Halitosis, “bad breath” is a detectable foul smell, commonly identified by others,especially close
relatives. Many sufferers don’t realise they have foul breath.
Causes include; poor dental hygiene.4 out of 5 patients suffer halitosis which originates in the mouth.
Commonly, bacteria break down various products in food and saliva to produce a characteristic smell.
Most bacteria are found between teeth and at the back of the tongue. Conditions in the mouth e.g
dryness, inadequate saliva and disturbances in acid/alkali balance cause halitosis. Dental diseases like
periodontitis and gingivitis also lead to bad breath. Food and drink intake also contributes to halitosis e.g
alcohol, garlic, onions, cheese. Unclean dentures, poor dental restoration and oral cavity lesions,
especially advanced cancerous lesions produce halitosis.
The second commonest origin of halitosis is the nose. Conditions such as sinusitis, dry nasal mucus
membranes, infections of the nose, nasal polyps present with halitosis. Halitosis and a purulent
discharge from a nostril in a child points to a foreign body in that nostril. Other rare sources of halitosis
include the tonsil, a defect in the pharynx (diverticulum), gastro esophageal reflux, metabolic diseases,
kidney and liver disease.
Halitosis is worsened by obesity, alcohol and cigarette use, unclean dentures, poor oral hygiene, and the
menstrual cycle. Some patients suffer “halitophobia”, a fear of bad breath even without actual bad
Measures to prevent and treat halitosis include avoiding causative foods and drinks, plenty of water
intake, eating more fruits and vegetables, less meat, avoiding tobacco, dental flossing , removing
dentures when sleeping and disinfecting them, brushing teeth and tongue, especially posterior part.
Visit an ENT specialist when symptoms persist. Assessment and examination of your mouth, nose and
throat will identify any direct cause and management instituted appropriately. In some cases, referral to
a dentist or psychiatrist will be advised.

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