Formula Medical Group
Apple Valley, CA

James Krider, MD

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Bad breath odor - halitosis

Breath odor, or halitosis, is a symptom of numerous disorders, some of them innocuous, and others quite serious. In many cases, bad breath is nothing more than the result of eating certain foods. The most frequent dietary offenders are onions, garlic, and alcoholic beverages.

Smoking produces an unpleasant breath odor, as does certain medications. Food particles trapped between the teeth, as well as buildup of plaque and resulting tooth decay, can lead to bad breath. In addition, breath odor can sometimes be a sign of a serious illness.

Causes of breath odor

Acute bronchitis
A painful cough that brings up foul-smelling phlegm is a common symptom of an acute attack of bronchitis. This condition often follows a severe cold or flu.

Acute kidney failure
This is a medical emergency that usually comes on suddenly completely shutting down the flow of urine. The feet may swell, and facial puffiness, shortness of breath, and headache may develop. In addition, the breath may smell like urine.

This relatively rare disorder leads to an accumulation of mucus in the breathing tubes {bronchial tree) and is characterized by a chronic cough. As the disease progresses, it destroys lung tissue. Thus, the cough frequently produces thick and extremely foul-smelling sputum.

Foul breath may be a symptom of cancer of the lung, esophagus, tongue, mouth, throat (pharynx), or voice box (larynx). Bad breath accompanied by other symptoms, such as spitting up blood, coughing, difficulty swallowing, and weight loss should be investigated by a doctor.

Cirrhosis is chronic inflammation and hardening of the liver, usually caused by alcohol abuse. In addition to malodorous breath, other symptoms may include jaundice, a distended abdomen, puffiness, and appetite loss.

bad breath odor can be a symptom of a serious disease

Bad breath odor can be helped by brushing your tongue.

Chronic gastritis
A bad taste in the mouth along with sour-smelling breath, heartburn, burning pain in the abdomen, and related symptoms may indicate chronic gastritis or in­flammation of the stomach.

Dental problems
Tooth decay and disorders affecting the gums, are probably the most common cause of bad breath. Periodontal disease leads to the forma­tion of pus that is discharged from the gums, causing foul breath. The gums bleed easily and are often eroded, making the teeth loose.

People with diabetes may develop breath that smells fruity or sharp, similar to nail polish remover. This odor can be a sign of hyperglycemia (excessive blood sugar) and ketoacidosis, a buildup of ketones (acid) in the blood. Ketoacidosis, which occurs mainly in people with Type 1, or juvenile diabetes, requires immediate care.

This infectious disease is now uncommon, thanks to routine childhood immunization. Symptoms include a sore throat, cough, the formation of a membrane in the throat, a foul mouth odor, fever, and difficulty swallowing.

This inflammatory disease affects the liver, destroying patches of tissue. It is often accompanied by jaundice, a yellowing of the skin and eyes. Sickly sweet breath is a

common symptom, along with dark urine and light-colored stools, nausea, and abdominal pain.

Salivary-gland disorders
A lack of saliva results in bad breath. In fact, the reduced flow of saliva during sleep explains why many people wake up with bad breath in the morning. Radiation ther­apy, infection, and cancer all may affect the salivary glands.

When the tonsils are chronically inflamed, there is a constant nasal discharge, leading to bad breath, a low fever, and a low energy level. Sometimes an abscess forms in the area of the tonsils.

Advice about breath odor

  • If there are no other symptoms, halitosis may simply be due to poor dental hy­ giene. Brushing the teeth after every meal and flossing regularly usually takes care of the problem. Using a mouthwash that controls oral bacteria is also helpful.
  • Seeing a dentist at least once a year (preferably, twice) can prevent serious tooth decay and gum diseases that cause bad breath.
  • Stopping smoking usually improves breath odor, and has many other health benefits as well.
  • Breath odor accompanied by a discharge, pus, coughing, or fever that continues for more than a few days in­ dicates that a medical consultation is in order.
This article was last reviewed November 10, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Bronchitis, acute
Cancer, esophageal
Cancer, larynx
Cancer, lung
Cancer, mouth
Cancer, pharynx
Dental cavities
Diabetes, type 1
Gastritis, chronic
Gum inflammation
Infectious hepatitis
Kidney failure, acute
Periodontal disease
Salivary-gland disorder
Throat abscesses

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