Bad breath
Breath odor, or halitosis, is common, if unpleasant, distinctive, or offensive.
Considerations
Some medical disorders will produce specific, characteristic odors to the breath.
- A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a characteristic sign of ketoacidosis (such as diabetic ketoacidosis), a potentially life-threatening condition.
- A fecal odor to the breath (the breath smells like feces) can occur with prolonged vomiting, especially when there is a bowel obstruction. It can also occur temporarily if the person has a nasogastric tube in place (a tube placed through the nose or mouth to the stomach to drain the stomach contents).
- The breath may have an ammonia-like odor (also described as urine-like or "fishy") in people with chronic kidney failure.
Common Causes
If previously normal breath turns into halitosis, causes could include:
- Food or beverages consumed (such as cabbage, garlic, raw onions, or coffee)
- Vitamin supplements (especially in large doses)
- Poor dental hygiene
- Dentures
- Cavities
- Tobacco smoking
- Alcoholism
- Throat infection
- Sinusitis
- Lung infection
- Gum disease (gingivitis, gingivostomatitis)
- Abscessed tooth
- Impacted tooth
- Foreign body in the nose (in children)
- Often (but not always) there is a white, yellowish, or bloody discharge from one nostril
- Drugs
- Paraldehyde
- necrotizing ulcerative gingivitis
- Acute necrotizing ulcerative mucositis
- Acute renal failure
- Bowel obstruction (can cause breath to smell like feces)
- Bronchiectasis
- Chronic renal failure (can cause breath to smell like ammonia)
- Diabetes (fruity or "sweet chemical" smell with ketoacidosis)
- Esophageal cancer
- Gastric carcinoma
- Gastrojejunocolic fistula (fruity-smelling breath)
- Hepatic encephalopathy
- Diabetic ketoacidosis
- Lung abscess
- Ozena, or atrophic rhinitis
- Periodontal disease
- Pharyngitis
- Zenker's diverticulum
Home Care
Use proper dental hygiene (especially flossing), and remember that mouthwashes are not effective in treating the underlying problem.
Fresh parsley or a strong mint are often effective ways to fight temporary bad breath. Avoid smoking. Otherwise, follow prescribed therapy to treat the underlying cause.
