Bad Breath (Halitosis) Overview

You wonder about it. Everybody does. Do I have bad breath? You fear your spouse and best friends won’t tell you. So you cup your hands, exhale into them by mouth, and then inhale through your nose in an effort to smell your own breath. It seems okay…but still, you wonder. Do I have bad breath?

It doesn’t help to turn on your TV. The commercials make halitosis seem epidemic. They warn darkly that without this or that mouthwash or breath-freshening gum, spray, or candy, you’re fated to suffer “morning mouth” or “dragon mouth” with horrendous consequences: lost lovers, missed promotions, and vicious gossip behind your back. Those commercials can’t possibly be for real, you tell yourself. But still, you wonder.

Halitosis (Bad Breath) Overview

Americans are so worried about our breath that we spend $1 billion a year on mouthwashes and other breath products in hopes of keeping it fresh.

Most people who worry about bad breath don’t have it, according to Walter Loesche, D.D.S., a professor of dentistry and microbiology at the University of Michigan School of Dentistry in Ann Arbor. Unfortunately, you never know.

In one study, Israeli dental researchers asked 52 people in Tel Aviv to self-test their breath using three age-old techniques: exhaling through their mouths into cupped hands and smelling it, licking their wrists and smelling it, and spitting into their hands and smelling it. Then the researchers smelled everyone’s breath. The result: The participants could not judge their breath by any self-test.

So how can you tell if you have bad breath. Dr. Loesche says: Ask a child. Children will tell you. Adults may not.

Most bad breath is caused by bacteria that live in the mouth, according to William Replogle, Ph.D., a professor of family medicine at the University of Mississippi Medical Center in Jackson. Two things keep these odor-causing bacteria in check—good oral hygiene (daily brushing and flossing) and salivation, which helps wash malodorous products of bacterial metabolism out of your mouth.

Bacteria in your mouth feed on food residues, and form plaque, the sticky deposits that cling to teeth and cause gum disease (gingivitis). If you don’t brush and floss it away regularly, the bacteria in your mouth produce foul-smelling compounds that give you bad breath. In addition, mouth bacteria also produce gum-irritating toxins that cause your gums to pull away from your teeth, opening up pockets that harbor even more bacteria, and lead to even worse halitosis.

Recently, Dr. Loesche and Michigan colleague Erika DeBoever, D.D.S., discovered the culprit in may cases of chronic halitosis—the tongue. The backs of some people’s tongues contain deep crevices where odor-causing bacteria thrive.

“Morning mouth,” the furry-tongued bad breath first thing in the morning, is a natural by-product of sleeping, Dr. Replogle explains. When you sleep, you stop salivating, and odor-causing compounds build up in your mouth. For the same reason, chronic dry mouth increases risk of bad breath. Many drugs can dry your mouth, among them: antihistamines, decongestants, pain relievers, antidepressants, diuretics, and cancer chemotherapeutics.

Finally, as you age, your breath generally gets worse. The reason is that the elderly produce less saliva than they used to.

Bad Breath Warnings

If persistent bad breath doesn’t clear up after a few weeks of aggressive home treatment and professional teeth cleaning, consult a physician. A number of potentially serious conditions can cause bad breath, among them: diabetes, kidney failure, lupus, hiatal hernia, liver and gallbladder disorders, and certain cancers.