The causes of halitosis may be local, systemic, adaptative, physiological, or emotional. For a successful treatment, a careful evaluation of possible causes of a change in the patient’s breath is needed:

Local causes: cavities, periodontal diseases (in the gum and at basis of the teeth), xerostomia (low saliva flow), tongue coating, root-canal (endodontal)problems, and so on.




            
 
     Periodontal disease – generalized inflammation and gingival retraction

    
    Tongue coating 
   


Systemic causes: diabetes, hepatic dysfunction, gastrointestinal alteration, sinusitis, complications in the lungs and other body parts.

Emotional causes: anxiety, stress, phobias and depression.

  Usually, the cause of halitosis is an association of two or more factors. This highlights the importance of undergoing a specialized professional evaluation.

Important:  The use of mouthwash, sprays, oral deodorants, lozenges and other mouth hygiene products without professional counseling can only but mask halitosis. The effect of such products does not eliminate the causes of a change in mouth odor.