What types of halitosis are there?

Bad breath affects many people causing discomfort and social problems. In this article we discuss the different types of halitosis that exist and what their causes may be.

Most of the time it is caused by oral or throat problems, but it can also be caused by other underlying medical conditions that need to be treated. Thus, a person can have true physiological or pathological halitosis, or suffer from pseudohalitosis or halitophobia.

True halitosis

This variety, also called genuine halitosis, is the presence of an unpleasant odor in the mouth with excessive intensity, so it is perceived by others. There are two types of true halitosis: physiological and pathological.


Physiological halitosis is one that the body produces naturally or in response to the consumption of certain foods or beverages. It is occasional and lasts a short time. Some types of physiological halitosis are the following:

  • Bad morning breath: it is the typical breath when waking up. During the night the production of saliva and self-cleaning mechanisms, such as the movement of the tongue and cheeks, decrease, generating a characteristic odor. It may be higher in people who breathe through the mouth or with chronic sinusitis.
  • Age: As a person ages, saliva production decreases and this generates bad breath. It is common in the elderly.
  • Fast: food stimulates the production of saliva. If the person does not eat, is dehydrated or has a hypocaloric diet, it is common for him to have bad breath due to the lack of salivary secretion.
  • Foods: some foods like onion, garlic, alcohol or highly spicy foods can give a bad smell to the mouth after being consumed.
  • Tobacco: frequent use of tobacco produces typical bad breath and favors dry mouth.

Some foods cause halitosis, such as garlic or onion.


This type of halitosis is the presence of bad breath in a chronic way, that is, the unpleasant odor in the mouth is frequent and persists over time. It arises as a consequence of pathological processes or diseases suffered by the person. They are classified, according to their origin, as buccal or extraoral.

Most pathological halitosis originate within the oral cavity, by the production of volatile compounds generated by bacteria in the mouth. The presence of active cavities, dental elements with deep cavities that accumulate impacted and decomposed food, periodontal disease, the presence of tartar, infectious processes or maladaptive prostheses can generate it.

Pathological halitosis of extra-oral origin is that produced by the presence of non-oral diseases, that is, bad breath comes from conditions in other areas of the body. As we mentioned, it is not that frequent and only represents 10% of the cases.

These are some of the extraoral causes that can cause this type of halitosis:

  • Respiratory problems, sinusitis and rhinitis: with foul and putrid odor.
  • Digestive disorders: they very rarely cause halitosis problems; only in cases of secondary complications. Dyspepsia associated with infections with Helicobacter pylori it's an example.
  • Liver or kidney failure: When the liver or kidneys are affected, the patient may have a fishy or musty odor in the mouth.
  • Diabetic cetoacidosis: uncontrolled diabetes causes a characteristic fruity breath.

Pseudohalitosis as a type of halitosis

It is called pseudohalitosis to the situation in which there is no bad mouth odor, but the patient believes that it does. It usually occurs in people who had bad breath at some point and after treating or reversing it, they fear that they will continue to suffer from it.

It can be helpful to have someone you trust regularly assess your breath and let you know that it does not smell bad. The dentist can explain and review oral hygiene measures that promote control and let the patient know that the intensity of their breath is socially acceptable.

Achieving the confidence and tranquility of the individual who has this type of halitosis is the goal of treatment.

A particular type of halitosis: halitophobia

Halitophobia is a psychological problem in which the patient feels an irrational fear of having bad breath. The breath of these people is normal, they do not have a bad smell, but they believe that they do, even if they are told otherwise.

Individuals with halitophobia become obsessed with the bad breath they think they have. This leads them to isolate themselves, avoid socializing and keep distance with people to talk.

Although they tend to have adequate oral hygiene by themselves, they can overdo the care of the mouth, use antiseptic substances or consume sweets or gum for the breath in an exaggerated way. This fear of having bad breath, if not treated by a psychiatrist, can trigger a neurosis.

