Breath odor
Alternative names
Bad breath; Halitosis
Definition
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Breath odor is unpleasant, distinctive, or offensive.
Considerations
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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
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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)
- 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
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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
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- 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
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The medical history will be obtained, and a physical examination performed.
Medical history questions documenting breath odor in detail may include:
- Quality
- 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?
- Aggravating factors
- Has the person recently eaten a spicy meal, garlic, cabbage, or other "odorous" food?
- Does the person take vitamin supplements?
- Does the person smoke?
- Relieving factors
- 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.
Update Date: 5/23/2003
Updated by: David Webner, M.D., Department of Family Medicine, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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