What health problems are associated with bad breath?

Bad breath can be an indicator of a medical disorder, such as a local infection in the respiratory tract, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment. If you find yourself with chronic bad breath, talk to your dentist and ask for an oral exam. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.

Bad breath is commonly linked to the following health problems:

  • diabetic ketoacidosis (breath smells fruity)
  • lung disease or infection
  • renal failure (breath smells like ammonia)
  • sinus or throat infection
  • stomach or gastrointestinal (GI) problems
  • tonsillitis
  • tonsillolith (tonsil stones) or hardened mucus deposits on tonsils
  • tooth infection or gum disease (gingivitis)

If you have bad breath that does not resolve by changing your diet and using good dental hygiene, check with your healthcare professional for an evaluation. You may have a dental or medical problem that needs treatment.

Tom Berry
Oral & Maxillofacial Surgery
If no obvious dental causes can be found for bad breath such as poor oral hygiene or periodontal disease, then a consultation with your doctor would be appropriate. Certain medical conditions can contribute to bad breath such as diabetes, kidney disease, or liver disease.

Foul-smelling bacterial infection and chronic mouth inflammation are the most common causes of bad breath. Dental cavities and mouth, tongue, and gum infections are the most common culprits of these bacterial infections.   Bronchiectasis, an infection and enlargement of the bronchial tubes, and lung abscess can also cause halitosis.  There are however, three serious illnesses which can all give specific mouth odors:

* Liver failure causes a fishy odor (fetor hepaticus) 

* Kidney failure an ammonia odor, and 

* Diabetic coma (ketoacidosis) a fruity odor. 

There are also many healthy individuals have persistent bad breath because of  poor digestion.


Examination, Classification, and Treatment of Halitosis; Clinical Perspectives  

Ken Yaegaki, DDS, PhD • Jeffrey M. Coil, DMD, MSD, PhD, FRCD(C) 

 J Can Dent Assoc 2000; 66:257-6


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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.