiene, tooth decay, gum disease, dehydration, eating particularly spicy foods, certain medical conditions, conditions such as acid reflux or enlarged (hypertrophic) tonsils, side effects of some medications.

It can trigger the concern of some parents who go to the pediatrician just as it can become an embarrassing topic among teenagers. Therefore, being aware of the common causes can help alleviate a lot of the stress associated with this condition.

Babies with reflux are prone to regurgitation of stomach acids and partially digested foods.

If you suspect a similar condition, if the child often has stomach pain and vomiting of a difficult cause to establish, it will be useful to consult the pediatrician to evaluate if it is necessary to change the diet or if there is a need for specific drugs.

Hypertrophic tonsils or adenoids

Another frequent cause of halitosis can be enlarged tonsils or adenoids. In fact, the latter, which are located in the back of the throat, can host many bacteria that proliferate locally causing bad smell.

Large tonsils can also be the cause of snoring and sleep apnea, especially in children. The advice remains to talk to your pediatrician to evaluate the symptoms together and consider a visit to the otorhinolaryngologist specialist.


Finally, some medications can lead to a decrease in the flow of saliva into the oral cavity, helping the bacteria that normally inhabit the mucosa to proliferate, causing bad breath.

Paying attention to how much water our little ones drink and possibly encouraging them to hydrate more is a valid way to rule out a cause of halitosis that seems obvious but may not be.

Types of bad breath

Bad breath can be occasional or chronic. Another classification sees it divided into halitosis, pseudohalitosis and typical halithophobia.

  • Typical bad breath – the classic variant, in which the unpleasant odor can appear due to the accumulation of bacteria, infections, food, etc.
  • Pseudohalitosis: in this case, the subject does not really have the disorder, but is sure of the opposite. Since there is no real problem, the treatment consists in trying to convince the subject; it is quite rare and occurs in about 15% of cases.
  • Halitophobia: occurs when a person has been successfully treated, but the perception of unpleasant breathing continues; in this case, psychological therapy is required.

What are the symptoms associated with bad breath

Symptoms associated with bad breath can be:

  • Presence of a whitish membrane…