Halitosis (Bad Breath): Causes, Treatment and Home Remedies

Between 20% and 25% of the global population experiences noticeable bad breath at times, while 6% suffer from it constantly. Bad breath is not only unpleasant for those around but can also be unnoticed by the affected individual, as the nose quickly adapts to smells. Often, bad breath indicates oral health issues, with over 86% of cases originating in the oral cavity. Problems in the ear, nose, and throat area are the second most common cause, affecting about one in twelve patients. The prevalence of halitosis increases with age, affecting men and women equally.

What are the causes of bad breath?

Halitosis is generally divided into two main categories.

Transient Halitosis

Temporary bad breath is often diet-related, occurring after consuming certain foods like garlic or onions. Smoking can also contribute to transient halitosis. Surprisingly, fasting or extreme diets can negatively impact breath as well, due to the lack of natural "cleansing" from increased saliva production and the "wiping function" of the tongue during eating. "Morning breath" is caused by reduced self-cleaning during sleep, decreased salivation, reduced tongue movements, and dry mouth. Both transient and morning bad breath typically dissipate quickly and should not be confused with chronic halitosis.

Chronic Halitosis

The causes of chronic halitosis are often found within the oral cavity (intraoral), including poor oral hygiene, fungal infections, tumors, and abscesses. Common causes outside the mouth (extraoral) include ENT diseases such as tonsillitis, sinus infections, and throat inflammation. However, ENT doctors note that halitosis is rarely a primary ENT issue.

Another extraoral cause of bad breath is diphtheria, an infection of the upper respiratory tract, which is often accompanied by a foul-sweet odor.

Sometimes medications can cause bad breath, particularly if they affect saliva flow or contain sulfur.

General diseases can also cause bad breath, including diabetes, bronchitis, pneumonia, inflammation of the esophagus, stomach, or lungs, as well as liver and kidney diseases. This is often due to an imbalance in the intestinal flora.

Decreased salivation can also contribute to chronic halitosis. Causes include systemic diseases, certain medications (such as anti-Parkinson drugs), and damage to the salivary glands from radiation therapy during cancer treatment.

Older dentures or braces can often develop a specific odor. This happens when they become "saturated" with odor-causing substances due to inadequate cleaning.

What can you do about bad breath?

Toothbrush, toothpaste, dental floss or interdental brush, tongue scraper, and mouthwash—these tools for good oral hygiene are well known and have been detailed in our other articles. Naturally, professional teeth cleaning is also an essential part of maintaining oral health.

Which home remedies really help against bad breath?

Some home remedies, such as coffee beans, parsley leaves, or ginger, provide quick and temporary relief from occasional bad breath. Natural yogurt and mouthwashes with lemon or lime water are also popular options. However, these remedies are largely ineffective against chronic halitosis, which may be caused by an underlying illness. In such cases, only a doctor can provide the appropriate diagnosis and treatment.