Bad Breath and Why People Get It

 Bad Breath, otherwise known as halitosis, is experienced by millions of people every day. Halitosis can be a minor transitory embarrassment or it can be a constant severe problem that never goes away and consumes one’s life and is a constant source of embarrassment.  There are numerous reasons a person might experience bad breath, but at the same time there are a lot of myths surrounding the causes and treatments for halitosis. I will touch on some of the more common causes and also some common myths surrounding this condition. Let’s address some common causes of bad breath first.

Probably the most common cause of halitosis is simply poor oral hygiene. This is usually the main cause of minor transitory bad breath issues and is easily resolved with proper oral hygiene. Gum disease, also known as periodontal disease, can produce mild to severe chronic halitosis. The gram (-) anaerobic bacteria that are responsible for causing gum disease produce volatile sulfur compounds (VSC), and these are what people notice when they are near someone with bad breath. Once the gum disease is treated the bad breath usually resolves rather quickly. The most common reason people suffer from long term chronic halitosis is due to an imbalance in the oral bacteria in their mouth. This does not mean they have poor oral hygiene. It merely means they have more anaerobic bacteria in the mouth than they normally should. There are numerous reason why this imbalance may occur but some common causes are due to dryness of the mouth (xerostomia), excessively long taste buds that allows excessive anaerobic bacteria and mucous to accumulate in and on the tongue, and post-nasal drainage which results in the buildup of a biofilm or mucous on the tongue. I have been treating patients with the chronic forms of halitosis for over 18 years and many of our patients travel great distances to seek a resolution to their condition. In fact the majority of our patients travel from outside of the state or even the country to seek our help. It may be hard to understand why someone would travel such distances for help with this problem but unless you have experienced such a condition is it hard to relate to it, or understand how much it can affect a person’s life. Over the years I have studied the causes or etiologies of chronic halitosis and this has provided me an insight as to how to help patients suffering from this problem.

Unfortunately there are a lot of myths related to halitosis, it’s causes, and how to resolve it.  Some common myths that we see related to halitosis are:


1.     Halitosis comes from the stomach.
        Only in extremely rare cases does this occur. Cleansing the intestines offers no benefits in
        treating halitosis.

2.     Halitosis comes from the lungs.
        Only rarely does this occur and it can be a manifestation of a serious disease.

3.     Halitosis is a hereditary problem.
        This is absolutely not true. Certain conditions that can contribute to a bad breath condition can
        be hereditary, but there is no halitosis gene that can be passed on to an offspring.

4.     Mouth washes and breath mints can help a breath problem.
        This is not true. They only mask the problem for a few short minutes at best. Alcohol based
        mouthwashes in fact will worsen the problem because they dry out the mouth thus increasing
        the volatilization of breath odors.

5.     Internal breath fresheners can eliminate a chronic halitosis condition.
        Products taken for food-induced odors will have little effect on a chronic halitosis condition.
        There are, however, many food induced odors that can be offensive to others and there are ways
        to resolve those types of problems. The only product we have tested that has been shown to be
        effective against food induced odors such as garlic breath or onion breath is a product called
        Breath Gemz™. This product has the ability to eliminate the odors during or even well after a
        person consumes the foods that will produce strong or offensive breath odors.

6.     Brushing my teeth more will help eliminate my breath condition.
        This is also not true. Excessive brushing can dry one's mouth, thus increasing the halitosis
        problem. Excessive brushing can also damage the teeth and gums over time. It is very difficult
        to remove the specific odor causing bacteria with brushing and flossing alone, and most patients
        we see at our center tend to have very good oral hygiene.

7.     Halitosis is caused by foods.
        Foods such as onions, garlic, or cauliflower can induce certain odors but these are only
        transitory, and can be easily eliminated by avoiding that particular food. The odors they produce
        also are not of the "sulfur" type commonly seen in true halitosis conditions, and generally are
        not as offensive.

8.     There is no treatment for halitosis.
        There is a highly effective treatment for this problem, at the Center For Breath Treatment.

9.     Probiotics can help in eliminating my bad breath.
        There is no scientific evidence to support the benefits of probiotics in the treatment of halitosis.
        The use and benefits of probiotics for treating a bad breath condition is very overstated and over
        simplified. For that reason we do not recommend the use of these products.

10.   I have heard that the bacteria H. Pylori causes halitosis. Is this true?
        This is absolutely false. H. Pylori is a common cause of peptic ulcers and when patients have
        been placed on antibiotics to eliminate the H. Pylori they sometimes find that their chronic
        halitosis condition improves. The reason for the improvement has nothing to do with the
        elimination or reduction of the H. Pylori. I may occur because the antibiotics temporarily reduce
        the amount of the anaerobic bacteria that are contributing to the halitosis condition. Once the
        antibiotic regimen is completed the bad breath always returns.

11.   Rinsing with hydrogen peroxide will help cure my bad breath.
        Hydrogen peroxide has never been shown to be helpful in treating halitosis. It is considered a
        cytotoxic product (toxic to cells) that will damage the tissues in the mouth. An occasional use of
        the product will not cause any significant damage to the oral tissues but any prolonged or regular
        use of hydrogen peroxide will breakdown the tissues and cause ulcerations of the tissues. We
        recommend patients do not use it for oral purposes.

When patients seek help from us in resolving a chronic halitosis condition we take them through a diagnostic process in which we determine what the causes of their halitosis condition are. There are always multiple causes and therefore the treatment usually requires a combination approach to resolving it. Treatment typically is focused on addressing the conditions that are resulting in the bacterial imbalance. For more information on treating this problem please visit the section on halitosis treatment on our web site.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.