Bad Or Changed Breath

Bad Or Changed Breath
Bad Or Changed Breath

Overview Of Bad Or Changed Breath

Halitosis is the proper term for bad or changed breath. Poor dental hygiene is the most prevalent reason for halitosis because it allows bacteria to build up inside the mouth. As a result, the bacterial colonies release sulfur compounds, causing foul odour. 

Some diseases and disorders can cause quite distinct breath odours. For instance:

  • Chronic kidney (renal) failure can cause the breath to have a strong smell of ammonia, also described as smelling “fishy”, or of urine.
  • Prolonged vomiting can cause a faeces odour, especially if the patient has a bowel obstruction. Having a tube temporarily inserted through the nose or mouth to drain stomach contents can also cause this unpleasant aroma.
  • Diabetic ketoacidosis is a potentially life-threatening condition caused by diabetes mismanagement. One big sign of ketoacidosis is fruity-smelling breath.

Causes Of Bad Or Changed Breath

Halitosis may be caused by:

  • Abscessed tooth
  • Alcoholism
  • Caries (cavities)
  • Certain vitamin supplements (especially in large doses). Fish oil, I’m looking at you…
  • Dentures
  • Diets that have a poor pH-balance.
  • Eating certain foods. Garlic, for example, is guaranteed to keep everyone away, not just vampires. Both raw onions and cabbage are other bad breath contenders.
  • Gum surgery.
  • Impacted tooth
  • Object lodged in the nose. This may be accompanied by a white, yellow, or bloody discharge from one nostril. This is a frequent pediatric complaint.
  • Overall poor dental hygiene. Brushing and flossing are very important.
  • Tobacco smoking
  • Tonsils with deep crypts and sulfur granules
  • Some medicines, including insulin shots, triamterene, and paraldehyde

Some diseases that may cause changed breath odor are:

  • Acute or chronic kidney failure
  • Acute necrotizing ulcerative mucositis
  • Bowel obstruction
  • Bronchiectasis
  • Diabetic ketoacidosis
  • Esophageal cancer
  • Gastric carcinoma
  • Gastroesophageal reflux disease (GERD)
  • Gastrojejunocolic fistula
  • Gum disease, such as acute necrotizing ulcerative gingivitis (ANUG), gingivostomatitis, or gingivitis.
  • Hepatic encephalopathy
  • Lung infection or abscess
  • Ozena, or atrophic rhinitis
  • Periodontal disease
  • Pharyngitis
  • Sinus infections
  • Throat infections
  • Zenker diverticulum

Exams & Tests

Your doctor will take a medical history and perform a physical exam. The physical exam will include a thorough inspection of both your mouth and nose. Throat swabs may be taken if you have a sore throat or mouth sores. Depending on the cause, your doctor may refer you to your dentist for care. Antibiotics may be prescribed for some conditions. The doctor will generally use instruments to retrieve the lost object, if you’ve shoved something up inside your nose.

The following medical history questions are important in narrowing the cause of bad or changed breath: 

  • Do you smoke?
  • Have you recently eaten a spicy meal, garlic, cabbage, onions, or other odiferous food?
  • Do you take vitamin supplements?
  • Have you had a recent sore throat?
  • Have you had a recent sinus infection?
  • Do you have an abscessed tooth?
  • Does your breath have any particular odour, such as fruit or ammonia?
  • What home care/ oral hygiene measures have you tried? How effective are they?
  • What other symptoms do you have?

Your doctor may order one or more of the following tests:

  • Blood tests to screen for diabetes or kidney failure
  • Endoscopy (EGD)
  • X-ray of the abdomen
  • X-ray of the chest