Sometimes, patients with halitophobia assume that they have bad breath by interpreting the expressions of their interlocutors as gestures that indicate displeasure. Personality is not usually affected, so it can be difficult to diagnose, although it is related to depressive states or obsessive-compulsive behaviors.

By explaining to patients that they do not actually have a true halitosis problem and that their symptoms may have a psychological basis, they often become angry or disbelieve the diagnosis. Ads for mouthwash, gum, or candy that exaggerate the importance of fresh, clean breath can trigger this excessive worry.

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Possible causes

As we already mentioned, Most of the time the origin of halitosis is due to problems within the oral cavity. Caries, periodontal problems, repair or prosthesis in poor condition, tartar or any situation in the mouth that favors the accumulation and proliferation of bacteria can generate bad breath.

Dry mouth, dehydration and prolonged fasting are also among the causes of bad smell from the mouth. The use of tobacco and the consumption of some foods can cause bad mouth odor.

In cases of bad breath caused by non-oral problems, the causes are diabetes and liver, kidney, respiratory or digestive disorders. The smell of the mouth usually has particular characteristics and sometimes helps in the diagnosis of pathologies that must be treated by a doctor.

In the types of imaginary halitosis, such as pseudohalitosis and halitophobia, the origin is within the psychological order. A treatment with a professional in this area will help the patient to solve it.

Treatments for types of halitosis

The presence of any of the types of halitosis It can generate discomfort, shame and shyness in those who suffer from them when interacting. Some people even identify this problem as the cause of unemployment, failure of relationships or friendship, social isolation or suicide attempts.

The first step in the approach is to consult a dentist to detect what is causing it and arrive at a diagnosis. Depending on this, the corresponding treatment may be carried out.

The perception of halitosis can be on the part of other people or something personal, imaginative.

Learn more about halitosis: What is halitosis?

Some care to avoid bad breath

These are some aspects to take into account to eliminate bad breath and promote oral health:

  • Maintain good dental hygiene: brush your teeth and tongue two or three times a day for two minutes. Daily flossing is necessary to remove bacteria that settle between teeth.
  • Using mouthwashes: Some solutions to make mouthwash help reduce the presence of bacteria in the mouth, others provide fluoride and provide the sensation of fresh breath.
  • See your dentist regularly: Going to the dentist frequently can detect problems that can cause bad breath. Visits every six months and regular cleanings will help keep your mouth healthy.
  • Avoid tobacco: Smoking predisposes you to many health conditions, affects your breath and dries out your mouth, so it is always advisable to avoid it.
  • Drink plenty of water: Drinking water and staying hydrated can help decrease dry mouth. For mouth breathers, using a humidifier at night can also be helpful.
  • Do not do long fasts: not eating food for a long time favors bad breath. Eating something every four hours can prevent it.
  • Keeping dentures in good condition: Cleaning dentures, retainers, or removable appliances helps you have good breath. Checking them periodically to prevent them from misfitting and accumulating bacteria is ideal.
  • Treat conditions that cause bad breath: When bad breath originates from non-oral pathologies, their treatment and control is vital to avoid odor from the mouth.

Other tips to reduce the different types of halitosis

Chew sugar-free gum or candy, Although it does not solve the problem, it stimulates the production of saliva helping to reduce bad breath. There are natural remedies that can contribute: infusions of mint, rosemary, fennel, anise or thyme. Using essential oils or chewing on cloves and juniper also helps.

However, while these behaviors can improve mouth odor for a time, the ideal treatment is always to address the origin of halitosis with a professional.

Bad breath has a solution

Of the different types of halitosis, those that are due to a problem in the mouth are the most common. Consultation with a dentist will help eliminate its origin and reverse this annoying situation.

Other times it may be due to an external situation that needs to be diagnosed and treated. As we mentioned, some people believe they have bad breath, but in reality they do not, they just imagine it. Also in such cases professional help is necessary.

Having good oral hygiene and consulting the dentist frequently helps prevent and avoid the appearance of this unpleasant symptom that bothers those who suffer from it and those around them.