In this article:
Halitosis, or bad breath, is a very common problem but still an embarrassing one. The realization that a foul smell is released from your mouth every time you speak, eat, yawn, or even just breathe can give a serious blow to your confidence and deter you from engaging with people.
However, there is no need for you to carry this psychosocial burden, especially when the problem is easily treatable through strict oral hygiene, dietary modifications, and lifestyle changes along with therapeutic measures recommended by the doctor.
The treatment for halitosis is usually customized to suit each patient, depending upon the underlying cause. (1)
Causes of Persistent Bad Breath
There are many causes of bad breath. The air that you inhale is odorless. Something is added to it during the breathing process so that it is tainted with something unpleasant when you expire air.
Therefore, the cause of bad breath can come from anywhere in the breathing tract – from the tip of the nose or teeth to the depths of the lungs.
- A common cause of bad breath originates in the tonsils. The tonsils can develop cracks and holes in their surface, usually after attacks of tonsillitis. Swallowed food can get trapped in these holes, where it becomes packed together with dead cells, bacteria, and other particles. The result is smelly white lumps called tonsil stones. Tonsil stones slowly rot, and the bacteria involved in the rotting process release smelly, often sulfur-based gases. These gases easily mix with expired air, giving your breath an offensive smell. (2)
- The lungs are where blood releases carbon dioxide and picks up oxygen, so a bloodborne process can often cause bad breath. An example is eating garlic, which gets into the bloodstream and ends up in exhaled air.
- Rarely, actual medical illnesses such as fulminating hepatitis can also cause bad breath. Other lung-induced causes of bad breath include malignant tumors of the bronchus (one of the main air tubes leading to the lungs). (3)
- Further up the breathing tube, where it meets the swallowing tube (esophagus), lies an area of weakness in the wall where pouching can occur.
- Food that is meant to be swallowed and digested in the gut sits in the pouch and rots. The smell then rises up into the throat and mixes with exhaled air. Food that is trapped in between the teeth can also rot and produce a putrefying smell. Generally, poor dental hygiene is associated with bacterial growth and the release of obnoxious gases.
- Chronic sinusitis is also associated with a bad smell due to the growth of specific types of bacteria. The smell is often detected by the patient and those around him/her. (4)
The Easiest Way to Check if Your Breath Stinks
Many people lick their hands, breathe on it, and then smell it. This is not a good test, as saliva has its own smell and does not absorb or release any smell that is breathed out onto it.
No medical procedures are available to detect bad breath. The diagnosis only really comes from others.
If the bad breath is due to tonsil problems, it comes and goes. Hence, it may be there one day and vanish on the other.
To check if you have bad breath, use a plastic spoon and scrape the back of your tongue. Allow it to dry before smelling to check the odor. However, this method is not completely reliable.
Better yet, ask a family member or a close friend for their honest opinion.
Treatment for Bad Breath
The treatment for bad breath depends on its cause.
The most common cause is chronically infected teeth and gums, along with poor dental hygiene and food trapping between the teeth. In this situation, it is vital to take dental advice and have regular checkups, treatment, and dental hygiene maintenance.
The second most common cause of bad breath is a chronic tonsil infection, with or without tonsil stone formation. Regular antibiotics and antiseptic mouth gargles may help to alleviate the chronic infection.
Tonsil stones can also be removed by using water jets applied to the cracks and holes where tonsil stones form, twice a day.
However, by far the best way to treat a chronic tonsil infection is to perform tonsil removal surgery, which leads to a permanent cure.
The most modern technique is a form of laser removal under a local anesthetic that uses a computerized pattern generator. This is a relatively painless way of achieving significant tonsil removal, sometimes over more than one treatment.
GERD and Bad Breath
Gastroesophageal reflux disease (GERD in the USA, GORD in the UK) is associated with bad breath if the disease is severe.
Bad breath occurs when the stomach contents, which have a vomit-like consistency and smell, are refluxed all the way up from the stomach to the mouth. However, this type of bad breath is intermittent and rare.
Effectiveness of Apple Cider Vinegar for Treating Bad Breath
Apple cider vinegar will not make any real difference to those with bad breath, although its own slightly apple-like and vinegar smell may help to mask it.
Most-Asked Questions About Bad Breath
Is bad breath a hereditary condition?
Bad breath is not known to be hereditary but because it is very multifactorial, there is a possibility that eventually, a link may be found.
Can bad breath be treated permanently?
Depending on the cause, bad breath can often be treated quite easily and permanently.
What foods can help combat bad breath?
No foods can actually help in treating bad breath, but avoiding certain foods such as garlic and fish will definitely help.
Can bad breath be a sign of cancer?
Bad breath is also known as fetor and is commonly associated with cancers of the breathing tube, such as bronchogenic and oropharyngeal (throat) cancers.
Cancer growth is disorderly and rapid, and cancer cells often partially outgrow their blood supply. As a result, parts of cancer die spontaneously.
It is the dying tissue that causes the breath to smell, again due to bacterial growth and the release of noxious gases. Cancer, however, is a very rare cause of bad breath. (5)
Halitosis, or bad breath, is the presence of malodor in exhaled breath, which can be temporary or persistent.
Temporary bad breath is usually the result of eating pungent foods or poor oral hygiene that can be resolved through brushing and mouth rinsing.
However, persistent halitosis can be a sign of a more stubborn or serious underlying condition. In such a case, you must consult your dentist for a thorough diagnosis. Once the root cause is determined, the doctor will recommend the appropriate treatment.