Bad Breath (Halitosis)

Halitosis (synonyms: Foetor ex ore; halitosis; cacostomia; halitosis; halitosis; ICD-10-GM R19.6: halitosis) refers to a foul odor of the air breathed, which can also be heard when exhaled through the nose, with the mouth closed. Here, the cause lies in diseases of the respiratory or gastrointestinal tract (respiratory or digestive tract) and certain metabolic diseases.

Halitosis is distinguished from the so-called foetor ex ore (stench, musty smell), which refers exclusively to the malodorous air exhaled from the mouth. The local cause is the mouth/nose/throat area (90% of cases).

Halitosis is classified into:

  1. True halitosis
    • Physiological (normal) halitosis – The causes of physiological halitosis are found directly in the mouth. In about 90% of cases, the cause is in the oral cavity due to bacterial decomposition of organic materials. The foul odor comes from the back of the tongue or from consumed food and stimulants such as garlic or alcohol.
    • Pathological (pathological) halitosis – Pathological halitosis can have both oral (affecting the mouth) and extraoral (outside the mouth) causes. Less than 0.1% of cases have a gastrointestinal cause, such as esophageal diverticula, cardia insufficiency, gastroesophageal reflux, gastroesophageal reflux, gastroesophageal reflux, gastroesophageal reflux, gastroesophageal reflux, gastroesophageal reflux. GER, gastroesophageal reflux) or pyloric stenosis (narrowing (stenosis) in the area of the stomach outlet).
  2. Pseudohalitosis – In pseudohalitosis, halitosis is perceived only by the affected person, but not by outsiders. Through objective examinations, the patient learns that there is no bad breath.
  3. Halitophobia – Halitophobia (halitosis fear) is when the patient has an unfounded and persistent fear of suffering from halitosis and thinks thereby bothering others.

The prevalence (disease frequency) for Foetor ex ore is 25% of adults (in Germany).

Course and prognosis: If the affected person is often asked by fellow people about his foul-smelling breath and also has the impression himself that he has bad breath, he should see a doctor. Especially if there is no obvious reason for the bad breath. Bad breath can indicate disease processes.