Halitosis is an unpleasant, persistent smell on your breath. It's caused by the build-up of bacteria in the mouth, due to food debris, plaque, gum disease or coating on the tongue. Other causes of persistent bad breath are due to certain health problems or medicines but these causes are uncommon.

Halitosis is problematic in that you cannot usually notice the bad smell of your own breath. You may have to ask a family member or a close friend to be honest and tell you if you have bad breath.

Halitosis can usually be treated with good oral hygiene.

What are its symptoms?

Halitosis symptoms depend on the underlying cause of bad breath. This includes:

  • Poor dental hygiene: Teeth are coated with film or plaque, food debris in teeth, pale or swollen gums.
  • Mouth infections: Red and swollen gums that bleed easily, draining pus between your teeth, loose teeth, open sores on the tongue or gums.
  • Respiratory tract infections: Sore throat, swollen lymph nodes in the neck, fever, nasal discharge, mucus-producing cough.
  • Cigarettes: Stains on teeth and tobacco residue.
  • Dry mouth: Difficulty swallowing dry foods, difficulty speaking for a prolonged period because of dry mouth, burning sensation in the mouth, unusually high number of dental cavities.
  • Systemic illnesses: Symptoms of diabetes, lung disease, kidney failure or liver disease.
  • Certain foods such as garlic.

If your symptoms persist after addressing these issues, consult your dentist. If he/she suspects a more serious condition is causing your bad breath, you may be referred to a specialist.

How is it diagnosed?

In a halitosis diagnosis, your dentist will smell the breath from your mouth and nose and rate these on a scale. Because the back of the tongue is most often the source of the smell, your dentist may also scrape it and rate its odour.

If you have bad breath and suffer from diabetes, gastro-oesophageal reflux disease (GORD) or chronic liver or kidney disease, your doctor will most likely tell you that your medical condition needs immediate attention.

What are your treatment options?

Halitosis treatment depends on its cause. Usually, the most effective treatment is improving your dental hygiene. As part of your daily routine, you should:

  • Brush your teeth, tongue and gums: your dentist may also recommend toothpaste that contains an antibacterial agent.
  • Use a good mouthwash: Mouth rinses containing cetylpyridinium chloride, and those with chlorhexidine can prevent production of odours.
  • Floss between your teeth.
  • Clean your tongue.
  • Clean your dentures and take them out at night.

To maintain good breath:

  • Eat a balanced diet
  • Cut down on sugary food and drink
  • Drink less alcohol
  • Stop smoking
  • Cut down on coffee
  • Drink plenty of water to help prevent a dry mouth
  • Chew sugar-free gum after eating, to stimulate the flow of saliva

Sometimes bacteria can be removed only by professional cleaning. Your dentist might also recommend replacing faulty tooth restorations, which can be a breeding ground for bacteria.

If you have gum disease, you may be referred to a gum specialist (periodontist). Gum disease can cause the gums to pull away from the teeth, leaving pockets that accumulate odour-causing bacteria.

Can it be prevented?

Prevention of halitosis from dental problems is easy with good oral hygiene. Brush your teeth, tongue and gums after meals, floss, and rinse with mouthwash.

Visit your dentist regularly (at least twice a year) for examinations and professional teeth and gum cleaning.

You can also combat bad breath by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles.

Other remedies that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, raw carrots and celery.

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2015