Bad Breath-How Bad Can it Be?
- Food: Food is a primary source of bad odors that come from the mouth. Some foods, such as garlic, onions, and spicy foods, exotic spices (such as curry), some cheeses, fish, and acidic beverages such as coffee can leave a lingering smell. Most of the time this is short term. Other foods may get stuck in the teeth, promoting the growth of bacteria, which causes bad breath odor. Low carbohydrate diets may also cause “ketone breath.” These diets cause the body to burn fat as its energy source. The end-product of making this energy is ketones, which cause a fruity acetone-like odor on the breath when exhaled.
- Tobacco products: Smoking and chewing tobacco can leave chemicals that remain in the mouth. Smoking can also precipitate other bad-breath causes such as gum disease or oral cancers.
- Poor dental hygiene: When a person does not brush or floss regularly, food particles remaining in the mouth can rot and cause bad odors. Poor dental care can lead to a buildup of plaque in the mouth, which causes an odor of its own. Plaque buildup can also lead to periodontal (gum) disease. The mild form of gum disease is called gingivitis; if gingivitis is not treated, it can advance to periodontitis.
- Health problems: Sinus infections, pneumonia, sore throat (pharyngitis) and other throat infections, thrush, bronchitis, postnasal drip, diabetes, acid reflux, lactose intolerance, other stomach problems, and some liver or kidney diseases may be associated with bad breath.
- Dry mouth: Also called xerostomia, dry mouth can also cause bad breath. Saliva helps moisten and cleanse the mouth, and when the body does not product enough saliva, bad breath may result. Dry mouth may be caused by salivary gland problems, connective tissue disorders (Sjögren’s syndrome), medications, or breathing through the mouth.
- Mouth infections: Cavities, gum disease, or impacted teeth may cause bad breath.
- Dentures or braces: Food particles not properly cleaned from appliances can rot or cause bacteria and odor. Loose-fitting dentures may cause sores or infections in the mouth, which can cause bad breath.
- Medications: Many medications, including antihistamines and diuretics, can cause dry mouth (see above), which can cause bad breath. Other medications that may lead to bad breath may include insulin shots, triamterene (Dyrenium), and paraldehyde.
- “Morning breath”: Bad breath in the morning is very common. Saliva production nearly stops during sleep, which allows bacteria to grow, causing bad breath.
- Other causes of bad breath: Objects stuck in the nose (usually in children), alcoholism, and large doses of vitamin supplements may also cause bad breath.
When should someone see a doctor about bad breath?
Most of the time, bad breath can be cured with proper oral hygiene. It is rarely life-threatening, and the prognosis is good. However, bad breath may be a symptom of a medical disorder.
If proper oral hygiene does not eliminate bad breath, see a dentist or doctor for a diagnosis if bad breath is accompanied by
- persistent dry mouth,
- sores in the mouth,
- pain or difficulty with chewing or swallowing,
- broken teeth or dental pain,
- white spots on the tonsils,
Also see a doctor or dentist if bad breath develops after taking a new medication, after recent dental surgery, or any other symptoms develop that are of concern.
Bad breath in babies or young children may be a sign of infection or undiagnosed medical problems. Consult a child’s pediatrician or dentist if an infant or young child has bad breath.