There are many reasons for chronic bad breath or halitosis. It may be more than that garlic toast, wine tasting or that fasting diet—it could be a medical problem. Most of the time bad breath does start in the mouth so the common diagnosis is food, smoking, drinking or dental problems. Dieters should also be aware that ketoacidosis, the breakdown of chemicals during fasting, also creates bad breath.
In addition, there are medical conditions that cause or contribute to bad breath.
The medical condition dry mouth or xerostomia inhibits the production of saliva. Saliva helps cleanse and moisten the mouth by neutralizing acids produced by plaque. This dry mouth condition enables dead cells to accumulate on the tongue, gums and cheeks. The odor is caused by decomposition of these cells. This is what causes morning breath especially for open mouth sleepers. Beyond xerostomia, some medications and smoking can cause dry mouth and odor.
Many other diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia, sinusitis, and lung, kidney or liver disease.
Conditions of the mouth, nose and throat can cause halitosis. Sometimes bad breath is associated with sinus infections because nasal discharge from the sinuses in the back of the throat. If a young child has bad breath, he/she may have a small object in his nose – like a bean or a small toy. A throat infection, bronchitis and upper respiratory infection in which the sufferer coughs up an odorous greenish or yellowish discharge can cause bad breath too. Periodontal disease is an infection of the mouth causing bad breath. Odor can also occur with chronic lung infection or a lung abscess.
Other systemic bad breath causes may be kidney or liver failure. A urine-like mouth odor can be caused by kidney failure while liver failure may cause an odor described as fishy. Gastro esophageal reflux disease (GERD) causes the chronic repeat (reflux) of stomach acids and this condition can be associated with bad breath.
Of course, beyond the infectious or systemic causes of halitosis, the food we eat can cause bad breath. The breakdown of food particles in and around the teeth can cause odor. If teeth are not brushed and flossed, these food particles create bacteria and hydrogen sulfide is emitted. Onions and garlic are the best examples of ‘bad breath’ foods – those containing volatile oils. After these foods are digested and the pungent oils are absorbed into the bloodstream, they’re carried to the lungs and are given off in breath until the food is eliminated. This may take 72 hours.
Routine daily hygiene including brushing, flossing and periodic dental visits will take care of 90% of the cases of chronic bad breath. Consult a trusted medical professional if you suspect a medical cause.