Bad breath

Bad breath, or halitosis, is a problem that most of us encounter on a daily basis. This incredibly troublesome condition interferes with daily life, causes depression, and hinders normal social interactions. However, few of us are aware of the reasons behind the unpleasant odor from the mouth.

The causes of this condition are usually not dangerous, and only in isolated cases is bad breath a sign of a serious illness. However, the foul odor from the mouth can effectively complicate life, discourage acquaintances, hinder making new friends, and may even disqualify one in the eyes of employers. Bad breath is often a bigger problem for those around the person affected by this condition than for the individual themselves.

The air exhaled from the mouth has an unpleasant odor, which can be problematic in close interactions with others. If a conversation partner slightly withdraws when spoken to, one may wonder if an unpleasant odor is emanating from their breath. Imperfections in the sense of smell often mean that a person with bad breath is unaware of it.

In the vast majority of cases, the direct cause of bad breath is anaerobic bacteria. These bacteria live on the surface of the tongue and throat, which is their natural environment. While aiding digestion, they break down proteins in food, mucus, blood, and the dying tissue of the oral cavity. Under certain conditions, these bacteria break down proteins in larger quantities than usual.

Other causes can include dental diseases (cavities, pulp necrosis, decaying retained tooth roots), bacterial inflammation of the gums and periodontium, oral thrush (such infections occur after antibiotic therapy or when the immune system is weakened, e.g., after illness, in the absence of vitamins, during periods of extreme fatigue), coating on the back of the tongue, ulcers and fistulas in the oral cavity, worn-out, porous dentures that are difficult to clean, reduced saliva flow, and drying of the mucous membranes: mouth breathing, staying in air-conditioned rooms, smoking, alcohol abuse, and taking certain medications (e.g., diuretics, psychotropic drugs) that dry the throat and mouth and inhibit saliva secretion, garlic, and onions (besides being present in the mouth, the aromatic substances in garlic and onions are also absorbed in the intestines and exhaled through the lungs).

Unpleasant breath can also originate from the throat, esophagus, or stomach. For example, it may accompany peptic ulcers, acute gastric inflammation, malabsorption syndrome, overeating (acidic digestive juices released from the filled stomach into the esophagus can poison the breath), esophageal diverticula, esophageal strictures, achalasia of the esophagus, or intestinal obstruction. Causes of unpleasant breath may also include inflammation of the nasal mucosa, sinuses, throat or tonsils, as well as lung diseases such as purulent bronchitis, bronchiectasis, and pneumonia.

Rare causes include diabetes (an abnormal blood sugar level leads to the development of so-called ketoacidosis, and gases with a specific acetone odor appear in the exhaled air), liver diseases, uremia (a disorder involving the retention of protein metabolism products such as urea), and disintegrating tumors.

Treatment is effective only when it eliminates the causes. The causes should first be sought where they are most common, namely in the oral cavity. It is necessary to eliminate cavities, remove tooth roots and dental calculus, and treat inflammation of the gums and periodontium. Regular and thorough oral hygiene is crucial. The foundation is the meticulous cleaning of teeth and interdental spaces (dental floss). It is also important to clean the tongue. Bacteria accumulated on the tongue produce volatile sulfur compounds with a sharp odor. The coating can be removed with a special brush. Special mouthwashes and brushes for cleaning teeth and the tongue are available at pharmacies.

Chewing gum or sugar-free candies can be helpful (they stimulate saliva secretion). It is worth eating a piece of apple or a slice of orange to produce more saliva and thus flush microorganisms from the mouth. Rinsing the mouth with water or special mouthwashes available at pharmacies is also an option. When experiencing dryness in the mouth, it is advisable to drink more water. Quitting smoking can bring many health benefits, not only an improvement in bad breath. Avoiding the consumption of products with an unpleasant odor is recommended. Refrain from drinking alcohol.

If bad breath suddenly appears without a specific cause and if the unpleasant odor persists despite changing habits and maintaining good oral hygiene, it is advisable to consult a doctor. If halitosis persists, it is necessary to rule out any other diseases. The doctor will identify the cause and initiate treatment for the condition causing the unpleasant breath (e.g., treatment for stomach, throat, tonsil, or lung diseases).