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What Causes Bad Breath?

causes of bad breath
Published By Dr. Rachel Hall at 13 August, 2018

Bad breath is embarrassing! But a quick breath check can save you from more than just an awkward social situation — it could save your life. Breath-test technology can detect things like stomach cancer in its earliest stages, However, gastric cancer isn’t the only medical condition your breath can reveal.


Causes of Bad Breath

Bad breath odours vary and depend on the underlying cause. Here are some common bad breath causes:

  • As food particles break down in the mouth, bacteria increase, resulting in bad doors. Onions, garlic, and certain spices are common bad-breath causes.
  • Tobacco products. Smoking tobacco also results in a smelly breath, as does chewing tobacco.
  • Poor dental habits. Not flossing or brushing your teeth regularly is a common cause of bad breath. This happens when tiny bits of food stay trapped in your mouth. Your tongue can be another bad-breath cause as bacteria coats it, causing foul odours.
  • Dry mouth. A condition called a dry mouth is a bad-breath cause as saliva in the mouth is reduced. Dry mouth is a common cause of morning breath, especially in people who sleep with their mouth open.
  • Dental infections. Tooth decay, gum disease, surgical wounds, and dying teeth are all causes of bad breath.
  • Postnasal drip. Mucus that hardens in the tonsils can be a cause of bad breath. Chronic postnasal drip and sinus drainage are also bad-breath causes.

An acidic stomach or chronic reflux of stomach acid (gastroesophageal reflux disease, or GERD) is linked to bad breath. Treating GERD may cure the bad breath.

  • Other serious causes. Some types of cancer and metabolic diseases can leave a distinctive breath smell. Talk to your doctor if you detect a metallic or another odour.

Should You Worry About Bad Breath

Some people worry too much about their breath even though they have little or no mouth odour, while others have bad breath and don’t know it. Because it’s difficult to assess how your own breath smells, ask a close friend or relative to confirm your bad-breath worries. Or visit a fresh breath clinic for a proper analysis.

While poor dental hygiene accounts for most cases of halitosis, bad breath can sometimes signal another underlying medical condition. And you don’t have to give off an odour, either: Even the freshest breath can be screened for various health problems.


Stomach Cancer Is a Serious Cause of Bad Breath

Routine screening for stomach cancer is uncommon, largely because the current method – endoscopy – is invasive. But that may change with the development of breath-test technology called nanoarray analysis, which identifies the levels of certain compounds that are linked to stomach cancer.

Researchers in Haifa, Israel, looked at breath samples of 484 people who had fasted for 12 hours and avoided smoking for at least 3 hours prior to the test. Ninety-nine of the participants had received stomach cancer diagnoses but had not yet begun treatment. The nanoarray analysis accurately distinguished between the different early stages of stomach cancer and also helped physicians identify patients at higher risk of developing the condition.

A larger trial is currently underway in Europe to determine if nanoarray analysis can be used as an effective screening method.


Breath Tests May Diagnose Lung Cancer

Could lung cancer be a cause of bad breath? Pathologists normally perform biopsies and ultrasound scans to diagnose lung cancer, but using breath tests may be a cheaper, non-invasive alternative, according to a 2013 study. Using a preprogrammed “electronic nose,” which detects different profiles of volatile organic compounds (VOCs) in exhaled breath, researchers from the University of Latvia examined breath samples from 475 subjects, which included a mix of 252 lung cancer patients, 223 patients with different lung conditions and healthy volunteers, 265 smokers, and 210 non-smokers.

They found that among the non-smokers, lung cancer was accurately identified in 128 subjects and misdiagnosed in only 5. Among smokers, the electronic nose correctly identified 114 people as having lung cancer, misdiagnosing 5.


Heart Failure May Be Diagnosed With Breath Samples

Researchers were able to use a simple breath test to identify patients suffering from heart failure, according to a March 2013 paper published in the Journal of the American College of Cardiology.

Cleveland Clinic researchers collected breath samples from 41 patients. Twenty-five were officially diagnosed with acutely decompensated heart failure. Sixteen patients had other cardiovascular conditions but showed no signs of heart failure.

