Definition

Breath odor is the scent of the air you breathe out of your mouth. Unpleasant, distinctive, or offensive breath odor is commonly called bad breath.

Alternative Names

Bad breath; Halitosis

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, which may occur in diabetes, and is 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 may also occur temporarily if a person has a nasogastric tube (a tube placed through the nose or mouth to the stomach to drain the stomach contents) in place.

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 (usually in children)
    • Often (but not always) there is a white, yellowish, or bloody discharge from one nostril
  • Drugs
    • Paraldehyde
    • Triamterene and inhaled anesthetics
    • Insulin - injection
Diseases that may be associated with breath odor (not presented in order of likelihood -- some are extremely unlikely):

Home Care

Use proper dental hygiene (especially flossing), and remember that mouthwashes are not effective in treating the underlying problem.

Fresh parsley or a strong mint are often effective ways to fight temporary bad breath. Avoid smoking. Otherwise, follow prescribed therapy to treat the underlying cause.

Call your health care provider if

  • Breath odor persists and there is not an obvious cause (such as smoking or eating odor-causing foods).
  • You have breath odor and signs of a respiratory infection, such as documented fever, cough, or facial pain with nasal discharge

What to expect at your health care provider's office

The medical history will be obtained, and a physical examination performed.

Medical history questions documenting breath odor in detail may include:

  • Is there a specific odor?
  • Is there a fishy smell?
  • Does the breath smell like ammonia or urine?
  • Does the breath smell like fruit or is there a sweet-chemical smell?
  • Does the breath smell like feces?
  • Does the breath smell like alcohol?
  • Has the person recently eaten a spicy meal, garlic, cabbage, or other "odorous" food?
  • Does the person take vitamin supplements?
  • Does the person smoke?
  • Does good oral hygiene improve the odor?
  • What home care measures have been tried? How effective are they?
  • Is there a recent sore throat, sinus infection, tooth abscess, or other illness?
  • What other symptoms are also present?

The physical examination will include a thorough examination of the mouth and the nose. A throat culture may be taken if the patient has a sore throat or mouth sores.

In rare cases, diagnostic tests that may be performed include:

Antibiotics may be prescribed for some conditions. For an object in the nose, the doctor will use an instrument to remove it.

Lots More Information:
•Diabetic ketoacidosis
•Nausea and vomiting
•Intestinal obstruction
•Chronic renal failure
Review Date:1/22/2007
Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.