Bad breath: is a matter of health

Bad breath is a sensitive topic that no one likes to talk about. The causes of bad breath mainly originate in the mouth itself, only in rare cases is there a relationship with a serious illness, fortunately.

In most cases, the cause of the unwanted smell can be found and successfully eliminated.

What causes the bad smell from the mouth?

The causes for bad breath are mainly in the mouth itself, in about 90%. Doctors speak of foetor ex ore (literally: bad smell from the mouth). If the person in question closes his mouth, his interlocutor also hardly smells anything. Odor is mainly caused by poor oral hygiene and dental problems, dry mouth, and substances that affect saliva and the oral mucosa, such as certain foods or tobacco, but also inflammation and sometimes tumors in the oral cavity.

The second form of bad breath, known as halitosis, is less common. Here is the exhaled air not only smells bad when it comes out through the open mouth but also when it comes out through the nose alone. In addition to known causes such as ingestion of garlic or alcohol, diseases in the nose and throat area, such as chronic rhinitis, or respiratory diseases, such as bronchitis or pneumonia, lead to halitosis in some people. Digestive problems in the esophagus and gastrointestinal tract can also be a reason for bad breath. Very characteristic respiratory odors can also be caused by metabolic imbalances such as diabetes, and kidney or liver failure.

When to see a doctor?

If bad breath has an easily understandable cause, such as eating raw onion in a salad or poor dental care, the breath odor will improve once the onion is digested or oral hygiene is adequate.

Anyone who has the impression that something is permanently wrong with their breath should see a doctor. This also especially applies if bad breath occurs suddenly for no apparent reason or if other symptoms occur, such as breathing difficulties, headaches, body aches, and pains in the stomach, or coughing.

The doctor will use specific questions and initial tests to assess the possible causes of the problem. If necessary, he refers patients to an appropriate specialist, who may be, for example, a dentist, an otolaryngologist, or a doctor specializing in internal medicine or gastroenterology.

Anyone suffering from bad breath should first check their oral hygiene and eating habits. It's best to get advice from your dentist or family doctor. Bad breath isn't just annoying to the people around you. It can also point to disease processes. Therefore, it is important to investigate the causes and take appropriate measures to restore the healthy condition of the mouth.

The main causes of bad breath at a glance:

Bad breath from the mouth (foetor ex ore):

• Garlic, onion and other foods that affect saliva and oral mucosa

• Alcohol, coffee and other beverages that affect saliva and oral mucosa

• Smoke

• Leftover food in the mouth

• Some medicines containing nitrates or sulfur

• Hunger, malnutrition

• Decreased salivation, dry mouth (breathing through the mouth, medication, …)

• Poor oral hygiene, irregular and careless brushing of teeth

• Bacterial coating of the tongue

• Dental plaque, tartar

• Ill-fitting dentures

• Dental disease, gum inflammation (periodontitis, gingivitis)

• Inflammation of the oral mucosa (aphthous stomatitis, gingivostomatitis)

• Fungal infections in the mouth (thrush, thrush)

• Tonsillitis

• Mononucleosis

• Abscesses in the mouth and throat (peritonsillar abscess)

• Tumors in the mouth and throat

• Diphtheria

• Syphilis (syphilis)

Bad breath from the mouth and nose (halitosis):

• Foods such as garlic, onion, alcoholic beverages, among others

• Chronic inflammation of the sinuses (sinusitis), nasal polyps

• Dry nasal (mucosal) membranes (excessive use of decongestant nasal sprays, drops; after radiation treatments, nasal operations)

• Tumors in the nasopharynx

• Respiratory diseases (purulent bronchitis, bronchiectasis, pneumonia, lung abscess)

• Esophageal diseases

• Heartburn, reflux disease

• Diaphragmatic hernia (hiatal hernia)

• Foreign bodies in the upper digestive tract

• Diseases of the stomach (stricture at the outlet of the stomach, stomach ulcers, stomach cancer)

• Bowel obstruction

• Food allergies, intolerances, celiac disease

• Diabetic coma (ketoacidosis, acetone-smelling breath)

• Kidney failure (breath smelling of ammonia or urine)

• Liver failure (hepatic coma, sweet-smelling breath like fresh liver)

Thordis Berger

Chief Medical Officer - Holmes Place