Bad breath, sometimes known as halitosis, is a common problem. In most cases, it is caused by a build up of bacteria in the mouth, as a result of food debris, plaque, or gum disease. Bad breath is usually brought on by the breakdown of proteins by bacteria somewhere in the mouth. However, there are several other possible causes that affect the airways, oesphagus and stomach that can also lead to bad breath.

A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a characteristic sign of ketoacidosis, which may occur in diabetes, and is a potentially life-threatening condition. A fecal odor to the breath (the breath smells like feces) can occur with prolonged vomiting, especially when there is a bowel obstruction. It may also occur temporarily if a person has a nasogastric tube (a tube placed through the nose or mouth to the stomach to drain the stomach contents) in place.

You may not always know that you have bad breath. That's because odor-detecting cells in the nose eventually get used to the smell. Other people may notice and react by recoiling as you speak. If you don't brush and floss your teeth daily, food particles can remain in your mouth, which promotes bacteria growth between teeth, around the gums, and on the tongue. This causes bad breath. In addition, odor-causing bacteria and food particles can cause bad breath if dentures are not properly cleaned.

Factors that affect the airways and cause bad breath

Sinusitis.

Polyps.

Dryness.

Foreign body.

Hindered air or mucus flow.

Bronchitis.

Pneumonia.

Bronchiectasis

Bad breath may be the sign of a medical disorder, such as a local infection in the respiratory tract, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.

Use proper dental hygiene (especially flossing), and remember that mouthwashes are not effective in treating the underlying problem. If simple self-care techniques don't solve the problem, you may want to see your dentist or doctor to rule out a more serious condition that may be causing your bad breath.

Fresh parsley or a strong mint are often effective ways to fight temporary bad breath. Avoid smoking. Otherwise, follow prescribed therapy to treat the underlying cause.

The key to successful treatment, is the surface of the tongue! The dorsal surface of the tongue in cross-section is like a shag rug -papillae forming deep crevasses which defy thorough cleaning. What collects in this surface is plaque, sticky bacterial, cellular debris and food particles which becomes an anaerobic incubator of bad odors. The tongue scrapper much be somewhat flexible to follow the contours of the tongue yet rippled, ridges or "rake-like" in profile to do a proper job. Several passes of this instrument scarped lightly over the tongue twice a day will effectively remove the majority of evil-smelling debris, food, and bacterial residue.