Bad Breath (Halitosis): Causes and Oral Care

Bad breath (halitosis) is the general term for the unwanted odours coming from the mouth that can affect a person's daily life. The source of the odour is often related to bacterial activity inside the mouth, although in some cases causes outside the mouth may also contribute. The cause and severity of the odour vary from person to person and can only be clarified through an examination.

Uzm. Dt. Emre Karakaya, within his work in the field of periodontology, is concerned with evaluating gum health and the intraoral factors that can lead to bad breath. The headings below are intended for general information and are not a substitute for a personal examination.

Intraoral Causes of Bad Breath

A large part of bad breath is associated with the volatile compounds released when bacteria in the mouth break down residues, particularly those that accumulate on the back of the tongue and along the gum line. Bacterial plaque that builds up on the tooth surface and tartar (calculus) that hardens over time can increase the surfaces on which these bacteria can reside. The whitish layer on the back of the tongue (tongue coating) is also one of the commonly encountered factors in odour formation.

Untreated gum inflammation (gingivitis) and more advanced gum diseases (periodontitis) can contribute to odour because of the bacteria that accumulate in the gum pocket. Advanced tooth decay, ill-fitting dentures and dry mouth (xerostomia) may also be counted among the intraoral sources of odour. The evaluation of gum-related problems and the determination of the appropriate approach are handled as part of the gum treatment process.

Causes Outside the Mouth

Bad breath does not always originate in the mouth. Nasal and sinus infections, inflammation of the tonsils, certain respiratory and digestive system conditions and some systemic diseases may also accompany the odour. In such situations the source of the odour may lie outside the mouth.

In addition, certain foods such as garlic and onion, tobacco use and some medications may cause temporary or persistent odours. When no clear cause is found during the intraoral examination, the practitioner may, where deemed necessary, refer the patient to the relevant medical specialties. Whether the odour originates inside or outside the mouth is determined through a detailed evaluation.

Professional Evaluation and Cleaning

The first step in evaluating bad breath is usually an intraoral examination that includes inspecting the teeth, gums and tongue. One of the fundamental procedures aimed at reducing bacterial accumulation is dental scaling, in which the hard deposits that build up on tooth surfaces and along the gum line are removed. The frequency and scope of the procedure vary according to the person's oral health and are determined through examination.

Measuring the depth of the gum pockets, evaluating the back of the tongue and identifying any decay or ill-fitting restorations may all be part of this process. The healing of the gum tissue after cleaning and the effect on odour vary from person to person. Appropriate care recommendations are planned individually according to the examination findings.

Daily Oral-care Recommendations

The basis of daily oral care is brushing the teeth regularly with an appropriate technique and cleaning between the teeth with dental floss or interdental brushes. Gently cleaning the back of the tongue may help reduce odours related to tongue coating. Adequate water intake may contribute to reducing dry mouth.

Regular dental check-ups and professional cleaning carried out at the recommended intervals can support keeping under control the deposits that may lead to bad breath; the general framework on this subject is also discussed in the article on why dental scaling is important. This content is intended for general information; the cause of bad breath and the appropriate approach vary from person to person, and it is recommended that you consult your dentist for accurate information.