Oral health / 23 Dec, 2019

Oh… bad breath!

Dr Goh Lit Ching

What is bad breath (halitosis)?

Halitosis is an unpleasant smell in the breath which is detectable by other people, but often not by the person suffering from bad breath. Most of the time, the only way to self-detect halitosis is if another person comments on it.

How frequent are people affected by halitosis?

Halitosis is very common, but the exact number of people affected is unknown.

Possible causes of bad breath

There are a variety of causes of halitosis, from normal bodily function through to medical and psychological illness.

Normal physiological causes of halitosis:

  • Present in the morning after a night’s rest
  • Foods (e.g. garlic, onion or spices etc.)
  • Dry mouth (e.g. dehydration)
  • Smoking
  • Medicinal side effects (e.g. dimethyl sulfoxide, disulfiram, some chemotherapy medicines or diuretics etc.)
  • Crash diet or low-carbohydrate diet – the breakdown of fat produces chemicals called ketones, which are then breathed out

Halitosis caused by medical illness:

  • Mouth – gum diseases or infection, teeth or dental caries, tonsil issues (e.g. tonsil stones/tonsilloliths)
  • Gastrointestinal – acid reflux, gastritis, liver problems
  • Nose – sinusitis, nasal polyps
  • Lungs – infections, bronchiectasis
  • Metabolic – diabetes, kidney problems

Psychological causes of halitosis:

  • Anxiety disorder, including phobia – fear of bad breath can result in odd behaviour to try to minimise what they think of as their bad breath
  • Obsessive Compulsive Disorder (OCD) – may present with fixed behaviours of teeth and tongue cleaning

Preventing halitosis

Preventing bad breath can be as simple as maintaining good oral health and a healthy lifestyle. Activities to consider include:

  • Good oral hygiene – through cleaning teeth, interdental spaces and tongue at least twice a day and using mouthwash
  • Regular visits to the dentist for scaling, polishing and dental check up
  • Limiting the consumption of sugary and acidic food and drinks
  • Stopping smoking
  • Drinking a lot of water to keep your mouth moist

Please consult a GP for a proper treatment plans if you believe various medical and psychological causes, as discussed above, may be impacting your halitosis.

References

For a full list of references, click here.
  1. HealthHub. (2019). Bad Breath (Halitosis). Retrieved on 19 December 2019 from https://www.healthhub.sg/a-z/diseases-and-conditions/47/topics_bad_breath
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