Bad breath – what you need to know

Halitosis / bad breath 

Halitosis is a technical term for “bad breath”. 

Halitosis is a common oral health condition that is found in at least 25% of the population. This percentage is higher in sectors of society whose standards of oral hygiene are slightly lower than required. 

It is said to be the third most common reason for patient attendance to the dentist, after gum disease (second) and tooth decay (first)

Symptoms range from the direct smell of food, which would have been recently consumed, to the direct smell of faeces from the oral cavity in rare extreme cases.

Most other symptoms range from mild to severe odour, depending on the origin of the problem and severity of the causative factors.



Foul odour origins vary from oral and perioral origin to Internal organs and certain chronic diseases

Oral & perioral causes – usually associated with aggregation of bacteria and strongly linked to poor oral hygiene

1. Dental cavities…. most commonly contain bacteria which produce odour for as long as the bacteria is eating up dental tissues in a process called dental caries / tooth decay.

Tooth decay is caused mainly by excessive consumption of sugary foods and worsened by poor oral hygiene.

2. Gum disease …. usually as a result of plaque bacteria that decimates gum tissue and produces odour in the process.

This condition is aggravated by poor oral hygiene.

The severity of gum disease ranges from mild irritation and inflammation of the gums to very severe necrotising forms of gum disease.

Chronic gum disease leads to periodontal disease, whereby the jaw bone and other tissues surrounding the teeth get damaged, sometimes irreversibly.

3. Sinusitis …… thick green mucus clogs up the sinuses and nasal cavities.

The odour from this bacterial aggregation expresses itself through both the oral and nasal cavities.

4. Tonsillitis ….. Hot on the heels of a sinus infection comes a post – nasal – drip. This spreads infections to the back of the throat and, subsequently (if untreated), the lungs.

The worst odour from the tonsilitis occurs when bacteria  surrounds the granules that form a around infected tonsils.

5. Throat infections …. infections often related to respiratory infections.

Odours from here manifest in both the oral and nasal cavities.

6. Oesophagus blockages, lesions and acid reflux can also cause odours that express themselves through the oral cavity

7. Food debris….. poor oral hygiene leads to food staying in the mouth for long  and producing sulphur byproducts that produce odours.

8. Tobacco…. tobacco on its own has a distinctive odour that permeates the oral cavity.

On the other hand, the chemicals in tobacco products aggravate gum disease.

This combination is often not good for fresh breath.

9. Chronic diseases …… Patients with liver failure, diabetes, renal failure and cancer are closely associated with certain smells that manifest in odours coming out of the oral cavity.

10. Miscellaneous …. Drugs often break down in the various organs like the liver, kidneys and the gut; this leads to the odour produced coming out of the oral cavity.

“Ketotic breath” – this is a phenomenon that occurs in those who train to reduce weight or are fasting for religious and other health reasons.

At some point in their fat breaking (lipolytic) routines, they start producing ketones as byproducts.

When this happens, a distinctive smell (“ketotic breath”) is produced that manifests itself through the oral cavity.


This article does not replace  a thorough examination examination by a relevant health professional.

It does not constitute official dental/ medical opinion.

FYI: Most of the information contained in here is readily available on the internet, for the sake of fact verification and broadening your understanding of your subject matter

Tel: 010 597 5095 for consultation