Halitosis, oral malodor, breath odor, mouth odor, foul breath, fetor oris, fetor ex ore, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in regular breathing – whether the smell is from the mouth or not. Bad breath has a significant impact – personally and socially – on those who suffer from it and is estimated to be the third most frequent reason for seeking expensive dental treatment.

In most cases (85–90%), bad breath originates in the mouth itself. The strength and unpleasantness of bad breath changes during the day depending on levels of oral dryness (which may be due to stress or fasting), eating certain foods (such as meat, fish, garlic, onions, curry and cheese), obesity, smoking and alcohol. Because the mouth is dry and inactive during the night, the odor is usually worse i the morning when getting out of bed. Bad breath may be transient, often disappearing following eating, brushing one’s teeth, flossing, and rinsing with specialised mouthwash.

Bad breath may also be persistent (chronic bad breath), which is a more serious condition, affecting at least  25% of the population in varying degrees.It can negatively affect your personal, social and business relationships, leading to poor self-esteem and increased stress.

Although the causes of breath odor are not entirely understood, the most unpleasant odors are known to arise from proteins trapped in the mouth which are processed by oral bacteria. There are over 600 types of bacteria found in the average mouth. Several dozens of these can produce very high levels of foul odors.

Other parts of the mouth may also contribute to the overall odor although they are not generally as common as the back of the tongue. These locations are inter-dental and sub-gingival niches, faulty dental work, food-impaction areas in-between the teeth, abscesses and unclean dentures.

When brushing the teeth he most widely-known reason to clean the tongue is for the control of bad breath. Currently the most common method used to control bad breath is to use mints, mouthwash or gum. These actions may temporarily mask the odors created by the bacteria on the tongue, but do not cure bad breath because they do not remove the source of the bad breath. In order to prevent the production of the sulfur-containing compounds mentioned above the bacteria on the tongue must be removed. Most people who clean their tongue use a toothbrush, a scraper or a tongue cleaner such as the Orabrush.

There is some controversy over the role of periodontal diseases in causing bad breath. Whereas bacteria growing below the gumline (subgingival dental plaque) have a foul smell upon removal, several studies reported no statistical correlation between malodor and periodontal parameters.

The second major source of bad breath is the nose. In this instance, the odor exiting the nostrils has a pungent odor which differs from the oral odor. Nasal odor may be due to sinus infections or foreign bodies.

Putrefaction from the tonsils is generally considered a minor cause of bad breath, contributing to just 3-5% of cases. Approximately 7% of the population suffer from small bits of calcified matter in tonsillar crypts called tonsilloliths that smell extremely foul when released and can cause bad breath.

Some people believe – and some unscrupulous businesses through advertising have attempted to foster the belief – that bad breath comes from the stomach rather than from the mouth.

In fact, most researchers consider the stomach as a very uncommon source of bad breath (except in belching). The esophagus is a closed and collapsed tube, and continuous flow (as opposed to a simple burp) of gas or putrid substances from the stomach indicates a health problem – such as reflux serious enough to be bringing up stomach contents or a fistula between the stomach and the esophagus – which will demonstrate more serious manifestations than just foul odor.

One popular home method to determine the presence of bad breath is to lick the back of the wrist, let the saliva dry for a minute or two, and smell the result. This test results in overestimation, as concluded from research, and should be avoided. A better way would be to lightly scrape the posterior back of the tongue with a plastic disposable spoon and to smell the drying residue. A spouse, family member, or close friend may be willing to smell one’s breath and provide honest feedback. Home tests are now available which use a chemical reaction to test for the presence of polyamines and sulfur compounds on tongue swabs, but there are few studies showing how well they actually detect the odor. Furthermore, since breath odor changes in intensity throughout the day depending on many factors, multiple testing may be necessary.

Things you can do right now to reduce or eliminate your bad breath include

Eating a healthy breakfast

Chewing gum

Gargling

Maintaining proper oral hygiene

Maintaining water levels

The details above have been taken from Chris Gibson’s excellent book Banish Bad Breath. There’s a lot more inside and we’ve had excellent results from it.  If you want to permanently eliminate bad breath you really need to take a look at:

http://www.banishbadbreath.com

Hope this helps

Chris and the team.

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