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Bad breath is medically called halitosis and is also known as fetor oris, fetor ex ore and oral malodor. It is defined as detectable bad smell on breath. It could develop due to numerous reasons involving multiple organs of the body. Eventually, the breath passes through the throat and bad breath is smelled when it comes out of the mouth. Throat is a very dynamic crossroad in the body that is connected to the nose, mouth and the ears from the top and the esophagus and trachea in the bottom. Therefore, any disease within these organs could possibly lead to involvement of the throat. Oral and nasal cavity diseases are the major causes of bad breath.

One of the most important causes of halitosis is poor oral and dental hygiene. The importance of good oral and dental hygiene cannot be stressed enough. It is of utmost importance to regularly brush the teeth and to have frequent dental visits. Decayed tooth can be a culprit of bad smell. Mouthwashes can help to increase the level of oral hygiene. They should be chosen according to the dentists' advice for specific purposes on a case-by-case basis since different mouthwashes are available in the market. A very successful measure for many people is simple gargling of saline (saltwater) on a regular basis.

Halitosis can also happen with an infection in the throat which could be originating from any adjacent structure. It could also be due to dumping of infectious secretions in the throat. Chronic sinusitis is a famous example which could be somehow over-diagnosed yet continuous infectious secretions from the sinuses into the nasal cavity and into the throat can cause coughing and bring-up purulent bad-smelling secretions in the mouth. These secretions tend to stick to the walls of the throat and become the source of a bad breath. Infections could be limited to the throat.

Smoking is very important in halitosis. It has many effects that lead to the development of halitosis letting alone the unpleasant smell of cigarette smoke that others feel even when a smoker is not smoking. Smoking increases the chance of developing upper and lower respiratory tract infections which may lead to development of bad breath. Smoking decreases the movement of cilia which normally clean up the secretions in the respiratory system and may cause a bad breath. It also negatively contributes to the development of other disease that may become the source of halitosis.

Gastroesophageal reflux disease (GERD) is very important and may be the source of halitosis. It may lead to chronic respiratory infection or inflammation and frequent coughing. The list of diseases that may cause a bad breath is very lengthy. Some of them are primarily diseases of other organs that may lead to halitosis. After ruling out oral and nasal causes of a bad breath, thorough physical exam is undertaken as an attempt to make the diagnosis.

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