Bad or Changed Breath

Bad breath is embarrassing! We all know. 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 stomach cancer in its earliest stages, according to an April 2015 study published in the journal Gut.

However, gastric cancer isn’t the only medical condition your breath can reveal. According to the Mayo Clinic, bad-breath odors 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 odors. Onions, garlic, and certain spices are common bad-breath causes.
• Tobacco products. Smokingtobacco also results in 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 odors.
• Dry mouth. A condition called dry mouth be 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 other odor.

Some people worry too much about their breath even though they have little or no mouth odor, 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.

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 odor, either: Even the freshest breath can be screened for various health problems.

When is bad breath most likely to occur?

Everybody has bad breath from time to time, especially first thing in the morning. You also may have bad breath when you are hungry, when you are dieting, or after eating foods with a strong odor, such as garlic, onions, or pastrami.

What causes bad breath?

Many things can cause bad breath. A major cause is decreased saliva. Saliva has a cleaning action that helps reduce or eliminate bad breath. When saliva decreases, bacteria can grow, causing bad breath.

Bad breath caused by a decrease in saliva may be especially noticeable:

• In the morning. The flow of saliva almost stops during sleep. The reduced cleaning action of the saliva allows bacteria to grow, causing bad breath.
• When you are hungry. Bad breath is more common in people who miss meals or are dieting. Chewing food increases saliva in the mouth. When you are not eating, saliva decreases and bacteria growth increases, causing bad breath.
• When you are dehydrated. When you become dehydrated, you do not produce as much saliva. The reduced cleaning action of the saliva allows bacteria to grow, causing bad breath.
• From diseases that affect the salivary glands, such as Sjögren’s syndromeor scleroderma.
• When you are taking certain medicines.
• After drinking alcohol beverages.
• Eating foods with a strong odor, such as garlic, onions, or pastrami.
• Smokingor using smokeless (spit) tobacco, such as snuff or chewing tobacco.
• Bacteria and plaquebuildup in the mouth from food caught between teeth, dentures, or dental appliances.
• Mouthand throat problems that can cause mouth odor include:
• Throat or mouth infections, such as strep throat.
• Dental problems, such as cavities.
• Gum disease(periodontal disease), which may cause a metallic breath odor.
• Tonsilswith deep tunnels (crypts) that trap food particles.
• Throat or mouth cancers.
• Problems in other areas of the body that can cause mouth odor include:
• Problems with the nose, such as a sinus infection, nasal polyps, or an object in the nose.
• Diabetes. A symptom of very high blood sugaris a strong, fruity breath odor.
• Digestive systemdisorders, such as reflux (gastroesophageal reflux disease), bowel problems, or cancer.
• Human immunodeficiency virus (HIV) infection.
• Liver
• Lungproblems, such as an infection or cancer

How is bad breath treated?

To help improve your breath:

• Gargle with water.
• Brush your teeth, tongue, roof of your mouth, and gums at least twice a day with toothpaste.
• Floss your teeth once each day.
• Eat a low-fat diet rich in fruits and vegetables.
• Eat less meat.
• Do not smoke or use other tobacco products, such as snuff or chewing (spit) tobacco.
• Avoid foods and drinks that cause bad breath, such as garlic and alcohol.
• Eat at regular intervals. Dieting or missing meals can decrease saliva and cause bad breath.
• Chew sugar-free gum, suck on sugar-free mints, or drink water, especially if your mouth is dry. Try using breath sticks, which contain the ingredients found in a mouthwash and dissolve in your mouth.
• Remove dentures, removable bridges, partial plates, or orthodontic appliances and clean them once each day or as directed by your dentist. Pieces of food and germs can collect on these appliances and cause bad breath.
• Use a mouthwash for temporary relief of bad breath. Swish it around in your mouth for 30 seconds before spitting it out.
• Have regular dental checkups.
• Make an appointment to see an ear, nose, and throat specialist (otolaryngologist) if you have frequent problems with mouth odor.

Diet and Breath

The obvious connection between diet and breath is smelly foods, like garlic, coffee, and fish. Obviously, these foods do have an effect, but it’s temporary: you can brush your teeth and get rid of it. A harder problem is bad breath that persists even if you aren’t eating anything particularly smelly – clearly there’s something else going on here.

