The Most Common Causes of Bad Breath
Bad breath is a common health problem which greatly affects the day to day activities of so many people. The offensive odor from the mouth is unpleasant to those who come in close contact with bad breathers.
The problem will be doubled by psychological trauma leading to depression. The sufferers from this problem will be isolated from the society. This can even lead to marital disharmony.
Literally speaking all human beings are bad breathers. Oral cavity contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrefies them. This process results in the formation of offensive gases like hydrogen sulphide, methyl mescaptan, cadaverin, skatol causing bad odor. Most of us control this by regular brushing, tongue cleaning and gargling. Even after maintaining cleanliness in the mouth some individuals suffer from offensive smell due to various causes which has to be diagnosed and treated properly.
Here are the most common causes of bad breath.
1) Poor oral hygiene:
If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offensive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken in-between meals can also produce bad breath because of improper cleaning.
Bad breath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva has got some antibacterial properties which help to keep the mouth clean. Saliva contains oxygen molecules which are needed to make oral cavity aerobic. So the reduction in it’s quantity during sleep makes a favorable condition for anaerobic bacteria.
2) Food habits:
The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favor bad breath. Meat, fish, milk products, eggs, cakes, nuts, pear can cause bad breath. Some food articles can produce particular type of smell which may be unpleasant. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away, a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food. Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.
3) Biofilm:
There is formation of a thin sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteria are seen .The thick coating on the tongue is always associated with bad breath. Even a thin biofilm can make anaerobic condition favorable for bacterial proliferation.
4) Dental caries:
This is a destructive process causing decalcification with destruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli. Food particles are deposited inside these cavities and are putrefied by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrefied completely. Caries are common in schoolgoing children and in those who do not maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.
5) Gingivitis:
Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling, pain and discharge. If the condition becomes worse the infection spread towards periodontal area leading to continuous discharge called pyorrhea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis. All these conditions can produce offensive smell.
6) Gum retraction:
When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.
7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps between the teeth and gum. This will provide shelter for the food debris and bacteria causing bad breath.
Ulcerative lesions and coatings:
Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria, viruses, food allergies or due to autoimmune disorders. Apthous ulcer is the commonest among ulcerative lesions. Others are herpes, fungal infections, vincents angina, infectious mononucleosis, scarlet fever, diphtheria, drug reactions. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating (candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth and tongue. It is considered as a precancerous condition. Offensive breath is associated with these conditions.
9) Diseases of the salivary glands:
Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavorable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity. Some times the salivary duct is obstructed by stones or tumors. Cancer of the salivary gland is associated with offensive odor. In suppurative parotitis purulant discharge into the mouth causes bad breath.
10) Tonsillitis:
Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.
11) Tonsillar plaques and tonsillar fluid:
If bad breath persists even after maintaining proper oral hygiene there is possibility of this condition. Serous fluid secreted from the folds of tonsil is very offensive. Some patients complain that they hawk some cheesy materials from the throat, which are very offensive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteria. In such conditions tonsillectomy gives noticeable relief from bad breath.
12) Pharyngitis and pharyngeal abscess:
Pharynx is a fibro muscular tube which forms the upper part of the digestive and respiratory tract. Inflammation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offensive discharge of pus in to the throat.
13) Dentures:
Denture users may complain about bad smell due to lodgment of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.
14) Tobacco:
Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasant for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these cause offensive smell.
15) Smoking:
Smokers always have bad smell. It can also produce lesions in the mouth and lungs causing bad breath. Smoking increases carbon dioxide in the oral cavity and reduces oxygen level, causing a favorable condition for bacteria. Smoking reduces appetite and thirst hence acid peptic disease is common in chain smokers.
16) Lesions in the nose and ear:
Bad breath is occasionally seen in sinusitis (infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the Eustachian tube (passage from middle ear to the throat) can also cause offensive odor. Chronic rhinitis (infection of mucus membrane of nose) and foreign bodies in the nose can also produce bad smell in the expired air.
17) Diabetes mellitus:
Mostly all diabetic patients suffer from bad breath. Coated tongue, ulcers and coatings in the mouth, increased sugar level in tissues are responsible for halitosis. Bacterial growth in diabetic patient is very faster than non diabetic individuals.
18) Fevers:
Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis, AIDS produce bad smell.
19) Fasting and dehydration:
Dry mouth favors bacterial activity. So any condition which produces dryness in the mouth makes the breath offensive. Even though the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.
