How is bad breath (halitosis) diagnosed?

There are two great self-tests for determining if you have halitosis (bad breath) as it is difficult to accurately smell your own breath. First, lick your wrist or back of your hand after washing them and allow this to dry for 5-8 seconds then smell. This will determine if you have bad breath from the anterior (front) part of your tongue. Second, use a teaspoon upside down and scrape the back of your tongue forward. A whitish film should come off on the spoon. If this film smells than your bad breath is from the sulfur compounds excreted by bacteria that live in this film on the posterior (back) of your tongue. If your self-test is positive, you should see your dentist as halitosis (bad breath) is a sign of a bacterial imbalance, periodontal (gum) disease, or sometimes can be caused by a gastric reflux disorder as well.

Since halitosis is bad breath, your dentist will be able to smell it.  He wil look for the causes to rule out any dental problem, like gum disease.  He may ask you about any other medical conditions you might have.  If he cannot find a dental reason for the halitosis, he will recommend that you follow up with your regular medical doctor.

Some types of halitosis (bad breath), such as morning breath, do not require a diagnosis because they are normal and are not causes for concern. However, if poor hygiene or an underlying medical condition is causing symptoms, a diagnosis is necessary to treat the patient.

The healthcare professional will ask about oral hygiene and personal habits that may lead to bad breath (such as smoking). A dentist or physician may notice bad breath during a routine examination. Sometimes, the type of odor may suggest a particular cause. For instance, a urine-like smell may indicate kidney failure, while a fruity smell may indicate uncontrolled diabetes. If the patient has plaque buildup on the teeth or pale or swollen gums, gum disease may be suspected.

In order to definitively determine the underlying cause, tests may need to be performed in addition to a physical examination. Commonly performed tests include X-rays of the chest or sinuses, blood tests, urine tests, and sputum tests.

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