This study goes over some of the causes of bad breath. In 90% of cases, the problem has something to do with the bacterial population of the mouth. The human mouth naturally plays host to a lot of different bacteria, just like the gut. Just like healthy gut flora, healthy mouth bacteria don’t cause problems, but if something goes wrong, various species of mouth bacteria can produce several different compounds that make your breath smell bad.

The study also goes over some other related problems. For example, the inflammation involved in gingivitis and other inflammatory diseases can make the problem worse. Another problem is saliva. Saliva basically “washes” the mouth at regular intervals If you’re not making enough saliva for some reason, bacterial populations in the mouth can get more concentrated. Dehydration, diabetes, some medications, and some other treatments can caused reduced salivary flow.

But not all bad breath comes from the byproducts of mouth bacteria. The authors also cite respiratory system diseases (tonsil infections especially), gastrointestinal diseases (like esophagitis) and endocrine system problems (like diabetes and metabolic disorder) as potential causes.

Diet-Related Fixes

The study linked above suggests treatments ranging from the totally obvious (brush your teeth, drink more water) to the less-common (use a tongue scraper). It doesn’t really go into diet, but the causes of bad breath described in the paper suggest some possible diet fixes.

For one thing, there’s that population of mouth bacteria. It’s one thing to just get rid of them with Listerine, but what about asking why they’re out of balance and causing breath problems in the first place? We know that gut bacteria are very modifiable by diet – different types of fiber, carbohydrates, and even fat can change them in various ways. They’re also modifiable by supplements, either probiotics (directly supplementing with helpful bacteria) or prebiotics (supplementing with specific types of fiber that help bacteria grow).

Can mouth bacteria also be modified with diet? Not as easily, but there’s one notable exception: sugar. Sugar is a form of simple carbohydrate, and simple carbohydrates can feed various types of bacteria – this review explains that a long-term high sugar intake can change the bacterial population of the mouth, which is one way that it contributes to causing cavities. The review suggests that the high amount of sugar in the Western diet might be one reason why we need to spend so much time and energy on reducing our mouth bacteria with toothpaste and mouthwash.

Reducing sugar obviously has a benefit for avoiding cavities. It’s not clear yet whether or not this will translate into better breath, because it’s not clear that the species affected are the same species, but it’s worth a shot. The composition of the mouth bacteria can also affect gingivitis, a very common inflammatory disease associated with bad breath, so changing mouth bacteria could affect breath that way. This study suggested probiotics for better oral health via modifying the mouth flora, but noted that we don’t actually know which strains will be helpful for which people.

Another possible way that diet could affect breath is through inflammation. If inflammation can make a bacterial problem worse, then an anti-inflammatory diet may be helpful. This study, for example, gave some evidence that Omega-3 fats can be useful for modulating inflammation in the mouth specifically. Diet can also be very helpful in addressing esophagitis and acid reflux issues, another problem that the study fingered as a cause of bad breath.

Diabetes and “Keto Breath:” The Same Symptom, but Two Different Problems

“Keto breath” refers the changes in your breath that sometimes appear on a very low-carb or ketogenic diet. Keto breath smells sweet and a little fruity, and sometimes like nail polish remover or pears; it’s not like ordinary “bad breath.” Not everybody gets it; many lucky people never notice it or see only a very slight difference.

“Keto breath” is basically a side effect of a keto diet that’s running along smoothly. A ketogenic diet forces your body to burn fat for energy instead of carbohydrates. A byproduct of this is ketone bodies. The presence of ketone bodies is a good sign in general – it means you’ve reached ketosis successfully and all the metabolic magic is working correctly – but ketone bodies can cause bad breath when they’re exhaled.

The production of ketones isn’t unique to ketosis. It can also occur in a life-threatening complication of diabetes (especially Type 1 diabetes) called ketoacidosis. In ketoacidosis, the person’s body isn’t making enough insulin, so there are very high levels of glucose in the blood, but the glucose can’t get out of the blood and provide energy to the body. You have to get energy from somewhere, so your body starts burning fat for fuel instead, creating a lot of ketone bodies.

Alcoholics can also go into ketoacidosis, because alcoholism prevents the body from making enough glucose, so it turns to fat for energy and starts making ketones instead.

