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Breath odor

• Overview
• Treatment

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):

• 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 )
• Diabetes (fruity or sweet chemical smell with ketoacidosis)
• Esophageal cancer
• Gastric carcinoma
• Gastrojejunocolic fistula (fruity-smelling breath)
• Hepatic encephalopathy
• Diabetic ketoacidosis
• Lung abscess
• Ozena , or atrophic rhinitis
• Periodontal disease
• Pharyngitis
• Zenker's diverticulum

• 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.

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