Bad Breath: Don’t Let That First Kiss Be Your Last

Bad Breath: Don’t Let That First Kiss Be Your Last

 Oral malodor, also known as halitosis are commonly referred to as bad breath. Halitosis can be an embarrassing odor that emerges from the mouth and is easily detected by others. Surprisingly, some people with bad breath might not even know they have a problem.


What are the causes of bad breath? Oral malodor upon awakening is common and is generally not regarded as halitosis. However, longstanding oral malodor is usually caused by oral, or sometimes nasopharyngeal diseases.  The most likely cause of oral malodor is the accumulation of food debris and dental bacterial plaque on the teeth and tongue, resulting from poor oral hygiene, which can lead to gingivitis and periodontal inflammation. Although most types of gingivitis and periodontitis can give rise to malodor, acute necrotizing ulcerative gingivitis causes the most notable halitosis. Adult Chronic Periodontitis, characterized by gradual plaque related loss of bone around the teeth, can cause variable degrees of oral malodor due to gram-negative anaerobic bacteria.


Another cause of halitosis is the lack of oral cleansing because of xerostomia (dryness of the mouth). Chronic dry mouth can cause malodor because saliva is necessary to clean our mouths and remove foreign particles that could cause bad breath. Halitosis can be caused by a medical condition, such as respiratory infections, diabetes, or gastrointestinal disturbance.



Halitosis that arises from the mouth is the consequence of microbial breakdown of food debris, cells, saliva, and blood. The oral microbes most likely to cause the oral malodor are Gram-negative bacteria, which are the same bacteria that cause Chronic Periodontitis. However, no obvious association exists between oral malodor and any specific bacterial infection, suggesting that halitosis reflects complex interactions between several oral bacterial species. These bacterial interactions are most likely to occur in the gingival crevices and periodontal pockets, but oral malodor can also arise from the tongue (and this explains why oral malodor may sometimes occur in people with good oral hygiene). When particles of food aren’t completely removed from the mouth, they collect bacteria on the tongue and around the gums. These bacteria feed on the food and protein material in the mouth, as well as their byproducts.



Oral malodor can happen to anyone, so keep in mind the various things you can do–or avoid preventing bad breath.



  • Poor oral hygiene
  • Periodontal disease
  • Tongue coating
  • Food impaction
  • Unclean dentures
  • Faulty crowns, bridges, and fillings
  • Tobacco
  • Medications (several drugs produce dry mouth as a side effect)
  • Diet
  • Systemic illness, including gastrointestinal disorders


  • Make and keep routine dental appointments for cleaning and check-ups
  • Follow your dental professional’s instructions for daily brushing, flossing, and rinsing.
  • Use antibacterial toothpaste
  • Take special care of any dental restorations, appliances, or prosthetics
  • Consult your dentist or hygienist if you experience dry mouth
  • Take good care of your overall health


Having your teeth professionally cleaned on a regular basis may significantly reduce halitosis. The dentist and hygienist remove deposits on teeth above and below the gum line that harbor bacteria, and also may advise you about your diet to help control bad breath. If your dentist determines that the cause of your bad breath is gum disease, you may need a specialized periodontal cleaning to remove the odor-causing bacteria and plaque. This specialized cleaning is called scaling and root planning.


If after a routine examination and cleaning you still experience bad breath–even though your mouth is considered healthy– the cause may be a medical disorder. In such instances, we may refer you to your primary care physician to determine if the cause is from a medical problem.


  • Brush and floss twice a day
  • Use over-the-counter mouthwashes
  • Use antibacterial toothpaste with fluoride
  • Eat sensibly
  • Drink plenty of liquids
  • Brush your tongue twice a day
  • Chew sugar-free gum like Xylitol