Halitosis: A Common Disorder

Halitosis, also known as "bad breath" or "oral malodor," afflicts more than 90 million Americans, according to some estimates. It can be embarrassing and socially unacceptable for those people who experience it. Most adults probably suffer from bad breath occasionally, with perhaps about 25 percent suffering on a regular basis.

Bad breath can be a sign of a health problem and is typically caused by poor dental hygiene and the activity of bacteria in the mouth.

However, other factors may be involved, including gum disease, tooth decay, heavy metal buildup, infection of the respiratory tract such as sinus infection, nose or throat infection, infection of the windpipe, improper diet, gastric problems, constipation, smoking, fever, diabetes, foreign bacteria in the mouth, indigestion, inadequate protein digestion, liver or kidney malfunction, postnasal drip, stress, and too much unfriendly bacteria in the colon.

Halitosis can also be caused by a buildup of toxins in the gastrointestinal tract, salivary gland disorders, chronic bronchitis, sinusitis, or diabetes. Dieting, alcohol abuse, or fasting can cause bad breath as well. "Morning breath" results from dehydration and a reduction in the amount of saliva when we sleep, which is needed to wash away bacteria in the mouth. Dieters and people who are fasting may experience bad breath because the lack of food causes the body to break down stored fat and protein for fuel; metabolic wastes resulting from that process have an unpleasant odor as they are exhaled from the lungs.

In the past, bad breath was often considered to be an incurable affliction. However, in recent years it has become increasingly evident that bad breath is usually treatable once a proper diagnosis is made.

The main problem is knowing whether or not we have halitosis. Normally, we are unable to detect our own bad breath. That's because our nose, which typically filters out and disregards background odors, filters out and disregards own bad breath. This process is called acclimation.

Some people suffer from bad breath without knowing it, while others build up exaggerated fears about breath odor even though they do not have it. The best way to find out whether we have bad breath is to ask for someone else's opinion. If we don't ask, other people are unlikely to tell us. And since bad breath can sometimes -fortunately rarely - be a sign of a significant general health problem, we should not be reluctant to tell people dear to us that they have a bad breath problem.

As always, your questions and comments about bad breath and oral health are invited.