Halitosis is a fairly common symptom that patients complain about to their dentist.

It is the unpleasant odor that exudes from the oral cavity and which often puts the patient in an embarrassing position in their social life.

Bad breath can be due to a variety of causes, but in most cases it is attributed to periodontal disease, decayed teeth, worn prosthetic restorations and intense coating on the dorsal surface of the tongue. In fact, the increase in the concentration of specific microbial populations in the oral cavity leads to an increased concentration of volatile sulfur metabolic by-products that are the cause of bad breath. In addition to this cause, other less common factors include specific gum infections e.g. ulcerative gingivitis, dry mouth, foci of necrosis (as in cases of osteonecrosis or cancer with necrotic - ulcerative areas in the mouth or oesophagus), tonsillitis or pus from tonsillar crypts, sinusitis, active gastroesophageal reflux, oesophageal diversions, etc. Naturally, it is expected that in many cases it is necessary to consult with Doctors of other specialties, e.g. Otolaryngologist, Gastroenterologist, in order to document a specific diagnosis.

In the case of common halitosis attributed to the microbes of the oral cavity, it is necessary to check for prosthetic restorations that require replacement, restoration of decayed teeth, appropriate periodontal treatment, instructions for implementing an oral hygiene program and regular re-examination. In other cases, the treatment of each pathogenic outbreak will contribute to the cessation of bad breath.

Frequently asked questions

I recently had my teeth cleaned yet I still have halitosis. What could be wrong?

If you suffer from a relatively severe periodontal disease, regular gum cleaning is not enough to stop halitosis. Periodontal scaling, a deeper and more extensive gum cleansing, may be needed.

I brush my teeth 3-4 times a day but I still suffer from bad breath. Why is this?

As mentioned, a broader examination must be done to identify the causes of bad breath. However, if no obvious cause can be found, then it is possible that there are outbreaks of inflammation, e.g. caries in some not visible areas of the mouth. A panoramic x-ray will reveal possible such foci. In addition, prosthetic restorations should be evaluated to see if they need to be replaced due to wear. Finally, in addition to the frequent brushing of the teeth that must be done with proper technique to clean all the dental surfaces, whilst the interdental spaces must be cleaned with the interdental brushes as well as the dorsal surface of the tongue.

How is sinusitis related to possible bad breath?

Inflammation of the sinus cavity is likely to affect the function of the ciliated epithelium, which covers the airway, preventing the continuous removal of mucus and inflammatory secretions. In such a case, the stagnation and the gradual leaking of posterior nasal secretions through the pharynx are likely to contribute to bad breath, which is perceived when exhaling through the mouth.