What Causes Bad Breath?

The most common reason for bad breath is poor oral hygiene and/or diet and lifestyle habits, such as smoking. If you do not brush and floss your teeth twice daily and/or schedule regular examinations with your dentist, you increase your risk of developing gum disease or other oral health issues.

It is important to be aware that although halitosis is commonly the result of poor oral hygiene and/or lifestyle habits, it can also be an indication of an underlying health issue. One of the biggest indicators of whether bad breath is due to an underlying health issue is what your bad breath smells like. The five most common types of bad breath, causes, and methods of treatment include:

• Rotten Egg Smell: If your bad breath is reminiscent to the smell of rotten eggs, this may be an indication that there is an issue with your digestive track, such as GERD (Gastroesophageal Reflux Disease). Halitosis caused by GERD can be managed with antacids, medications, proton pump inhibitors, and by following a modified diet. In certain cases, surgery may be necessary to correct the issue.
• Sweet or Fruity Smell: Bad breath that has a sweet or fruity smell may indicate ketoacidosis, which is complication of diabetes, and/or kidney failure. Because patients with diabetes or kidney disease do not produce enough insulin, they are more likely to produce ketones, which produce a sweet or fruity odor. There are a number of treatments that may need to be performed to normalize insulin and blood sugar levels, including electrolyte replacement, fluid replacement, and/or insulin therapy. If ketoacidosis was caused by an illness or infection, antibiotics may also be necessary.
• Fungus or Moldy Smell: Microbial buildups, infections, or growths in the sinuses can result in breath that smells like fungus or mold. Patients with a sinus infection may have thick mucus that drips to the back of the throat. When breathing, this overabundance of metabolites, foreign particles, and microbes can cause an unpleasant smell that is similar to fungus or mold. Bad breath caused by a sinus infection is typically treated with a combination of antibiotics and over-the-counter pain medication.
• Fecal Smell: If your breath has an odor similar to feces, this likely indicates that you have a bowel obstruction, which occurs when your small and/or large intestines are no longer able to process waste. If you are experiencing constipation along with breath that smells like feces, there is a very high chance that you have a bowel obstruction, which should be addressed immediately. Halitosis caused by bowel obstruction may require emergency medical care, which can include bowel rest with IV fluids or surgical intervention. Following a surgical procedure, pain medication and/or antibiotics may be prescribed.
• Fishy Smell: If your kidneys are damaged and no longer able to filter waste, toxic chemicals can build up throughout your body, which can cause your breath to develop a fish smell. Halitosis caused by liver failure may require a liver transplant for serious cases. For less severe cases, medication may be administered, and treatment may be provided to assist with alcohol dependence and making other lifestyle changes, such as losing weight and/or exercising regularly.

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