Halitosis: what causes bad breath?

Written by: Dr Neesha Patel
Published: | Updated: 06/11/2019
Edited by: Laura Burgess

It can be embarrassing to have a case of bad breath (or halitosis) and even worse if you don’t realise that you have it. But have you ever wondered what the cause is? One of our expert periodontists Dr Neesha Patel explains the possible reasons behind the unpleasant smell and which oral products can help.

What causes bad breath?

There are many possible causes of bad breath, which may include:

  • Morning breath – which is temporary and something that everyone may experience to some degree. When you sleep the mouth dries out due to reduced flow in saliva and an increase in microbial (bacterial) activity.
  • Smoking – this can be due to the smell of stale tobacco and also due to reduced saliva production, or periodontal disease often found in smokers.
  • Certain foods and drinks – such as garlic, onions, spices, brussel sprouts and alcohol may cause temporary bad breath. It may persist if these are consumed often.
  • Poor oral hygiene – particles remain in the mouth if you do not take care of your teeth by brushing and flossing daily. Plaque (bacteria) form and remain on your teeth and tongue, and if they are not cleaned regularly the gums become irritated, which may lead to periodontitis. Chemicals such as volatile sulphur compounds are produced by the bacteria which causes bad breath.
  • Conditions of the mouth and teeth – including periodontitis and gingivitis, dry mouth, poor denture hygiene, dental abscesses or infections such as oral candidiasis can lead to halitosis.

The above causes are the most common but other causes also exist, including diseases of the respiratory tract, diseases of the gastrointestinal tract (including gastro-oesophageal reflux) and systemic diseases such as diabetes, cirrhosis and kidney failure.

Read more on smoking and oral health

What treatment is best for bad breath?

Many people will make attempts to mask their breath using products such as mints, chewing gum, tooth brushing or mouthwashes as they feel self-conscious of their breath. It is important to realise that many of these products merely mask the halitosis and if someone feels they have bad breath they should seek a professional assessment.

The best treatment approach will depend on the underlying cause of halitosis. Once you have seen a specialist, they can advise you on a suitable course of treatment to meet your individual requirements.

How can I prevent bad breath?

Preventing bad breath should start with excellent oral hygiene, including tongue cleaning. In addition to this, some mouthwashes can provide additional benefits but only when used in a clean mouth. Choosing a mouthwash that deals with the cause and helps eliminate volatile sulphur compounds is important, you do not want to just mask the bad breath with a minty flavour.

Ultradex mouthwash and breath spray has been clinically proven to eliminate volatile sulphur compounds and help keep breath fresh for 12 hours. It contains chlorine dioxide for a superior clean and fluoride to strengthen the teeth and protect them from decay.


Do not hesitate to book an appointment with Dr Patel if you're worried about your oral health. 

By Dr Neesha Patel

Dr Neesha Patel is a leading consultant periodontist in London who is also the Clinical Director at Pure Periodontics clinic. She specialises in laser periodontics and all aspects of gum health including receding gum, gum disease and gummy smile treatment.

Dr Patel has worked in both general practice and hospital settings, including restorative dentistry and oral and maxillofacial surgery. She gained postgraduate qualifications from the FGDP of the Royal College of Surgeons of England and has since gained a Masters in Clinical Dentistry (Periodontics) from Queen Mary University with distinction.

She also successfully completed the Membership in Restorative Dentistry of the Royal College of Surgeons of Edinburgh examination and was awarded specialist status by the General Dental Council. Dr Patel lectures extensively on continuing education courses and newly-qualified dentists.

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