Researchers then used mass spectrometric technology to analyse the breath samples for molecular and chemical compound signs of heart failure.


Fruity or Acetone Breath May Indicate Diabetes Complications

Poorly managed diabetes can make you more susceptible to gum disease and dry mouth. When blood sugar levels aren’t stabilised, the weakened body isn’t able to fight bacteria that can cause infections that harm the gums. These same infections are what cause bad breath.

But a fruity breath odour or an odour similar to acetone (commonly used in nail polish remover) can also point to a serious complication in diabetic patients called ketoacidosis. When the body doesn’t have enough insulin, it instead uses fatty acids for energy, which produces acidic ketones, by-products of fat metabolism. These acids, which include acetone, hydroxybutyrate, and acetoacetate, can accumulate in the blood and lead to a diabetic coma or death.


Fishy Breath May Be a Sign of Kidney Failure

Fishy breath isn’t always from seafood: A mouth that smells like fishy-odour urine, similar to ammonia, may indicate kidney failure.

The kidneys are responsible for removing toxic chemicals from the blood by creating urine. In kidney failure, also known as end-stage renal disease, the kidneys become so damaged that they are no longer able to filter waste products and toxic chemicals from the blood. When this happens, the dangerous toxins and waste not discharged from the body accumulate and affect nearly every part of the body. Fishy-Breath odour can occur when kidney failure affects the respiratory system and causes breathing problems.


Sleep Apnoea Can Cause Morning Breath

Morning breath may seem normal after a night of sleeping. Saliva production decreases during sleep, which gives odour-producing bacteria an opportunity to multiply and grow.

But leaving your mouth open for long periods of time can sometimes cause the slowed production of saliva during sleep. People with sleep disorders such as sleep apnoea and snoring may have trouble breathing through the nose and are more likely to breathe through their mouths, which is a cause of bad breath.


GERD May Be a Cause of Bad Breath

Digestive conditions such as acid reflux and gastroesophageal reflux disease (GERD) are bad-breath causes. Both digestive conditions can delay or prevent food from processing efficiently in the stomach. When food doesn’t move through the digestive system, it can start to decay. Small amounts of undigested food may even regurgitate and cause bad breath. Dentists may also detect GERD in patients when they notice an inflamed red throat and acid erosion in the teeth.

But GERD isn’t the only digestive health issue that can affect your breath. A 2008 study published in the Journal of Medical Microbiology suggests that the H. pylori bacteria that cause stomach ulcers can be a cause of bad breath.


Allergies and Postnasal May Drip Lead to Foul Breath

Respiratory tract infections such as the flu, bronchitis, and sinusitis are common causes of bad breath. When respiratory tract infections break down or inflame the tissues in the respiratory system, it can trigger the production of bacteria-feeding cells and mucus.

Allergies and postnasal drip may also be what causes bad breath because these conditions tend to clog the nose. This nasal congestion may force you to breathe through your mouth, which can lead to dryness and the growth of bacteria that cause foul breath.


Stop Bad Breath Linked to Tooth Decay and Gingivitis

When the enamel on your teeth erodes, food particles can get deposited in those holes, called dental caries. Because brushing your teeth can’t remove these food deposits, they can eventually grow bacteria, which is what causes bad breath.

Gingivitis is another medical condition that is a cause of bad breath. When the gum becomes inflamed with bacteria, it can result in severe pain and funky-smelling discharge.


Bad Breath Testing

If you feel you may be suffering from bad breath then ask us about our in-house Fresh Breath Clinic where we can analyse a sample of your breath and tell you exactly what is happening and how to treat it. Contact us today.


  • Dr. Rachel Hall

    Dr. Rachel Hall

    Rachel is the founder and principal dentist at Evolve Dental Healing with over 30 years experience, practising holistically since 2001. Not your typical dentist, Rachel is a passionate opinion leader, challenging convention to empower people to make better dental and health choices, helping thousands to have healthy natural smiles. A respected writer and presenter on holistic dentistry, health and wellness it is Rachel’s mission to revolutionise the way people look at their dental health.

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