Why Do You Have Bad Breath ?

Dr Akinsiku Oluwanimbe

15th Mar, 2016



So we talked about bad breath (halitosis) some time ago, if you missed it, here is a summary:

Bad breath could be psychological; where you just think your mouth is smelling while nobody around you can perceive it. Treatment is through medical and psychological counselling.

We also have causes within the mouth, which originate from the tongue, plaques, reduction in saliva, alcohol and smoking. Maintaining a good oral hygiene, regular scaling and polishing (twice in a year), are ways of preventing these sources of bad breath.

So today we would be talking about causes of bad breath that originate outside the mouth called "Extra Oral" causes.

They include:

  1. Medications: the use of drugs meant for certain medical conditions can cause dry mouth which cause bad breath. E.g. antihistamines, diuretics.
  2. Food: e.g. garlic, onions consumed in large quantities. As the body breaks down these food, they are absorbed into the blood stream and transported to the lungs. The lungs carry air out as foul breath.
  3. Respiratory tract infections: e.g. pneumonia, sinusitis, bronchitis, pharyngitis, tonsillitis, lung abscess, bronchiectasis. 15% of halitosis originate from the eye, nose, and throat region. Inflammation of the tonsils for example by certain bacteria and viruses cause halitosis. Also infection of the paranasal sinuses caused by a lodged foreign body can be a cause.
  4. Acid reflux: this is a chronic reflux of stomach acid. This happens when food doesn't move efficiently out of the stomach into the intestines. It starts to decay and other times, some parts of the undigested food can be regurgitated contributing to foul breath. People with gastro-esophageal acid reflux (GERD) also experience acid erosion of their teeth due to the substance regurgitated.
  5. Endocrine disorder: e.g. diabetes. The pancreas produces insulin which converts glucose to glycogen for storage. When there is no insulin, glucose accumulates in the blood stream but is unavailable in the cells. The body cells therefore gets energy from other sources such as fat. The end product of this energy making process is ketone which causes a fruity acetone-like odor in the breath in diabetes patients.
  6. Other causes include liver/kidney disease. Renal disease in form of chronic renal failure is associated with high urea nitrogen levels in the blood and low salivary rates. Uremic odors subsequently gets expressed in the mouth. In the liver, due to decreased liver function, waste products are excreted through the lungs causing odor. It is a sweet excremental odor called Fetor hepaticus.
  7. Metabolic causes could be as a result of several disorders e.g. trimethylaminuria which causes a specific fish odor. Sufferers are deficient in the enzyme that converts this compound to non-odorous compound. Hence, it accumulates and it’s excreted in the urine, sweat and breath.


Treatment for halitosis is done based on the cause.

Got a bad breath? Why don't you chat with one of our Dentists today! Please visit the chat room.

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