Breath odor

Alternative names

Bad breath; Halitosis

Definition

Breath odor is unpleasant, distinctive, or offensive.

Considerations

Some disorders will produce specific, characteristic odors to the breath.

A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a characteristic sign of ketoacidosis (such as diabetic ketoacidosis), a potentially life-threatening condition.

A fecal odor to the breath (the breath smells like feces) can occur with prolonged vomiting, especially when there is a bowel obstruction. It can also occur temporarily if the person has a nasogastric tube in place (a tube placed through the nose or mouth to the stomach to drain the stomach contents).

The breath may have an ammonia-like odor (also described as urine-like or "fishy") in people with chronic kidney failure.

Common Causes

If previously normal breath turns into halitosis, causes could include:

• Food or beverages consumed (such as cabbage, garlic, raw onions, or coffee)
  
• Vitamin supplements (especially in large doses)
  
• Poor dental hygiene
  
• Dentures
  
• Cavities
  
• Tobacco smoking
  
• Alcoholism
  
• Throat infection
  
• Sinusitis
  
• Lung infection
  
• Gum disease (gingivitis, gingivostomatitis)
  
• Abscessed tooth
  
• Impacted tooth
  
• Foreign body in the nose (in children)
  o Often (but not always) there is a white, yellowish, or bloody discharge from one nostril
  
• Drugs
  o Paraldehyde
  o Triamterene and inhaled anesthetics
  o Insulin - injection
  

Diseases that may be associated with breath odor (not presented in order of likelihood - some are extremely unlikely):

• Acute necrotizing ulcerative gingivitis
  
• Acute necrotizing ulcerative mucositis
  
• Acute renal failure
  
• Bowel obstruction (can cause breath to smell like feces)
  
• Bronchiectasis
  
• Chronic renal failure (can cause breath to smell like ammonia)