Halitosis Guide | Causes, Symptoms & Treatment Of

This in-depth guide covers the signs and symptoms of halitosis (bad breath) as well as practical solutions targeting its root causes.


Woman holding nose

Halitosis affects millions of people in the U.S. every year. Despite following an effective oral hygiene regimen, many people are prone to overgrowths of protein-eating bacteria that cause halitosis. In extreme cases, bad breath can be a sign of an underlying health condition, however, these cases are rare and most individuals with halitosis are in generally good health. With proper tools and specialty products, this common health condition can be effectively controlled.

Table of Contents

  1. What is Halitosis?
  2. Symptoms of Halitosis
  3. Common Causes of Halitosis
  4. Halitosis Treatment Methods
  5. Tips and Strategies
  6. Summary

1. What is Halitosis?

Halitosis is a chronic condition affecting more than 90 million Americans or 25 percent of the U.S. population. International studies indicate just 17 percent of Army recruits at age 20 never experienced halitosis or morning breath. Bad breath is an indiscriminant condition, impacting people in all parts of the world – females and males, young children to older adults. The majority of halitosis cases are caused by bacteria and microbes residing inside the mouth. The remaining 10 percent of cases are caused by specific medical conditions. Bacteria and the foods feeding these odor-causing microbes have been causing halitosis for thousands of years.

As many bad breath sufferers already know, chronic halitosis is an uncomfortable and embarrassing problem. It affects the person with the issue as well as people around them. Halitosis is often associated with morning breath, however, this chronic condition can strike at any time of the day or night. At work, at home, on a date or with a spouse, bad breath is an embarrassing problem that can cause social anxiety and negatively impact self-confidence.

Chronic halitosis can be aggravated by diet, oral health conditions, oral hygiene methods, smoking, drinking, and medications that cause dry mouth. Bad breath often disappears after brushing, flossing, and gargling with a specialty mouthwash, therefore it can be difficult to measure the severity of the condition.

2. Symptoms of Halitosis

For less than 1.0 percent of the population, bad breath is a constant presence, however, many people with halitosis are unaware of their condition. Self-diagnosing bad breath is difficult because many people are desensitized to the smell of their own breath, even though they have no difficulty detecting halitosis in others. To confirm the presence of bad breath, have a trusted friend or family member smell your breath and nose to determine the source of the odor. You can also lick your wrist and wait five seconds for it to dry. Smelling the odor on your wrist provides a sense of what your breath smells like to others.

Although patients with halitosis often experience unusual flavors, having an odd taste in one’s mouth is not a true indicator of bad breath. Two of the most common symptoms of halitosis are morning breath and bad odors or tastes when the mouth is closed for extended periods. Many odor-causing bacteria thrive in anaerobic or low-oxygen environments. If the mouth is closed for hours at night and for a good portion of the day, this opens the door for odor-causing bacteria to multiply and metabolize food particles at a faster rate.

3. Common Causes of Halitosis

Increased bacterial growth is the most common root cause, accounting for an estimated 90 percent of all cases. Technically, volatile sulfur compounds (VSCs) released by oral anaerobes give breath the "rotten egg" smell so offensive to others and distressing to the sufferer. Anaerobic bacteria do not grow in oxygenated, clean environments and therefore cannot produce VSCs. While biofilm accumulations on the tongue do not correlate precisely to odor levels, a whitish or yellowish film is an indication of excessive bacterial colonies.

The Role of Bacteria in Halitosis

The human mouth is home to more than 600 unique bacterial organisms. In a person with fresh breath, bacteria are carefully balanced, with minimal undesirable odor-causing microorganisms. Scientists have identified approximately 32 species of bacteria found only in patients suffering from halitosis. These odor-causing microorganisms live by breaking down proteins into amino acids and gaseous byproducts. The smell of bad breath is often pervasive because it contains a number of notoriously foul-smelling compounds and volatile gases such as hydrogen sulfide (the compound responsible for rotten eggs), dimethyl sulfide, which produces a fishy odor, and methanethiol, a compound found in rotten cabbage, aged cheeses and several other unsavory items.

