Bad Breath

Bad breath can be caused by factors within the mouth, which are referred to as local factors. It may also be caused by systemic factors, which means bodywide diseases or conditions.

A person who has bad breath may not be aware of the odor. However, his or her acquaintances and the healthcare provider are generally aware of the problem.

Following are some local causes of bad breath:

• poor oral hygiene
• smoking
• tooth abscess
• impacted wisdom tooth
• certain foods, such as garlic
• not eating for a long time
• alcohol
• mouth or throat infections, such as strep throat
• gingivitis, which is an inflammation of the gums
• periodontitis, or an inflammation of the structures supporting the tooth
• sinus infection
• cold or flu
• nose infection
• overgrown tonsils catching food, which is common in children

Some systemic, or bodywide, causes of bad breath include the following:

• drugs and medications
• kidney disease
• lung abscess, or pus pocket within the lungs
• bronchitis
• conditions that cause dry mouth, such as Sjogren syndrome
• stomach or bowel problems
• constipation
• poorly controlled diabetes
• liver disease
• certain kinds of cancer
• infection with the AIDS virus

Prevention of bad breath starts with good oral hygiene. People should brush twice a day with fluoride toothpaste and floss teeth daily. Removable dentures should be taken out at night, cleaned, and soaked overnight. Mouthwash is not an effective treatment for bad breath, since it hides the real cause. Mouthwash can also irritate the tissue in the mouth. Mouthwash and breath mints are only temporary solutions and may mask more serious problems. Also, some breath mints may contain sugars, which can cause cavities.

Someone in good health may have bad breath at times, such as in the morning after a long sleep. However, a person with persistent bad breath should see a healthcare professional.

It is difficult to self-diagnose bad breath. If bad breath is suspected, an examination by a healthcare professional might be needed. If an underlying disease or condition is suggested by a history and physical, further tests may be ordered.

Bad breath itself has no long-term effects. However, an underlying disease, such as diabetes or periodontal (gum) disease can cause significant problems if it goes untreated.

Bad breath is not contagious and poses no risk to others. However, an underlying disorder such as AIDS may be highly contagious.

If improving home oral hygiene does not remove the bad breath, a healthcare professional should be seen. Once the cause of bad breath is found, the problem is usually solved quickly.

There are no side effects to good oral hygiene.

Once bad breath is eliminated, there should be no further treatment.

Any new or worsening symptoms should be reported to the healthcare provider.