Halitosis

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.