Bad Breath (Halitosis): Causes, Detection, and How to Treat It

Have you ever felt self-conscious while talking because you were worried about having bad breath? You’re not alone — more than 50 percent of the world’s population has reportedly experienced the same thing.

Bad breath or halitosis is a condition that is not dangerous, but can affect social life and may indicate that your body’s health is not in good condition.

What Is Halitosis?

Halitosis is a condition characterized by an unpleasant odor from the oral cavity, which can be either physiological (normal) or pathological (caused by disease).

Types of Halitosis

True Halitosis: Physiological vs Pathological

Physiological (normal):

• Morning breath upon waking up
• After eating strong-smelling foods (garlic, onions)
• Smoking
• When hungry or fasting

Pathological (caused by disease):

• Oral cavity infections
• Gum disease (periodontal)
• Coated tongue
• Oral fungal infections
• Digestive tract disorders
• Respiratory diseases
• Systemic diseases (diabetes, kidney disorders, liver disorders)

How Does Bad Breath Occur?

Halitosis occurs because bacteria that colonize the oral cavity, especially on the gums and tongue. The process:

1. Bacteria need protein to survive
2. Protein comes from food debris, dead cells, blood, and saliva
3. Bacteria break down protein into sulfur-containing compounds called VSC (Volatile Sulfur Compounds)
4. VSC is what causes the unpleasant odor — like the smell of rotten eggs or cabbage

How to Detect Bad Breath

Self-Examination

You can check for bad breath yourself with these methods:

• Spoon test — Scrape a spoon on the back of your tongue, wait a moment, then smell it
• Dental floss test — Use dental floss between teeth, then smell it
• Saliva test — Spit saliva into a cup, then smell it
• Wrist test — Lick your wrist, wait for it to dry, then smell it

Professional Examination

For more accurate results, a dentist can perform examinations using:

• Organoleptic — Direct assessment by the dentist
• Halimeter — A device that measures sulfur compound levels
• Gas Chromatography — Analysis of breath gases
• BANA test — Detects bacteria that cause bad breath

How to Treat Bad Breath

Basic Steps (for all types of halitosis)

1. Brush your teeth at least twice a day — after breakfast and before bed — make sure to brush all tooth surfaces and between teeth
2. Clean your tongue, especially the back, with a toothbrush or tongue scraper — the tongue is a favorite spot for odor-causing bacteria
3. Use dental floss (flossing) — floss cleans food debris between teeth that a toothbrush can’t reach. Food trapped between teeth (food impaction) can cause bad breath and infection. Avoid using wooden toothpicks as they can injure the gums
4. Rinse with antiseptic mouthwash — choose one without alcohol and use as directed. Avoid long-term use to prevent irritation
5. Don’t skip meals — When hungry, stomach acid increases and pushes gas toward the oral cavity, causing odor. Eating a little or drinking water helps. Chewing sugar-free gum containing xylitol with mint flavor is also effective in reducing bad breath and proven good for oral health
6. Avoid strong-smelling foods like garlic, durian, and onions — even after brushing, the smell of these foods often lingers
7. Increase consumption of fibrous and water-rich fruits and vegetables

Additional Treatment by Type

Pathological true halitosis:

• Visit a dentist for plaque and tartar cleaning (oral prophylaxis)
• If related to systemic disease, see the relevant specialist doctor
• Pay attention to the type of odor as a clue: ammonia odor is often found in kidney disease patients (due to urea breakdown in saliva), while ketone odor (like rotten fruit) is characteristic of diabetes patients

Pseudohalitosis:

• Check for olfactory organ disorders
• Perform regular oral cleaning supplemented with antiseptic mouthwash

Halitophobia:

• If proven free of halitosis but still feeling it, consult a psychiatrist or psychologist

When to See a Doctor?

Consult a dentist immediately if:

• Bad breath doesn’t improve after maintaining oral hygiene for 2 weeks
• Accompanied by bleeding or swollen gums
• Accompanied by cavities or tooth pain
• Accompanied by prolonged dry mouth
• Accompanied by other symptoms such as stomach pain, nausea, or chronic cough

Conclusion

Halitosis is a common and non-dangerous condition, but it can affect self-confidence and social life. The good news is that bad breath can be treated — from simple steps like maintaining oral hygiene to professional treatment by a dentist.

If you experience bad breath that doesn’t improve, don’t hesitate to consult a dentist so the cause can be identified and treated properly.