Other Common Causes

In addition to a persistent coating on the tongue, many cases of halitosis are accompanied by dryness in the mouth. Dry mouth sometimes referred to as xerostomia (the subjective sensation of a dry mouth) results in decreased saliva flow which directly affects the mouth's ability to remove debris and remain aerated. Saliva is an important part of the digestive process. It is vital for keeping the mouth, gums, and tongue hydrated, washing away food particles and bacteria, and simultaneously maintaining a healthy pH level.

In addition to a mouth full of food particles that haven't been properly rinsed away, oxygen content is also greatly reduced due to poor oral hygiene. Not brushing and flossing regularly allows plaque to erode teeth and gums. Plaque is rich in anaerobic bacteria (the main culprit in producing VSCs) and causes gingivitis, periodontal disease, and tooth decay.

Odor-causing bacteria are the chief cause of halitosis, however, there other factors that play a role in bacteria proliferation – from genetic to nutritional.

  • Chronic diseases such as uncontrolled diabetes, metabolic disorders, liver and kidney disease, gastroesophageal reflux disease (GERD), several autoimmune diseases, and other conditions are contributing factors because they increase the anaerobic condition in the mouth.
  • Consuming protein-rich foods such as meat and cheese can aggravate the condition, particularly when these foods are allowed to cling to the teeth for extended periods.
  • Diet, alcohol, and smoking have been linked to bad breath and halitosis.
  • Occasionally, sinus infections and postnasal drip can affect the taste and smell of breath.
  • Patients with unsightly puffy gums, enlarged gum pockets, and excessive plaque have a much higher risk of developing halitosis. These microorganisms live on dentures, in abscessed teeth, between teeth, and inside gum pockets.
  • Tonsil stones (tonsilloliths) are calcified growths accumulating inside the enlarged tonsil cavities, visible as small white lumps on either side of the throat. Halitosis caused by tonsil stones is often accompanied with a sore throat, difficulty swallowing, and a bad taste in the back of the mouth.
  • Some genetic factors can also contribute to halitosis. For example, patients with large taste buds or papillae are more likely to have odor-causing bacteria trapped and growing on their tongues.

4.Halitosis Treatment Methods

The famous physician Hippocrates was among the first to recommend an herbal mouthwash containing red wine and spices as a treatment for halitosis, back in 1550 B.C. Although the ancient Egyptians developed recipes for toothpaste predating the great pyramids, toothbrushes are a much newer invention, in use for only the past 500 years. Despite these ancient inventions and many recent high-tech advances, bad breath and halitosis remain chronic problems for many people.

Oral Health Regimen

An effective halitosis treatment plan starts with a good oral health regimen. Individuals with halitosis should floss, brush, and gargle carefully and thoroughly. Dietary changes can also improve bad breath and create an environment inhospitable to odor-causing bacteria. To overcome halitosis and target odor-causing bacteria, most individuals need to follow an ongoing treatment plan and daily oral health regimen at home, work, and on the go.

In addition to thoroughly flossing and brushing, anyone suffering from halitosis should follow up with a gentle tongue scraper or tongue cleaner and a specialty mouthwash. Using specially designed tongue scrapers is the most effective way to physically remove bacteria from the tongue. Tongue scrapers and tongue cleaners can remove much more bacteria than a toothbrush alone. Proper brushing should include the teeth, gums, and cheeks to ensure all food and bacteria are thoroughly removed. In many cases, switching to an automatic toothbrush is a great way to remove more food, plaque, and biofilm accumulations.

Zinc gluconate is an important ingredient in antibacterial mouth rinses, oxygenating chewing gum, and odor-controlling toothpastes, including those produced by TheraBreath. Zinc gluconate is a dietary form of zinc paired with gluconic acid, which is naturally produced by penicillium and beneficial bacteria, as well as fermenting glucose. Zinc gluconate is essential for neutralizing the bacteria responsible for oral malodors. Specialty throat sprays and mouthwash attack bacteria and natural odors rather than masking them.

TheraBreath oral hygiene products provide effective and powerful ingredients necessary to alleviate bad breath and the embarrassing problems caused by chronic halitosis. TheraBreath mouthwashes, gargles and rinses do not contain alcohol and sodium lauryl sulfate, two ingredients that exacerbate bad breath and dry mouth. These products attack the sources of bad breath by stimulating saliva flow and circulating antibacterial, oxygen-rich saliva to all areas of the mouth. They also target VSC-producing anaerobic bacteria hiding in the back of the throat that thrive on protein-rich mucus and postnasal drip.

