Halitosis (bad breath) is a common condition caused by sulphur-producing bacteria that live within the surface of the tongue and in the throat. The treatment for halitosis will depend on the underlying cause. Smoking, dry mouth, dental infections and nasal or sinus infections can cause bad breath. Good oral hygiene, including brushing flossing and tongue cleaning, is important. Other treatments may include mouthwashes, nasal spray or antibiotics.
Halitosis (bad breath) is mostly caused by sulphur-producing bacteria that normally live on the surface of the tongue and in the throat. Sometimes, these bacteria start to break down proteins at a very high rate and odorous volatile sulphur compounds (VSC) are released from the back of the tongue and throat. Halitosis is not infectious. About 2.4% of the adult population suffers from bad breath.
Causes of halitosis
Apart from the sulphur-producing bacteria that colonise the back of the tongue, the other major causes of halitosis are:
- Dental factors – such as periodontitis (infection around the teeth) or poor oral hygiene
- Dry mouth – caused by medicines, alcohol, stress or a medical condition
- Smoking – which starves the mouth of oxygen.
- Acid and bile reflux from the stomach
- Post-nasal discharge – for example, due to chronic sinusitis
- Kidney failure, various carcinomas, metabolic dysfunctions, and biochemical disorders, together account for only a very small percentage of halitosis suffers
- Foods - such as onions, garlic or cauliflower, which induce certain odours. However, these effects are only short-lived.
Symptoms of halitosis
The features of halitosis can include:
- A white coating on the tongue especially at the back of the tongue
- Dry mouth
- Build up around teeth
- Post-nasal drip, or mucous
- Morning bad breath and a burning tongue
- Thick saliva and a constant need to clear your throat
- Constant sour, bitter metallic taste.
There is no one treatment for halitosis. The treatment will depend on what is causing the problem. Avoiding dehydration and good oral hygiene, including brushing and flossing, are important. Some mouthwashes, lozenges and toothpastes can assist in fighting halitosis.
Gentle but effective tongue cleaning may also be required. A variety of tongue brushes and scrapers have been produced in recent years. The tongue should be brushed in a gentle but thorough manner, from the back towards the front of the tongue, keeping in mind that the hardest to reach back portion smells the worst.
People with chronic sinusitis may find the regular use of a saline nasal spray helpful. A course of an antibiotic, effective against anaerobic bacteria (such as metronidazole, to reduce the overgrowth of sulphur-producing bacteria), may also help. Speak to your dentist, doctor or chemist to identify the cause of your halitosis and to find the most effective treatment for you.
Where to get help
- Your doctor
- Your local chemist
Things to remember
- Halitosis is caused by sulphur-producing bacteria in the tongue and throat.
- The major causes include a dry mouth caused by certain foods, smoking, poor oral hygiene and a coated tongue.
- The treatment of halitosis will depend on the underlying cause.
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North East Valley Division of General Practice
Last reviewed: August 2013
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