Bad breath, medically known as halitosis, is a significant health problem that can affect a person’s social life, self-confidence, and even psychological well-being. Many people think this condition is only caused by poor oral hygiene, but in reality, bad breath is a complex, multifactorial issue. Experienced dentists in Izmir, such as Dt. Emre Sarkın and Dt. Özlem Gülbenli Yılmaz, emphasize that bad breath can result not only from local (oral) causes but also from systemic (body-related) problems.
Prevalence of Bad Breath in the General Population
Research shows that one in four people experience bad breath at some point in their lives. This may be a temporary “morning breath” or a chronic condition causing constant discomfort. Correctly identifying the underlying cause of persistent bad breath is essential for effective, lasting treatment. Bad breath is merely a symptom—the real issue lies in correctly understanding what causes it.
Oral Causes from a Dentistry Perspective
The most common causes of bad breath include poor oral hygiene, tooth decay, tartar, gum diseases (especially gingivitis and periodontitis), bacterial buildup on the tongue surface, and dry mouth. In their dental practices in Izmir, Dt. Emre Sarkın and Dt. Özlem Gülbenli Yılmaz report that the majority of patients presenting with bad breath have these oral-related issues.
Gum diseases: Inflammation or recession of the gums allows bacterial plaque and infected tissue to accumulate beneath the gum line, leading to bad breath. If untreated, this can progress, damage bone tissue, and cause tooth loss.
Buildup on the tongue surface: Bacteria accumulating particularly at the back of the tongue produce foul-smelling sulfur compounds. This highlights the importance of tongue cleaning in daily oral care.
Dry mouth: Saliva helps clean bacteria from the mouth. Reduced saliva production (xerostomia) directly contributes to bad breath.
Non-Oral Causes of Bad Breath
Bad breath may also be linked to problems in other parts of the body. In cases that persist despite good oral hygiene, these causes should be considered.
1. Digestive System and Stomach Problems
- Gastroesophageal reflux (GERD): Stomach acid reaching the esophagus and even the mouth often causes bad breath, especially noticeable in the morning.
- Helicobacter pylori infection: This bacterium, linked to stomach ulcers and gastritis, has been associated with bad breath in some studies. It should be investigated in patients with stomach-related complaints.
- Constipation and intestinal dysbiosis: An imbalance in gut flora can increase gas production, which may be noticeable as bad breath.
2. Postnasal Drip and Respiratory Conditions
Postnasal drip, sinusitis, chronic nasal congestion, and tonsillitis can cause bad breath. Mucus buildup associated with postnasal drip increases bacterial growth in the throat, leading to unpleasant odors—often worse upon waking.
3. Systemic Diseases
- Diabetes: Poorly controlled diabetes can lead to dry mouth and ketone production, causing a characteristic “acetone breath.”
- Liver and kidney failure: In such cases, toxins accumulate in the body and are exhaled, producing “fishy” or “ammonia-like” odors.
- Blood disorders and cancers: Chronic, unexplained bad breath can be an early sign of some serious systemic diseases.
A Multidisciplinary Approach for Accurate Diagnosis
For effective treatment, the source of bad breath must be correctly identified. In the dental services provided by Dt. Emre Sarkın and Dt. Özlem Gülbenli Yılmaz, bad breath complaints are assessed through a multi-layered evaluation. An oral and dental examination is performed first. If no oral cause is found, the patient is referred to gastroenterology, ENT, or internal medicine specialists.
Steps to identify the cause of bad breath:
- Oral examination: Checking for tooth decay, gum disease, tongue structure, and dry mouth.
- Medical history: Investigating stomach issues, nasal congestion, systemic diseases.
- Laboratory tests and endoscopy: Especially for suspected stomach and intestinal causes.
- Odor tests: Using specialized devices to analyze the composition of gases exhaled from the mouth.
Treatment Methods
Treatment depends on the underlying cause. For oral causes:
- Professional tartar cleaning and root planing
- Treatment or extraction of decayed teeth
- Use of antiseptic mouth rinses and tongue cleaners
- Artificial saliva products for dry mouth
- Proper tongue cleaning and brushing techniques
For non-oral causes:
- Dietary and medical treatments for reflux
- Treatment of sinusitis or tonsil infections
- Control of diabetes and kidney disease
Bad Breath Should Not Be Ignored
Bad breath is often seen as merely a social issue, but it can signal serious underlying health problems. From tooth decay to stomach disorders, postnasal drip to systemic diseases, a broad evaluation is necessary.
If you suffer from chronic bad breath, visit a dentist promptly to uncover the real cause. Bad breath is not your destiny—through accurate diagnosis and proper treatment, you can restore your quality of life.