Bad breath may depend on different causes; however, in most cases it is linked to oral problems.
In one study, 406 patients with halitosis, equally distributed between the two sexes, were analyzed:
- in 86% of patients the halitosis was due to oral causes; specifically, among the oral causes, the most common was linked to the lingual patina, followed by gingivitis and finally by periodontitis.
- In 5% of cases, halitosis was due to otorhinolaryngological diseases.
- In 3% of the cases halitosis was due to the addition of oral cavity problems with otorhinolaryngological diseases.
- Only in 1% of patients did the cause of the halitosis lie in the gastrointestinal tract.
- In 5% of patients it was not possible to determine a precise cause of the disorder.
These results have been confirmed by other studies, so today it is believed that only 5-8% of cases of halitosis can be attributed to non-oral causes.
Therefore, the widespread opinion that bad breath depends mainly on gastro-intestinal disorders is absolutely groundless. The problem almost always depends "only" on poor oral hygiene. Tooth brushing, for example, alone is not enough; especially in the presence of halitosis it is important to also take care of brushing the tongue, so as to break down the microorganisms responsible for the production of volatile sulfur compounds at the base of halitosis.
In addition to being mechanically speaking, the tongue and teeth can also be "cleaned" chemically; in particular, rinses and gargles based on antiseptic chemicals, such as chlorhexidine, or capable of masking bad smells, such as menthol, can help improve the situation. It should however be noted that the effective anti-halitosis action of mouthwashes is debated.
To the correct use of the toothbrush it is then necessary to combine the use of dental floss to also clean the spaces between tooth and tooth, where the bristles of the toothbrush do not arrive. Regular visits to the dentist allow to remove any deposits of tartar preventing gingivitis and periodontitis; the dentist can also evaluate if the patient's oral hygiene is actually adequate or if it needs to be improved.
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