Bad breath, clinically known as halitosis or oral malodor, is a very common oral condition seen in more than 50% of the general population. It goes without saying that most people might have experienced bad breath at some point or the other. But most often than not, we feel embarrassed about it and fail to seek help. This is not a good sign because bad breath not only indicates poor oral hygiene or oral problems but can also be a sign of an underlying serious medical condition.
Types of bad breath
According to a research study published in the Journal of Natural Science, Biology, and Medicine, around 90% of the cases of bad breath are caused due to diseases of the oral cavity. Off the remaining 10% non-oral causes, 9% are due to problems of the respiratory system, gastrointestinal system, or urinary system and 1% is due to diet or drugs. This means that your breath can reveal a lot about your overall health and may warn you about any significant health problems.
Here is a brief on the types of bad breath and what it indicates.
Fruity breath: It is a known fact that diabetes can make you more prone to oral problems such as dry mouth and bad breath. However, uncontrolled diabetes can also cause fruity or acetone (nail polish remover) breath, which is a common sign of diabetic complication known as ketoacidosis. As the body doesn’t have enough insulin, it uses fats to produce energy and ketones (as a by-product). This causes ketone or fruity breath in people with diabetes.
Acidic breath: People suffering from lung disease and respiratory diseases can experience an acidic breath. This is because the respiratory infection can increase the mucus production, which leads to sinus blockage. People suffering from asthma and other conditions such as cystic fibrosis tend to breathe through the mouth, which makes the mouth dry and causes bad breath.
Ammonia breath: The unique sharp odor that you can smell around a urinal is due to ammonia present in the urine. Ammonia is the end product of urine metabolism. So when a person has ammonia-like breath it is a sign that there is something wrong with the kidneys. It could be due to a defective urine metabolism that causes ammonia breath and a sign of kidney damage or disease.
Musty breath: If your breath has a musty or moldy smell that it could be an indication of a liver problem. This can mean that the liver is not functioning properly or there is some damage to the liver. This is because the body tries to excrete by-products of amino acid breakdown which contains sulfur-rich compounds. So a faulty liver metabolism can lead to excretion of these compounds through breath, causing musty breath.
Foul fishy breath: Fishy breath doesn’t always result from eating seafood. It could also be due to a metabolic condition known as trimethylaminuria. This is a condition in which the body is not able to break down a compound known as trimethylamine. As a result, there is an accumulation of this compound in the body which is excreted through breath. It is a rare disorder that can cause a foul fishy breath similar to that of rotting fish or eggs.
Cheesy breath: A strong cheese-like smell could be a sign of an underlying nasal problem. It can be due to respiratory tract infection such as sinusitis, nasal polyps or postnasal drip. When you suffer from respiratory infection, it causes accumulation of the fluid and mucus triggered by microbial growth. This can cause bad breath. Moreover, nasal congestion can make you breathe through the mouth that further causes the dryness of the mouth and trigger bacterial growth, leading to foul breath.
Fecal breath: An imbalance in the digestive system can cause bad breath. These include digestive disorders such as gastroesophageal reflux disease (GERD), bloating, burping, gas, constipation or bowel obstruction. These conditions can either delay or prevent the processing of the food in the stomach. So when the food you eat is not digested in the stomach, it starts to decay and small amounts of undigested food and air can move up into the esophagus, which causes bad breath.
What does bad breath mean?
Firstly bad breath is a clear cut clue of a poor oral health and hygiene. Hence, it is important to know the root cause of the condition and treat it. For example, if bad breath is due to medications (which make the mouth dry and make you susceptible to foul odor), then talk to your doctor about the same. Avoid using natural remedies to get rid of bad breath or self-medication as it might provide only temporary relief and not treat the cause of it.
You can improve your immunity to deal with infections and lower your risk of experiencing bad breath due to poor immunity. If bad breath is caused due to an imbalance of the gut microbiome or improper digestion, then improve your digestion. However, if you experience bad odors such as a fruity smell or fecal smell, then do consult your doctor to know the underlying cause of the condition. This can not only help you to prevent foul breath but know the exact problem.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
1. Aylıkcı BU, Colak H. Halitosis: From diagnosis to management. J Nat Sci Biol Med. 2013 Jan;4(1):14-23.
2. Porter SR, Scully C. Oral malodour (halitosis). BMJ. 2006 Sep 23;333(7569):632-5.
3. Kapoor U, Sharma G, Juneja M, Nagpal A. Halitosis: Current concepts on etiology, diagnosis and management. Eur J Dent. 2016 Apr-Jun;10(2):292-300.
4. Bicak DA. A Current Approach to Halitosis and Oral Malodor- A Mini Review. Open Dent J. 2018 Apr 30;12:322-330.