Girl using breath freshener

We often treat bad breath in our society as something unpleasant to endure. . . We may not tell someone they have bad breath for fear of offending them.

Although it may seem to be a benign condition, halitosis (bad breath) can have some serious causes which need attention to avoid having further health problems. The various odours of bad breath are caused by waste gases which are excreted from the lungs as a by product of digestion and metabolism or released from the process of infection.

It‘s not enough to cover up the odour of halitosis with a breath freshener without looking for the underlying cause and fixing it. Halitosis is  “yellow light on the dashboard” of your body, warning you that something need diagnosis and definitive treatment

It’s awkward to be in conversation with someone who has less than appealing breath. It’s distracting and can take away from the conversation or the relationship. It may mean that you turn down the offer of a kiss for this reason. So is it more offensive to feel repulsed by bad breath and not say any thing to the person affected, or is it better to advise them that you have noticed this problem so that they have the chance to do something about it?

I found myself in this situation at a community function recently, speaking to a charming man. I immediately noticed an offensive odour when he spoke and it is hard for me not to flip into my “concerned medico” mode and address the issue. Often this sort of problem can be related to the dehydration of too much coffee, alcohol or exercise, but this was a more putrid scent. I did actually tell him delicately that I thought he might need to see a dentist to check this out, which he did appreciate and fortunately was not offended by my recommendation, telling me that he has been told for a very long time that he has bad breath .

It turned out that he had a chronic dental root abscess which was oozing from his gums, causing this revolting smell. Once drained, treated with antibiotics and then the tooth was eventually removed, the odour was gone forever. More importantly, dead dental tissue, if left untreated, could increase his risk for developing cancer, as our immune system has to pay attention to this low-grade chronic infection and may not manage its cancer cell surveillance as efficiently.

A checklist for the types of halitosis odour and the sort of conditions that cause them:

Unpleasant, stale
Dehydration, coffee, tea, smoking, maldigestion

Foetid
Maldigestion, intestinal fermentation, constipation, liver sluggishness

Pungent
Eating sulphur-rich foods (garlic, onions, chives), intestinal bacterial overgrowth

Sour
Hyperacidity, gastic reflux, asthma

Ammonia
Urinary tract infection

Sickly sweet
Diabetes, alcohol, fasting, weight loss from burning fat stores, intestinal candidiasis

Putrid (rotten)
Sinusitis, tonsillitis, tonsiliths (tonsil “stones”), lung abscess, dental infections such as a tooth abscess or periodontal (gum) disease

Fresh-baked bread
Typhoid fever

Bitter almonds
Cyanide poisoning (not a joke, but very rare. I had a French patient who was being slowly poisoned by her jealous mother)

What to do if you suspect you have bad breath/halitosis

Ask someone who cares about you if they have noticed whether you have bad breath, then.

1. See a doctor. Get checked out with a full blood count and complete serum biochemistry profile.

2. See a dentist or dental hygienist for a check up and clean.

Most of the serious causes of halitosis will be identified this way so you can fix the problem for good and save money on breath freshening mints!

Of course, if you are concerned about your health, there could be many more considerations to take into account. It is best to address these directly with your registered health practitioner, get tested for the conditions which can put you into what I call “the grey zone” − not too sick, but also not too well. Early intervention is the key to a quick recovery and disease prevention.