High levels of blood ketones can cause a sweet-smelling breath whether they come from diabetes or a perfectly safe low-carb diet, but ketosis and ketoacidosis aren’t the same thing just because they both involve high levels of blood ketones. Here’s a free full-text study explaining the difference. Ketoacidosis typically comes with symptoms like dehydration, nausea, and abdominal pain, while regular diet-induced ketosis doesn’t. If you have (or think you have) ketoacidosis, go to the doctor. But keto breath by itself, without ketoacidosis, doesn’t point to any serious problems.

Unfortunately, there’s not a huge amount of stuff that reliably works for treating keto breath. Keto breath has nothing to do with oral hygiene or your mouth being dirty, so no variety of brushing/flossing/mouthwash will help, except to mask the smell temporarily. Some people find that it eventually goes away on its own. Other people find that better hydration is helpful.

You can get rid of it completely by going out of ketosis, which doesn’t necessarily mean giving up low-carb, just eating enough carbs to stay out of ketosis (50 grams/day is a good ballpark, but your mileage may vary). So if you can reach your particular goals with a low-carb diet but without having to be in ketosis specifically, one option could simply be eating slightly more carbs.

Summing it Up

For most people with bad breath, oral hygiene can significantly help if not solve the problem. Brushing, flossing, mouthwash, and a tongue scraper are basics. Hydration can also help. But if you’re reading this, you’ve probably tried that to no avail – and there are other reasons why your breath might be bad.

For one thing, it’s true that bacteria in the mouth cause a lot of breath problems, but instead of just killing them off with antiseptic mouthwash, it’s worth asking why you have an overabundance of some particular bacteria. Is it because you eat a lot of sugar? Or is there an inflammatory disease making things worse? These things can be addressed with diet.

Another problem is keto breath, which is not the typical rank “bad breath” kind of smell. It’s a slightly sweet, “fruity” type of smell. Sometimes it goes away on its own but other times there’s just not much to do about it unless you’re willing to go out of ketosis. Gum, mints, mouthwash, brushing, flossing, and other oral hygiene will only mask the smell, since the ultimate problem is not coming from your mouth.

What Causes Bad Breath During Pregnancy?

There are many reasons behind bad breath or halitosis:

1. Hormonal Changes:

• Bad breath is one of the common pregnancy symptoms that arise because of the fluctuating hormonal levels as your fetus develops.

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• Also, the changes in the estrogen and progesterone hormones during pregnancy will increase plaque production in your teeth. The plaque contains bacteria which produces sulfur when it comes in contact with food. Increased amounts of plaque may lead to gingivitis; that may further cause infections in gum tissues.

2. Dehydration:

Lack of proper hydration is another primary cause of bad breath during pregnancy. For your body to support the growing fetus, you need to consume excess water. Lack of proper hydration leads to dry mouth, also known as xerostomia. You have to drink more water so that the saliva washes odor-emitting bacteria and leftover food particles. Bacteria cannot survive in an oxygen-rich environment, and as saliva is oxygen-rich, it helps to control bad breath.

3. Morning Sickness:

More than 50% of pregnant women experience morning sickness in between sixth to 12th weeks of pregnancy. It involves vomiting and nausea which can be a significant cause of bad breath. The foul smell of partially digested foods and stomach acids expel through the mouth causing bad breath. It is advisable to brush your teeth and clean your mouth after vomiting to remove the bacteria and bad odor.

4. Calcium Deficiencies:

You may need extra amounts of calcium during pregnancy for supporting your body and your fetus. If you do not take enough calcium, your body may use calcium from teeth and bones, deteriorating your teeth. It will, therefore, cause bad breath.

5. Lifestyle Changes:

The changes in your lifestyle that you go through during pregnancy could cause bad breath. Eating more than usual, eating sugary snacks and late night food cravings may cause plaque build up. You should practice a superior oral hygiene and take care of all your bad eating habits.

6. Food:

Foods like raw onion and garlic enter the bloodstream after the digestion process is complete. These foods contain strong-smelling compounds, which affect the breath via lungs. Coffee can also cause bad breath when pregnant.

7. Medical Conditions:

During pregnancy, some diseases can increase the risk of bad breath. If you suffer from health issues such as diabetes, digestive problems, throat infections, kidney problems, sinusitis and lung problems, then you are susceptible to halitosis during pregnancy.

8. Slow Digestion:

Your digestion process may slow down tremendously during pregnancy. The gas built up in the stomach gets relieved through burping, leading to bad breath.

