Halitosis is the medical term for bad breath. However, halitosis is not referred to the occasional “bad morning breath” since halitosis is used more to refer to a chronic bad breath condition, something that is almost always present and NOT occasional. True chronic halitosis can be defined as a condition in which a patient (it is truly a diseases and as such the person who has it should be considered a patient) emanates offensive odors from their mouth or nose and (unfortunately) these bad odors cannot be eliminated using regular oral hygiene procedures (flossing or brushing). But what are the causes of halitosis?
This article will give a rough idea of the possible causes of halitosis and does not pretend to be medical advice or to diagnose halitosis or bad breath. The causes of halitosis could be divided into: mouth conditions and other conditions
Causes of Halitosis: Mouth Conditions
Since offensive odors known as halitosis often come from the oral region of the patient it is easy to understand that some of the causes of halitosis are located right there in the mouth. Around 90% of the bad breath problems are caused by over development of specific bacteria located in the mouth. More specifically, by growing populations of gram-negative bacteria that strive of food remnants left in your mouth.
This is why it is so important to brush and floss frequently if you have bad breath. However, even with effective brushing and flossing you will still have halitosis because there are places in your mouth where bacteria can still grow. An area where the bacteria usually grow is on the tongue itself and more frequently on a region of the tongue known as posterior dorsum where is almost impossible to clean it effectively. But what causes the actual bad odor?
Most likely, the bad odor is caused by compounds (organic molecules) produced by the decomposition of food remnants, epithelial dead cells, and organic substances. In fact, the breakdown of proteins into individual amino acids and further decomposition of these into sulfur-based organic molecules (hydrogen sulfide and methyl mercaptan) are the most likely causes of bad breath. Volatile sulfur compounds have been shown to be related to halitosis.
Gum disease may be another cause of halitosis. However, it has not been effectively established the cause-effect relationship. The reasoning is that bacteria from the gum line may be using food to create bad odor substances. Also, some cases have been shown that putrefaction of tonsils are the cause of halitosis but this condition is fortunately not to frequent. In some cases small-calcified bodies in the tonsils (called tonsilloliths) are the main cause of halitosis.
Causes of Halitosis: Other (Non Mouth) Conditions
There are some causes of halitosis not located in the mouth. We will refer to these as Non mouth conditions. These are less frequent and require proper medical diagnosing. I am going to list them without too much explanation but be aware that there are many causes of halitosis not related to mouth conditions. Non mouth halitosis causes include: problems within the nose (sinus infections can cause nasal bad odor substance that can leave the nose or go to the mouth causing bad breath), systemic diseases such as bronchial and lung infections, infections in the liver or kidneys, trimethylaminuria (known as fish odor syndrome, and certain metabolic dysfunctions including diabetes.
What can you do if you have halitosis? The first thing is ask your doctor for medical advice. There are many medical and non medical treatments for halitosis but those will be the basis for my next article: Treatment of Halitosis.
Halitosis and other breath odors. Online book
Andrews, M.D. (2000). The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, Lippincott Williams & Wilkins