Bad breath is no modern dilemma. The Talmud warned against it in priests, Muhammad allegedly dismissed a follower from a mosque because of it, and the ancient Romans employed slaves to clean their mouths to prevent it.
Ancient Egyptians fashioned toothpaste out of a substance (natron) they used for embalming mummies and made breath-sweetening pellets of frankincense and myrrh. In the medieval Arabic empire, people chewed on the mouth-freshening twigs of the Salvadora persica shrub.
The Chinese were first to come up with the idea of brushing teeth to eliminate foul breath. Although the hog's-hair bristles they used in the 15th century were effective, the idea didn't catch on elsewhere for several centuries.
Toothpicks -- made of bone, ivory, quills, wood or various metals -- were popular around the world until the Victorian era, when they were suddenly considered uncouth.
In Europe and the U.S., tins of breath fresheners, called cachous, became a must-have item in the 1800s. The candies (sucked or chewed to "disguise a stinking breath," according to one 1850 self-help book) were made from cardamom, ambergris, musk, essence of violet, essence of rose, licorice or oil of cinnamon.
While people were sucking on cachous, English surgeon Joseph Lister was coming up with an antiseptic to kill the bacteria that frequently caused infections during surgery. After he presented his idea at a meeting in Philadelphia in 1876, one of the doctors in the audience, Joseph Joshua Lawrence, devised his own antiseptic formula made of alcohol, thymol, eucalyptol and menthol -- for the U.S. market. He called it Listerine, in honor of the man who had inspired him.
Lawrence sold Listerine to a drug company, Lambert Pharmacal, which marketed the liquid as a treatment for dandruff, gonorrhea and dirty floors -- before finally deciding to hawk it as a cure for halitosis. In fact, Lambert's ad campaign turned the word from an obscure medical term into a household term in the 1920s.
In the modern era of mouthwash and twice-daily brushing -- not to mention "curiously strong" mints, breath strips and mechanical toothbrushes -- bad breath is much rarer than it once was. Even so, today roughly one in three Americans has halitosis on a regular basis.
The most common cause: sulfur-producing bacteria that inhabit the mouth and feed on microscopic morsels of food stuck in teeth, gums, dentures, piercings or cavities, or on the tongue.
There are rarer causes too: dry mouth (a side effect of many drugs), infection with Helicobacter pylori (the bug that causes ulcers), infected tonsils, and a condition called Zenker's diverticulum, a little pouch in which food can get trapped that can form in the throat in people older than 50.
In more than a few instances, bad breath in children has been traced to objects stuck in their noses. Doctors in Turkey traced the persistently bad breath of a 4-year-old girl to a metal ring embedded in her pharynx. She'd swallowed it three years earlier.
Some people suffer psychiatric conditions characterized by delusions of halitosis. People with pseudo-halitosis often think they have bad breath but don't. In people with halitophobia, that sneaking suspicion becomes a constant and socially paralyzing fear.
Studies have shown that women are more likely than men to think their breath is bad, but men are more likely to actually be in need of a breath mint.
Rumors, on the other hand, suggest that halitosis doesn't preclude success. King Herod and Gandhi allegedly suffered from halitosis, as do (if the Hollywood gossip is true) several pop idols and big-screen heartthrobs.
Only one person has been willingly associated with bad breath, and that's Gerard Lambert, the pharmaceutical exec who made his millions marketing Listerine as a mouthwash. He once predicted his tombstone would read: "Here Lies the Father of Halitosis."