Cleansing the throat with oxygenating TheraBreath mouthwashes formulated with OXYD-8, neutralizes billions of anaerobes, leaving no sulfurous compounds to fill the mouth with noxious odors. Using TheraBreath toothpaste along with the mouthwash boosts the bad breath fighting elements of both products, helping people defeat bad breath and enjoy fresh breath.

Additional Home Remedies

  • Chewing cloves or parsley sprigs
  • Rinsing the mouth with a mix of lemon juice and water
  • Mixing peppermint leaves and water in a blender and gargling with the mixture
  • Eating guava several times a week may help because the fruit contains malic and oxalic acid as well as manganese and calcium, ingredients contributing to tooth and gum health
  • Eating an apple after each meal freshens breath and removes larger food particles stuck between teeth
  • Gargling with salt water and using saline nasal sprays helps reduce the amount of postnasal drip and mucus in the throat and mouth

Dietary Changes

Simple dietary changes can also improve halitosis and address root causes. Fruits and vegetables with high fiber content are great for removing biofilm and bacteria. Even abrasive cereals like shredded wheat can help remove bacteria growing inside the mouth, while benefiting the digestive system. Fresh or frozen berries are a good choice because they create an inhospitable environment for bacteria. Moreover, these fresh fruits are naturally rich in vitamin C, an excellent remedy for repelling odor-causing bacteria. The natural cultures in yogurt are another good way to introduce friendly bacteria into the digestive system.

Chewing sugar-free gum after meals, at work, or during problematic times of the day can help control embarrassing breath odors by stimulating the production of saliva and collecting food and bacteria. Effective treatment regimens should be easy to use every day, after every meal, and on the go. Portable throat sprays and alcohol-free breath sprays neutralize odors and are an effective way to control halitosis.

5. Tips and Strategies

Diet is a contributing factor for many individuals with halitosis. Avoidance is an effective treatment method in cases of halitosis aggravated by smoking, coffee, alcoholic beverages, and pungent foods such as garlic and onions. The sugar and proteins found in energy drinks and sports beverages can also feed bad breath-causing bacteria. Different substances can affect halitosis and the environment within the mouth. For example, smoking can dry the mouth and deplete oxygen, while coffee alters the pH level due to its excessive acidity. Drinking plenty of water and neutral liquids is a good way to stay hydrated and remove food debris from the mouth.

A multipronged approach is the best solution for tackling halitosis and reducing existing bacteria colonies. Practicing a good daily oral health regimen with appropriate products is integral to odor reduction. Data from one medical study showed tongue scrapers reduced participants’ bad breath by 70 percent. Specially designed tools and products for combating bad breath are inexpensive and can alleviate an embarrassing problem. At work or during the day, a small toothbrush, a travel-sized tube of toothpaste, and a small bottle of mouthwash are perfect for removing embedded food particles and bacteria-craving protein.


Bad breath occurs primarily due to mouth dryness, lack of saliva flow, accumulated mouth debris and the proliferation of anaerobic bacteria. In addition, the airless, stagnant conditions existing behind the tonsils provide an optimal environment in which bacteria can reproduce unabated. In addition to using products at home for neutralizing bacteria and odors, individuals should schedule regular dental checkups to maintain optimal oral health. This will help reduce tooth problems or tonsil stones that can cause bad breath. An effective, ongoing halitosis treatment plan can alleviate bad breath and make everyday situations more comfortable for everyone. Alleviating even the most severe halitosis is possible with the right tools, products, and treatment methods.

Convenient TheraBreath® starter kits are available with everything necessary to reduce sour, bitter, and metallic tastes, and undesirable odors – at home or on the go. Switching to specially formulated toothpaste and oral rinses is key to banishing odor-causing bacteria and saying goodbye to bad breath and chronic halitosis.

hese statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, or cure, or prevent any disease. The information contained herein is for educational purposes only. Before initiating any new oral treatment, please consult your oral care professional.

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