Nov 162011

The age-condition of halitosis, commonly known as bad breath, is much more common than most of us think. It is estimated that between 20 and 40% of the population has a problem with bad breath, be it chronic or temporary. Halitosis treatments range from commercial mouthwashes and mints to dental procedures or even surgery to alter the structure of the tonsils.

Over the past decade there has been extensive research whereby halitosis has been analysed both quantitatively and qualitatively, and this has led to new insights that have helped identify more potential causes and  treatments for halitosis. The study of bad breath is a scientific subject which is not only fascinating but that it traverses a wide range of fields such as physiology, psychology, chemistry and bacteriology. 

Bacteria on the surface of the tongue
A whole bunch of new species of bacteria have been associated with different types of halitosis, and it is now a well known fact that the vast majority of cases of chronic bad breath originate in the oral cavity (between 85 to 90% of cases).
Oral malodours are primarily associated with microbial metabolism: anaerobic bacteria (bacteria that thrive in environments where oxygen is scarce) are usually the ones responsible for the most offensive odours.
They feed by breaking down debris present in our mouths, and upon metabolism of proteins, foul-smelling compounds are released into the air, hence causing bad breath.
One of the most important discoveries that took place was that the overall combination of bacteria present on the surface of the tongue is in general quite different from the combination which lives in plaque (under the gum line and on our teeth). The posterior section of our tongue does not have a self-cleansing action, unlike the first half of it which is often in contact with our teeth and is under constant friction throughout the day, when we talk, chew, etc.
Filiform papillae located at the back of our tongue (they are the cone-shaped structures that cover the surface of our tongue, giving it its characteristic velvety appearance), can grow very long because they don’t get naturally trimmed with friction (as opposed to filiform papillae located towards the front). Hence, debris and bacteria are more likely to collect there, making this area one of the most common sources of bad breath in our mouths.
Contrary to what many would think, halitosis treatments that attempt to eradicate all bacteria present in the mouth are not a very wise approach when it comes to dealing with halitosis. There are many types of bacteria which, present in the right quantities, have a very beneficial role in our mouths, mainly protective.
For instance, bacteria usually protect us from an overgrowth of the fungus Candida, which is usually also present in our mouths, in small quantities.
When antibiotics are used and all bacteria in our mouths are wiped out, Candida populations can rapidly grow and cause a lot of trouble. Hence it is important to keep an equilibrium in the bacterial populations in our mouths. A treatment of chronic halitosis that aims to kill as many bacteria as possible (be it by using antibiotics or otherwise) has been shown to be counterproductive and very ineffective.
The causes of bad breath vary, but in general it is much more likely that the source is located somewhere within our mouth than anywhere else in our body. The importance of visiting a dentist and dental hygienist on a regular basis cannot be overemphasised, because halitosis is frequently a symptom of a condition or infection which is dental in nature. The widespread believe that chronic bad breath originates from the stomach is a false myth that has survived through the years, but in fact, it has been scientifically shown that cases of bad breath originating from the stomach are rare (less than 1% of cases).
 The importance of flossing our teeth daily
Improving our oral hygiene is another basic step which should not be underestimated. It is going to prevent halitosis from getting worse and, in the future, once the bad breath problem has been successfully treated, it will prevent halitosis from knocking on our door again. Brushing the tongue regularly with a specialised tongue brush and scraper is recommended, as well as flossing at least once a day.
Adequate diagnosis of all the underlying causes of halitosis (often multiple) is ultimately the key to treating this condition effectively. Bad breath is not, after all, a disease but just a symptom of other conditions, diseases and infections, hence there are a myriad of different types of halitosis, caused by the putrid smell released by a different combination of organic compounds.
Identification of the most probable origin of the oral malodours is vital in order to be able to use halitosis treatments that are targeted and effective, and while some professional tests can already associate certain types of bacteria and compounds with certain types of bad breath, the science of halitosis is still a very young field, and a lot more research is still needed.
In particular, the way the sinuses, the nose and tonsils can contribute to bad breath is still not completely understood. Hand-held devices that could instantly determine the most likely origin of our oral malodours (teeth, gums, tongue, tonsils, nose, sinuses, stomach…etc.) would be very useful indeed, particularly if they could be used from the comfort of our homes!
Finding halitosis treatments that are effective for each particular type of bad breath is of course one of the main goals of research, and hopefully the study of halitosis will bring is some new and exciting results soon.

>> Learn How You Can Treat Halitosis: 152-page Step by Step Guide

Bad Breath Guide


Other articles you may find useful:

Symptoms of Bad Breath 

Is There a Best Mouthwash for Bad Breath?

Tonsil Stones and Bad Breath

How to Eliminate Bad Breath in Easy to Follow Steps

Review: Dry Mouth Mouthwashes Put to The Test

  4 Responses to “Halitosis – Overview of Diagnostic Approaches & Treatments”

  1. There is a lot more research needed in the bad breath field. The current products on the market are simply not up to the job. While I agree that treating the underlying factors that are causing bad breath is important; sometimes those of us who suffer from this horrendous condition need a temporary remedy to simply alleviate the symptoms, and it would be nice if there were products which were really effective, even short-term.

  2. I just realized that I have post nasal drip and that this is probably the reason why my tonsils fill up with smelly stuff every day. If I don’t clean them, the gunk becomes tonsil stones. There are so many causes of halitosis it can be difficult to tell where your bad breath comes from… Thanks for all your articles and your book; it’s helping me a great deal.

  3. Halitosis can be difficult to treat purely because of the vast array of conditions which can cause it. There should be a standard protocol for doctors to follow so that they can diagnose properly. Some doctors can identify the characteristic bad breath associated with gum disease, but there are so many other types of bad breath. I am training to be a medical doctor and was looking for information on this field. You have good info on your site, well done!

  4. I don’t know what is causing my halitosis, I never thought there were so many things that could cause it. I guess I need to see a dentist first. Thank you

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