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Bad breath

Mel Rosenberg, PhD
Section Editor
Daniel G Deschler, MD, FACS
Deputy Editor
Howard Libman, MD, FACP


Bad breath (sometimes referred to as halitosis, oral malodor, fetor oris, or fetor ex ore) is defined as any detectable offensive smell carried on the breath. Gases that might appear in the breath in abnormal concentrations, yet are not detected by the nose, would not fall under this definition.

This topic will cover the etiology, pathogenesis, diagnosis, and treatment of bad breath. Other related topics such as gingivitis, periodontitis, and odontogenic infections are discussed elsewhere. (See "Gingivitis and periodontitis in adults: Classification and dental treatment" and "Epidemiology, pathogenesis, and clinical manifestations of odontogenic infections" and "Complications, diagnosis, and treatment of odontogenic infections".)


Bad breath has been with us for thousands of years. The problem is discussed at length in the Jewish Talmud, as well as by Greek and Roman writers. Islam also stresses fresh breath in the context of good oral hygiene.

Ancient folk remedies abound that are still in use. The book of Genesis (Chapter 37) mentions ladanum (mastic), which may be the mastic gum derived from the Pistacia lentiscus tree, which has been used in Mediterranean countries for breath freshening for thousands of years. Other folk cures include mint, anise, parsley (Italy), cloves (Iraq), guava peels (Thailand), and eggshells (China).

Modern literature on bad breath dates back to a monograph published by Howe in the 19th century. Experimental research on the subject dates back over 70 years.

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Literature review current through: Oct 2017. | This topic last updated: Dec 16, 2016.
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