What is Halitosis?

Halitosis is an unwanted bad odor that occurs in the mouth or nose, disturbs the people around, and in some cases even makes the person aware of their own odor. If more than one person feels that the other person’s mouth smells during the day in close contact or without close contact and if this situation continues for a while, there is a halitosis problem.
Bad breath has a negative effect on people. This situation, which negatively affects social life, brings psychological stress, pressure and self-confidence problems. People with bad breath are exposed to social isolation. Bad breath is a tangible symptom and can be detected by direct measurement of the sulfur compounds that cause the odor.
Patients who think they have bad breath or suspect that they have bad breath should be examined by a dentist.

Who Has Bad Breath?

Halitosis can be seen in the general population regardless of age. More than 50% of adults have experienced halitosis at some point in their lives. Especially after waking up in the morning, bad breath can be seen to the extent that it affects daily life. In addition, studies have shown that halitosis occurs 3 times more often in men than in women. This condition is 3 times more common in individuals over the age of 20. Although halitosis occurs at the rates mentioned, most patients are not fully aware of this condition and do not apply for treatment. People who cannot fully understand whether they have bad breath or not are experiencing odor paradox, these individuals should consult a dentist and be examined.
When we look at the general population, bad breath increases with increasing age. In the middle age group, severe bad breath is observed especially in the morning. In the older age group, bad breath increases due to reasons such as prostheses used, decreased salivary flow rate, medications used, systemic diseases.

What are the Causes of Bad Breath?

– Periodontal diseases (gum diseases), mucosal diseases
– Infections in the mouth
– Oral cancers
– Cleft palate
– Problems with prostheses
– Problems with implants
– Tooth stones
– Tooth decay
– Plaque accumulation on the tongue
– Tonsil diseases
– Dry mouth
2. Physiological Causes
– Reduced quantity and quality of saliva
– Dehydration
– Hunger
– Vitamin deficiency (especially vitamin A and B12)
– Bad breath in the morning
– Iron deficiency
– Zinc deficiency
3. Respiratory Causes
– Upper respiratory tract infections
– Upper respiratory tract tumors
– Foreign body in the respiratory tract
– Sinusitis
– Chronic nasal airway obstruction
– Tonsillitis
– Throat infections
4. Digestive System Causes
– Helicobacter Pylori
– Reflux
– Akalasia
– Hiatus Hernia
– Digestive system bleeding
– Pharyngoesophageal Diverticulum
– Liver failure
– Pyloric stenosis
– Duodenal obstructions
– Malabsorption syndromes
– Parasites
5. Metabolic Causes
– Diabetes
– Diabetic coma
– Uremic coma
– Kidney failure
– Liver failure
– Factor hepaticus
– Trimethylaminuria
– Hypermethioninemia
– Cystinosisbolic causes
6. Medicines
– Chemotherapeutics
– Antihistamines
– Antidepressants
– Antipsychotics
– Antihypertensives
– Anticholinergics
– Diuretics
– Narcotics
– Medicines containing nitrate, chlorac hydrate, iodine and alcohol
7.Food and Drinks


There are 2 types of halitosis; pathological halitosis and physiological halitosis. In some cases, both can be seen together. 85% of pathologic halitosis is of oral origin, 15% is caused by extraoral sources. Main causes of halitosis of oral origin;
– Gum problems (Periodontal problems)
– Mucosa diseases
– Problems caused by tongue and tongue root (hairy tongue, rusty tongue)
– Reflux and nasal discharge
– Dentures and implants in an unhealthy condition
– Tooth decay and bad fillings
– Decreased quantity and quality of saliva.
– Oral cancers
– Dry mouth
– Tonsil diseases

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What Drugs Can Cause Bad Breath and Taste Disorders?

– Chemotherapeutics
– Antihistamines
– Antidepressants
– Antipsychotics
– Antihypertensives
– Anticholinergics
– Diuretics
– Narcotics
– Medicines containing nitrate, chlorac hydrate, iodine and alcohol

What is the effect of the nose on bad breath?

The easiest way to distinguish between oral and extraoral sources is to compare oral and nasal odors. The first organ that comes to mind when considering extraoral causes of halitosis is the nose. Nasal breathing is the preferred type of respiration. Mouth breathing, which has an important place in the etiology of halitosis, occurs as a result of nasal obstruction.
If the cause of the odor is the nose or has medical causes, an otolaryngologist should be consulted for further evaluation. One of the most common anatomical causes of nasal obstruction is deviated septum. In people with deviated septum, other related nasal pathologies are more persistent and more common. If there is no oral cause explaining the pathology, it should be considered that a deviated septum may cause halitosis by mouth breathing in a person with bad breath.

What are the physiological causes of bad breath?

Hunger, smoking, poor oral care, menstruation, high-protein foods, food residues, odorous foods (onions, garlic, radishes, etc.), alcohol, coffee, tea, spices cause bad breath physiologically. The solution to these problems is quite simple and effective.

Is bad breath associated with diseases?

There are also diseases that are associated with bad breath;
Upper and lower respiratory tract diseases,
Gastrointestinal system (gastrointestinal) diseases,
Diseases of the esophagus and trachea,
Liver diseases,
Autoimmune system (immune) diseases
Blood diseases,
Renal failure
Since it may be a harbinger of diseases such as metabolic diseases, it should be taken seriously and if it is not of oral origin, you should definitely see a doctor.

The effect of smoking on bad breath

Smoking is a direct cause of bad breath. We can classify bad breath under two headings. The first of these is bad breath caused directly by bad odor, and the second is bad breath caused by dental and gum problems. Cigarette smoke contains USB (volatile sulfur compounds). Excessive smoking can lead to a hairy tongue, which increases the retention of tobacco odor and food residues.
Bad breath from smoking alone lasts for 24 hours. The dorsum of the tongue has been reported to be the primary source responsible for the formation of volatile sulfur compounds and it has been shown that removing rust from the dorsum of the tongue reduces the formation of volatile sulfur compounds. It was observed that the longest lasting efficacy was achieved by cleaning the tongue rust.
The most important rule in the treatment of bad breath is good oral hygiene. It is essential to brush teeth and tongue carefully, clean between the teeth, and have gingivitis treated. People with bad breath should be encouraged to reduce smoking, avoid harmful foods, eat at regular intervals and visit their dentist every 6 months.

Should we brush the tongue?

While many products are used to remove plaque from the teeth, the cleaning of an organ that harbors millions of bacteria that cause bad breath, the tongue, has been neglected.
The back ridge of the tongue is covered with bacteria. Swallowing and eating a soft diet, as most of us do, cannot remove this coating, so a white-gray layer rich in microorganisms remains intact.
The hydrogen sulfide and methyl mercap produced during the putrefaction of this layer on the tongue are directly related to bad breath. Therefore, brushing the tongue should be as important as brushing the teeth.
Plastic tongue scrapers and small brushes have been designed for scraping the tongue surface. These are particularly useful for patients with a nausea reflex. The tongue is protruded as far as possible, the tongue cleaner/scraper is placed as far back on the tongue as possible and gently pulled forward with force. Patients with halitosis should repeat this procedure several times a day.

Bad breath in children

There are specific halitosis according to age groups. In children between 2 and 5 years of age, there is a specific halitosis that develops mostly due to food residues and bacteria that settle in the tonsil crypts (ligaments).
A pediatric dentist (pedodontist) should be consulted first. If, despite the necessary diagnosis and treatment, bad breath is still not eliminated, then an appointment should be made with a pediatrician.


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