[Health Byte] Shanghai's First Bad Breath Clinic Opens in Huadong Hospital

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Many people are frustrated by bad breath, which impacts normal social life and even causes serious mental pressure. In Shanghai, Huadong Hospital has opened the city's first multidisciplinary department clinic for bad breath.

Halitosis troubles around 30 percent of people. The greatest difficulty in its treatment lies in unclear medical consultation guidance, as its causes involve stomatology, gastroenterology, ENT and multiple other departments. Most clinicians lack sufficient understanding of this condition, leading to improper diagnosis and ineffective treatment.

"This is why we opened this MDT clinic with participation of experts from gastroenterology, stomatology and ENT departments to offer patients a comprehensive diagnosis, treatment and guidance," said Dr Chen Yuanwen, director of Huadong Hospital's gastroenterology department.

According to experts, bad breath can come from oral issues like poor hygiene, periodontitis, cavities, tongue coating, and tonsil stones; systemic diseases like gastrointestinal disorders (e.g., acid reflux, H. pylori infection), sinusitis, diabetes (fruity breath), kidney disease (ammonia smell), and liver problems. Lifestyle factors like strong-smelling foods (garlic, onions), dry mouth, smoking, and alcohol consumption can also contribute to bad breath.

Clinically, single-department diagnosis often fails to pinpoint root causes. Dental issues, including periodontitis, dental caries, and impacted teeth, are common triggers. For internal disorders, gastritis, liver and kidney diseases, as well as diabetes, can all result in bad breath. Many gastroenterologists merely focus on Hp infection, gastroesophageal reflux, and arrange gastroscopy and enteroscopy, ignoring numerous other underlying systemic causes, he said.

"Young people under 40 and well-educated groups constitute the main patient groups at our MDT clinic, as most of them work in socially intensive occupations such as teachers, lawyers, and receptionists. Severe halitosis has triggered social anxiety, social withdrawal, depression, and self-isolation, and even seriously affected teenagers' daily communication, study and future development. Many patients suffer long-term mental stress, and repeated visits to clinics have shown little improvement," Chen said.

At the MDT clinic, doctors said they will do detailed checks to look for the reason for bad breath.

"Apparent oral diseases can be relieved through professional dental treatments. Yet many patients with neat oral conditions still struggle with persistent halitosis. Many people commonly hold wrong notions that dedicated medicine or surgery can cure the problem overnight. In fact, halitosis forms gradually due to long-term unhealthy living and oral habits," said Li Jing, director of Huadong Hospital's stomatology department.

"Maintaining oral flora balance matters far more than sterilization. Excessive sterilization will damage the original oral ecological environment and induce new health problems. Developing correct oral care habits, including regular brushing, flossing, and mouth rinsing, is the core solution to long-term breath freshness," she added.

Apart from the stomatology and gastroenterology departments, the ENT department is usually ignored by patients with bad breath.

"ENT problems are also vital hidden causes. Sinusitis, tonsil stones and habitual mouth breathing will alter the oral bacterial environment and produce an unpleasant odor. Without precise detection tools to confirm odor sources, doctors mostly adopt exclusion methods for systematic screening," said Dr Han Zhao, director of the hospital's ENT department.

"We also call on all clinical departments to attach greater importance to halitosis, help patients eliminate physical discomforts and relieve psychological pressure, to help them regain social confidence and a healthy life status," he added.

How to keep breath fresh:

1. Brush & floss daily: Clean all tooth surfaces and between teeth to remove food debris.

2. Scrape your tongue: The back of the tongue harbors the most odor-causing bacteria.

3. Stay hydrated: Drink water to stimulate saliva flow, which naturally cleanses the mouth.

4. Avoid trigger foods: Cut back on garlic, onions, coffee, and alcohol.

5. Quit smoking: Tobacco worsens dry mouth and bacterial growth.

6. See a specialist: If foul breath persists for over two weeks, consult a multidisciplinary halitosis clinic for a comprehensive evaluation.

Key takeaway

Bad breath is treatable and often preventable. While occasional "morning breath" is normal, chronic halitosis is not something to ignore or be ashamed of. It is a signal from your body that your oral hygiene or overall health needs attention. With proper care and professional guidance, you can regain fresh breath and confidence in social interactions.

If you go:

The halitosis MDT clinic is open on Tuesday mornings. Expatriate patients and those with commercial insurance can contact Huadong Hospital's international medical center to help arrange the appointment.

Tel: 6248-2423 (8am-4:30pm on workdays)

E-mail: huadongimc@163.com

Address: Building 1, 221 Yan'an Rd W., Jingan District

延安西路221号1号楼

Health Byte tips

Smoking is an important cause of bad breath. Local health authorities have been strengthening tobacco control efforts and encouraging medical staff to promote health education.

The rate of smoking violations in smoke-free public areas stood at 12.6 percent last year, down 0.4 percentage points from the previous year.

Public support for stricter regulations remains high, with 98.2 percent of residents backing a complete ban on smoking in indoor venues.

The city's overall smoking rate fell to 18.6 percent in 2024, the lowest on the Chinese mainland. The figure meets both the national targets under the Healthy China 2030 initiative and the global tobacco-control goals set by the World Health Organization.

There are some 7,000 chemicals in the smoke of tobacco, including hundreds of harmful ones and at least 69 carcinogens. Smoking and passive smoking are both harmful to health, medical experts said.

To enhance public awareness, Shanghai Health Promotion Center teamed up with local medical staff to film a series of anti-smoking short movies. All production, filming, and crew are local medical staff. The videos have bilingual subtitles.

Upcoming topics

Many people wear earphones all the time. Long-term, loud earphone use can damage hearing. Hear what the experts have to say in the next column. Stay tuned.

About the author

Cai Wenjun is a seasoned health reporter at Shanghai Daily. She has considerable experience covering the local medical system, hospitals, health officials, and top medical specialists. She has reported on major pandemics such as SARS, swine flu, and COVID-19, as well as advances in the local health business.