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Bad Breath: Causes, Other Associated Symptoms, and Prevention

Bad breath, also known as halitosis, is a common health issue that may be classified as: (1) true or genuine, and (2) delusional or imaginary. True or genuine bad breath is typically caused by sulfur-producing bacteria that reside on the surface of the tongue and in the throat. These bacteria break down proteins quickly, releasing malodorous volatile sulfur compounds (VSCs) from the oral cavity and throat. Bad breath can significantly impact an individual's self-esteem and social interactions. Below, we explore the causes and treatments for bad breath. 


Causes of Bad Breath 

The primary cause of bad breath is the metabolic by-products of bacteria in the mouth. When food residues, dead cells, and saliva are not adequately cleaned from the mouth, bacteria begin to break down these substances, producing volatile sulfur compounds (VSCs) and foul-smelling gases (putrescine, cadaverine, indole & scatole to name a few). 

Risk Factors for Bad Breath 

Conditions or activities that predisposes to development of bad breath include: 

  • Poor oral hygiene 
  • Periodontal disease or oral infections 
  • Dental plaque and tartar 
  • Dry mouth (due to reduced saliva flow) 
  • Tongues with very deep grooves (papillae), also called “fissured tongue” 
  • Consumption of certain foods, such as garlic and onions, spices 
  • Smoking, chewing tobacco or alcohol consumption 
  • Certain diseases, such as oropharyngeal tumors or cancers, gastroesophageal reflux disease (GERD), diabetes, liver, or kidney disease 


Other Associated Symptoms with Bad Breath 

Bad breath itself is a symptom often noticed by others; some individuals might also complain of an abnormal taste in their mouth, such as a bitter, sour or dry taste. 

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How to not have Bad Breath 

  • Good oral hygiene: This is the most crucial method for preventing and treating bad breath, including brushing teeth twice daily, using dental floss to clean between the teeth, and regular use of mouthwash. 
  • Regular dental check-ups: Regular dental cleanings and oral examinations can help remove dental plaque and tartar, preventing periodontal disease. 
  • Treating oral diseases: If bad breath is caused by periodontal disease or other oral conditions, appropriate treatment is required. 
  • Changing dietary habits: Reducing the intake of foods that cause bad breath, such as garlic, onions, and high-protein foods. 
  • Smoking cessation and limitation of alcoholic beverage intake 


Prevention of Bad Breath 

Here are some suggestions to prevent bad breath: 

  • Maintain good oral hygiene habits, including brushing twice daily and using dental floss. 
  • Regular dental check-ups and professional cleanings. 
  • Reduce the consumption of strongly flavoured foods. 
  • Use fluoride toothpaste to effectively prevent cavities and periodontal disease. 
  • Quit smoking and limit alcohol intake. 
  • Ensure adequate hydration to keep the mouth moist and prevent dry mouth which can lead to bad breath (remember, saliva is 99% water!). 


Medical Advice for Bad Breath 

Bad breath and a bitter taste in the mouth often trouble many people, especially those in busy urban environments who frequently consume strongly flavoured foods, leading to severe bad breath issues. To address long-term bad breath, it is essential to start with good oral hygiene habits and regular dental check-ups to prevent cavities and periodontal disease. If bad breath persists or other symptoms appear, it is advisable to seek medical advice promptly to rule out other causes of bad breath. 

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  1. Centre for Health Protection - Halitosis, Centre for Health Protection
  2. Mayo Clinic Staff. (2021). Bad breath. Mayo Clinic. Available at:
  3. American Dental Association. (n.d.). Halitosis (Bad breath). Mouth Healthy by ADA. Available at:

Topics: Body Check, Health & Wellness, Food & Nutrition, General Practice / Family Medicine, Gastroenterology

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OT&P Healthcare

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