20) Bedridden patients:
Bedridden patients suffer from offensive breath due to thick coating on the tongue. Water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favors anaerobic bacteria to become active.
21) Diseases of stomach and esophagus:
Eructation of gas and food produce unpleasant smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis, gastric ulcer and cancer of stomach.
22) Intestinal diseases:
Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative colitis. Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis.
23) Diseases of lungs:
Lung diseases like pneumonia, lung abscess, chronic bronchitis, bronchiectasis, tuberculosis, lung cancer can produce bad odor during expiration.
24) Liver disorders:
Liver diseases like hepatitis, cirrhosis, can cause halitosis. Gall bladder diseases with vomiting also causes unpleasant odor.
25) Psychiatric patients:
Bad breath is common in psychotic patients due to poor hygiene, irregular food habits, less water intake and.
26) Somatisation disorder:
This is a psychiatric disorder characterized by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain, nausea difficult respiration, bad smell. This condition is diagnosed after detailed examination of the patient with all investigations. Since this is a psychiatric disorder it has to be managed with a psychological approach.
Frequently Asked Questions
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QUESTION:
What Causes Bad Breath and How to Avoid it?
What are the main causes of bad breath and how should I avoid it?
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ANSWER:
Bad breath will murder your social life, so it’s reasonable for you to want to figure out what may be causing it. Some causes, such as spicy foods, are easy to solve, but others may also indicate something serious.
Macleans Confidence Fresh Breath Antibacterial Mouth Spray How do I know if I have got bad breath? Well, people can maintain a distance from you, but may be too polite to tell you the real reason.
If you’re lucky, someone will just be direct and just tell you, but failing that, you can lick your wrist and smell your saliva – if it stinks, your breath probably will too.
So lets look at 5 of the main causes of bad breath.
1. Smoking
Are you a smoker? Smoking, in addition to many other obvious ways in which it is bad for you, makes your breath smell of stale smoke. It also irritates gums and can increase your risk of gum disease, which can also be a cause of bad breath.
Solution? Quitting smoking.
2. Food
Next is the food. If you like raw onions and garlic, simply choose between this particular passion and decent breath. Alcohol and coffee also affect your breath, but fortunately you can get rid of your bad breath by limiting their consumption.
Solution? Watch what you eat and drink.
Note that if you eat infrequently, or diet this can also cause bad breath. This is also the case if you are not eating enough carbohydrates.
3. Hygeine
Of course, if you’re casual about keeping your mouth clean, no amount of cutting back on the garlic will help. It is not enough to brush your teeth only in the morning.
Corsodyl Mint MouthwashYour mouth is full of bacteria that cause plaque, gum disease and tooth decay.
When bacteria are mixed with saliva and food trapped between teeth, it produces a bad smell. The bacteria can reside on the tongue, which also affect your bad breath.
Solution? Floss and brush at least twice a day. Use a toothbrush with soft bristles, and take time to clean the teeth and tongue scraping can also help.
You can also rinse with antibacterial mouthwash, but this does not replace brushing teeth, no matter what your friends tell you. Make sure you visit your dentist regularly.
4. Gum Disease
So now that you are aware of these issues you are brushing twice a day and flossing, avoiding garlic and smoking but you are still suffering! What could it be?
You might have gum disease or dental decay and you should make an appointment to see your dentist immediately.
5. Medical Problems
Although this is rare, really bad breath could indicate a medical condition.
For example, your mouth could not produce enough saliva, or you could have an infection in the lungs, throat or nose. Bad breath also may indicate that you have diabetes, liver or kidney problems, or that you suffer from heartburn.
If you have been cleaning your mouth thouroughly and bad breath persists, you should immediately consult your doctor.
Recent studies have confirmed that poor oral hygiene, can increase the risk of heart attack.
Poor hygiene can lead to bleeding gums, which provide the bacteria with a route into the bloodstream, where they can initiate blood clots leading to heart disease.
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QUESTION:
What type of food beside garlic and onion causes bad breath?
I do know there are lots of factor causing bad breath.
I want to know specifically about certain food, fruits or vegetables we should avoid for this reason… at least for certain occasion!
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ANSWER:
Your question suggests that you want to cure or keep from having bad breath by choosing certain foods. This will help cure bad breath but it is not the real cause of your bad breath. The primary cause of bad breath is the bacteria on your tongue, especially the back one-third of your tongue. Look at your tongue in the mirror for some white stuff. This is the bacteria and this material must be removed to keep you from having bad breath. When you eat a smelly food, such as garlic, some of the material stays on your tongue and produces bad breath. Cleaning your tongue will reduce your bad breath from the garlic food. Most people think the garlic smell comes from your stomach but it actually comes from some of the garlic staying on your tongue.
