What is halitosis?

Halitosis, commonly referred to as bad breath, is an unpleasant smell that comes from the oral cavity.

There are many possible causes but good oral hygiene and regular visits to your dentist help to prevent many of them.

In all cases of halitosis, the dentist is the first person you should consult because he or she will be able to determine if the problem is related to your oral health

Who suffers from bad breath?

50% of the population complains about having bad breath and this phenomenon tends to increase with age (especially from the age of 50 and up). However, this problem, which seems harmless, may bring consequences such as social isolation, poor self-esteem and in some cases, depression. Halitosis can also be the symptom of a more serious condition which deserves medical attention.


In 85% of cases, the source of halitosis is located in the mouth. Bacteria from the mouth transform food and cellular debris, which may have the effect of producing unpleasant smells. These bacteria accumulate on the teeth and form plaque, tartar and tooth decay. They also proliferate at the gum level if there is presence of gingivitis or periodontal disease (inflammation of the tissues that support the teeth). Bacteria also accumulate on the tongue where they form, in combination with food debris, a whitish deposit. This deposit is more important in patients with periodontal disease.

Bad breath therefore often starts in the mouth and is related to:

  • Poor oral hygiene;
  • Periodontal disease (disease of the gums and bone that support the teeth);
  • Untreated caries;
  • Dry mouth, or xerostomia (can be caused by stress, medication or breathing through the mouth).

But there are also other causes (extraoral):

  • Chronic tonsillitis;
  • Sinusitis;
  • Postnasal drip on the back of the tongue;
  • Gastric disorders (less than 1% of cases of bad breath);
  • Kidney or liver failure;
  • Taking certain medications;
  • Consumption of certain foods or beverages (e.g.: a diet rich in protein, certain foods with a strong taste, coffee, tobacco, etc.);
  • Diabetes;
  • Cancer of the nose, throat or ear.

How can you treat halitosis?

The dentist will determine if the cause of halitosis is intraoral or extraoral. If extraoral, the patient will be referred to the appropriate specialist (otolaryngologist (ENT), gastroenterologist, etc.). If the source of bad breath is in the mouth, the treatment will depend on the exact cause and may take different forms:

  • Dental scaling

Any treatment should begin with a good scaling to remove tartaric acid deposits above and below the gums (factors promoting periodontal disease).

  • Treatment of periodontal disease

Periodontitis, an infection of the tissues supporting the teeth (gums and bone), is the most common cause of halitosis. Periodontal pockets that form with this disease are filled with bacteria; these produce sulfur elements that emit a bad smell. Furthermore, gingival bleeding after morning tooth brushing can also have an effect on the breath. If dental scaling does not solve the problem, periodontal pockets must be surgically eliminated. Good oral hygiene will then be necessary to avoid a relapse.

  • Treatment of cavities

If there is presence of caries, they should be treated with fillings. Normally, the decay alone is not responsible for bad breath unless it is at an advanced stage, or if there are several.

Other treatments to fight bad breath

  • Endodontics

In the case of dental necrosis, irreversible pulpitis and apical abscess, an endodontic treatment (root canal) or extraction will be necessary.

  • Orthodontics

If there is a dental malposition, orthodontic corrections may be recommended to ease teeth cleaning.

  • Oral hygiene

Tooth brushing at least 3 times a day (after breakfast and lunch and before bedtime) and flossing are good ways of preventing bad breath. If it is only a problem of morning bad breath, it can usually be solved by a better tooth brushing at night and in the morning.

  • Tongue scraping

If a lingual coating (deposit on the tongue) is detected, the dentist may undertake a decontamination using a tongue scraper.

  • Mouthwash and toothpaste

As a complement to treatment, the dentist may recommend the use of an antiseptic mouthwash containing chlorhexidine. Prolonged use should, however, be avoided because it can lead to a change in taste, discolouration of the teeth and a burning sensation on the tip of the tongue. Some baking soda toothpastes also improve breath. Note that mouth rinses and toothpastes are secondary solutions and have only a short-term effect. If the cause is not addressed, these solutions will not solve the problem of bad breath.

Also be aware that a majority of products on the market that claim to combat bad breath have no scientifically proven efficacy.