Human breath is composed of highly complex substances with numerous variable odors which can generate unpleasant condition like bad breath . It is very common in general population and nearly more than 50% of the general population. The prevalence varied between countries, age and gender. However, it creates social and psychological disadvantages for individuals, and these situations affect individual’s relation with other people.

There are several terms that describe the bad breath condition such as foetor oris, oral malodor, bad breath, fetid halitus, stinking mouth, bad mouth odor and halitosis.

Bad breath or halitosis can be subdivided as True halitosis, pseudo halitosis and halitophobia:

– True halitosis can be further subdivided into physiological and pathological halitosis

Physiologic halitosis: cause by fermented food progress by bacteria resulting in malodoured violated gas.  There is no presented pathologic condition in this case . 

Pathologic halitosis: originates from an oral cavity or a non-oral source

Oral cavity pathologies including several causes: dental cavities, periodontal disease, tongue coating, exposed tooth pulps, extractions/healing wounds, interdentally food impaction, dentures kept at night or not regularly cleaned, restorative crowns which are not well adapted, oral cancer and ulcerations. Most of these factors cause halitosis due to tissue breakdown, putrefaction of amino acids and decreasing of saliva flow. All these conditions result in the release of VSC.

Violatile sulphur compounds (VSC), namely hydrogen sulphide (H2S) and methyl mercaptan (CH3SH) which are by-products of the action of bacteria on proteins, are the main cause of oral malodor.

Xerostomia or dry mouth caused by physiologic factors or salivary gland diseases, tonsilloliths inscrease the risk of coating.

 Besides, there are approximately 9% reasons caused by several following diseases:

–  Otolaryngology and Respiratory Diseases

–  Gastrointestinal system

–  Urinary system

And 1% of the etiology is resulted from diets or drugs also cause bad breath.

 –  Pseudo halitosis: Patients who suffer from pseudo halitosis complain of the existence of halitosis though it is not perceived by others.

–  Psychogenic Halitosis: Psychogenic Halitosis is the one which is imagined. In this a person believes that his breath smells bad when it actually does not.

Treatment of bad breath

Becaused of a multi-etiology condition, there are several recommendation to treat the bad breath rely on the exact cause of the problem:

• Investigating and managing possible systemic (non-oral) conditions
• Improving oral hygiene by professional and patient administered tooth cleaning; regularizing atraumatic tongue cleaning; to use regularly the antimicrobial toothpastes and mouthwashes; rinsing with oil-water; having regular clinical review to ensure maintenance of effective oral hygien
• Visit dental clinic to treat oral cavity disease: tooth filling, periodontal treatment, calculus scaling, prosthodontics…
•  Xerostomia controlling: Drink enough water or use artificial saliva product in case of dry mouth. Besides, using of chewing gum may decrease halitosis, especially through increasing the salivary secretion. 
•  No Smoking or heavy-odour food using
• Pseudo halitosis and psychogenic Halitosis will be managed well by simple oral hygiene measure and dental counselin.