So, brush and floss your teeth and then clean your tongue, specifically the back one-third and you will not have bad breath. I use OraBrush tongue cleaner because it is designed to clean the back of the tongue. My wife tells me I have kissing sweet breath. It works for me.
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QUESTION:
What are some medical condition that causes bad breath? 10 points?
I have a bad breath but i have a very good oral hygiene
Could it be because of a medical condition, lets say ulcer
what could be a cure for some medical conditions that causes bad breath?
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ANSWER:
See … 10 points will not help you … Only you you can help yourself … Anyway, I feel for you. So I will give my thoughts.
Bad breath can be caused by various reasons: bad dental hygiene, gum disease (Which has nothing to do with how well you brush only), dry mouth, liver problems, nasal drips …. and so on. Since you seem to be in otherwise healthy condition, I would rule out some of the rare occasions when the issue can be caused by kidney and other conditions.
Thinking having good hygiene can be different than what a doctor would want for example. If you are brushing and flossing may be from some time, but prior to that you did not, then the plaque build up will cause persistent breadth issue. Only your periodontist can confirm that. If your regular dentist has not been able to resolve the issue, get a referral for the periodontist.
If gum disease is not the problem, cavities can collect the food. Sometimes, you may not be able to see the cavities and what you think as small cavity can be big inside. Only X-Ray’s can reveal these issues.
If you are not already, you should see a dentist every six months to get your teeth cleaned. If you are smoking you would need to stop. Drink lots of water. That helped me a lot. Oh, the other thing is to clean your tongue with a tongue cleaner regularly. Don’t over do it as tongue is real tender and can irritate easily.
Bad breadth problem in general is indicative of other systemic issues. It can be anything from mouth itself to other issues. Thus you should consult a doctor. My issue got cleared when I went to periodontist. Now I enjoy very smell free breath which in itself has increased my confidence.
Good luck,
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QUESTION:
What are the causes of bad breath? If a bad tooth is one, shouldn’t I have pain in that tooth?
Could allergies cause bad breath? I have a tingle on the roof of my mouth and a funny taste in my mouth. I have not been told I have bad breath but who really is going to say anything.
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ANSWER:
Gingivitis, not brushing, not brushing your toungue, certain medications, & a bad tooth can all cause bad odor. Also, just because a tooth doesn’t hurt doesn’t mean there’s nothing wrong with it. If you’re having a lot of sinus drainage b/c of your allergies that could do it too. Your sinuses drain down the back of your throat, there is an opening back there at the top of your oral cavity.
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QUESTION:
What causes bad breath? what can you do to get rid of it?
according to my b/f i sometimes have bad breath, he says it smells kinda sour. um i brush and floss regualrly and i use mouthwash too.
sometimes i get sinus infections could this cause my breath to smell?
and what can i do to try to get rid of it?
any suggestions will help.
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ANSWER:
Germs/bacteria: in your mouth, in your sinus, in your throat and of course the infamous gum problem gingivitis and I don’t mean the type of gum that you chew but the one your,,, our teeth grow out of. Also,, certain foods give you,, us,, a strong bad odor. So floss, brush, visit your dentist regualarly for teeth cleaning and of course use mouth wash and brush teeth after each meal ,, and don’t forget to also brush,, scrub your tongue. We harbor germs and such things between our taste buds. Honestly, I guarantee you his breath is not that great to smell either especially if he eats the same foods you eat and unless he constantly brushes and washes his mouth ,, which I doubt it, then he has room to complain. By the way, it is always easier to notice someone else’s body odors,, good and bad breath,, smell,, including mouth or from any orafices’ before you,,, we,, recongnize our/your own. It is possible that to some people your bf actually may smell ,, mouth, body odor worse than you. If your breath smells sour like lemon,, then,, what is his problem? Lemon or sour? or would he describe it as vomit smell? One more thing,, if he loves,, you,, and I mean loves you as in there is no other girl in the world or for that matter,, if all the women were lined up to pick anyone of them or all of them over you,, then you need to be found by the man that will not accept anyone or all the women over you. Can you believe that I feel that way about my favorite girl,, I would not take anyone of you or all of you over my one and only favorite girl,, now way jose, no how. Yes,, I know hard to believe that a man,, a person would feel that strongly about a girl. One more by the way,, if you two engage in oral s*x,, I bet he does not complain about that?