Symptoms Of Bad Breath (Halitosis) During Pregnancy:

You may have bad breath and not know it. It is fairly common. Here, we list some common symptoms of halitosis to help you determine if you have or are at a risk of bad breath.

• A lingering bitter taste in your mouth
• Dry mouth
• Thick coating on your tongue
• Discomfort in the throat
• Plaque buildup

How To Get Rid Of Bad Breath During Pregnancy?

Some remedies help you to get rid of the bad breath during pregnancy. They are as follows –

1. Maintain Oral Hygeine:

Oral hygiene is very important during pregnancy. If you feel you are breathing out bad odor, you should brush and floss your teeth more often. Use a toothbrush that has soft bristles and brush twice a day. Also, clean your tongue thoroughly with a soft tongue scraper. It eliminates the food particles that are stuck on the tongue.

Dental problems affect the developing fetus. Research studies reveal that gum diseases increase the risk of premature babies and underweight babies.

2. Do Not Eat Strong Smelling Foods:

Avoid eating strong-smelling foods like onions and garlic as they lead to bad breath. Also, cut the intake of tea and coffee. Even if you take tea or coffee in moderate amounts, rinse your mouth properly.

Also, foods that may not be the suspects for bad breath may cause trouble during pregnancy. You should maintain a list of problem-causing foods. Some meat products and spices also cause bad breath while pregnant.

3. Regular Dental Checkups:

Check with a dentist often to rule out any chances of dental caries and tooth decay. You should go for an oral examination during the early pregnancy stages to stay away from any complications to the mother and fetus.

4. Include Calcium Foods:

Deficiency in calcium may destroy the teeth and lead to dental caries. Pregnant women should take calcium rich foods like milk. Also, you can include calcium supplements for extra intake.

5. Drink More Water:

Consume lots of water to keep your body hydrated as dehydration can lead to bad breath. Drinking more water will also rid off the bacteria in the mouth. It will improve saliva production that decreases the bacteria in the mouth.

6. Natural Remedies:

You should avoid any drugs or medications that may affect your growing fetus. You can take natural breath freshening agents like lemon candies and mints that help in masking the bad breath.

7. Rinse Your Mouth:

Rinse your mouth using freshly squeezed lemon juice as it helps remove bad odor. You can also mix hydrogen peroxide with water and use the mixture to rinse your mouth. But do not swallow it as it is harmful. Also, rinse your mouth with salt water every day to reduce the bad breath.

8. Brush With Baking Soda And Salt:

Mix baking soda to the paste or get toothpaste that contains salt and baking soda and brush your teeth. It eliminates the bacteria and also neutralizes the acids that may cause bad breath.

9. Chewing Gum After Food:

Chewing gums remove bacterial accumulation in the mouth and also produce saliva. You can take sugarless gums to remove the leftover food particles in your teeth. It is one of the simplest ways to get rid of halitosis during pregnancy.

Be careful while brushing your teeth as stomach acids can soften your teeth enamel. When you brush harder, the teeth enamel may chip away causing tooth decay.

Consult your healthcare provider or gynaecologist to find the best way to treat bad breath.

Did you suffer from bad breath during pregnancy? How did you manage the problem? Do share your tips with our readers.

How is bad breath treated?

To help improve your breath:

• Gargle with water.
• Brush your teeth, tongue, roof of your mouth, and gums at least twice a day with toothpaste.
• Floss your teeth once each day.
• Eat a low-fat diet rich in fruits and vegetables.
• Eat less meat.
• Do not smoke or use other tobacco products, such as snuff or chewing (spit) tobacco.
• Avoid foods and drinks that cause bad breath, such as garlic and alcohol.
• Eat at regular intervals. Dieting or missing meals can decrease saliva and cause bad breath.
• Chew sugar-free gum, suck on sugar-free mints, or drink water, especially if your mouth is dry. Try using breath sticks, which contain the ingredients found in a mouthwash and dissolve in your mouth.
• Remove dentures, removable bridges, partial plates, or orthodontic appliances and clean them once each day or as directed by your dentist. Pieces of food and germs can collect on these appliances and cause bad breath.
• Use a mouthwash for temporary relief of bad breath. Swish it around in your mouth for 30 seconds before spitting it out.
• Have regular dental checkups.
• Make an appointment to see an ear, nose, and throat specialist (otolaryngologist) if you have frequent problems with mouth odor.

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