A sensitive topic that nobody likes to talk about.  But don’t worry, the causes of bad breath is mostly benign.

Garlic or onions leave you with bad breath. Exotically seasoned crisps, fatty sausages, coffee, alcohol or tobacco smoke all belong in the list of dishes and luxury foods that often lead to an unpleasant odor from the mouth. Some people react strongly to it, others only mildly. Chewing gum often provides the first remedy, and regular dental care does the rest.

Most people first have to brush their teeth in the morning to get the typical sleepy smell out of their mouths. But even those who have not eaten for a long time often do not smell good when they exhale or speak. Incidentally, the reason in both cases is a reduced flow of saliva.

The annoying thing about it: As a rule, only the others notice the bad breath, not the person affected. And hardly anyone dares to draw the attention of their counterparts to their intrusive breath. A few tactful but frank words would often help a lot. Because usually the cause of the unwelcome odor can be found and often be eliminated successfully.

Where does the smell in the mouth come from?

Most of the time, the main triggers for bad breath are in the mouth itself. Doctors speak of foetor ex ore (literally: bad smell from the mouth). If the person concerned has closed his mouth, his interlocutor hardly smells anything. The smell is mainly caused by poor oral hygiene and dental problems, dry mouth, substances that affect saliva and oral mucosa, such as certain foods or cigarette smoke, but also inflammation and sometimes tumors in the oral cavity.

The second form of unpleasant breathing air, medicinally halitosis, is much rarer. Here the exhaled air smells bad not only when it passes through the open mouth, but also when it only flows through the nose. In addition to known causes such as a garlic dish or the alcohol plume, diseases of the nasopharynx, such as a chronic runny nose, or respiratory diseases such as bronchitis or pneumonia lead to halitosis in some people. In addition, digestive problems in the esophagus and gastrointestinal tract can be a cause of bad breath. Very characteristic breath smells are caused by metabolic derangements in diabetes, kidney or liver failure and poisoning.

Bad breath: when to see a doctor?

If the bad breath has an easily comprehensible cause such as the raw onion in the salad or negligent dental care, the breath smell improves as soon as the onion is digested or the oral hygiene is corrected again.

Anyone who is made aware of their smell by others or has the impression that something is permanently wrong with their breath should consult a doctor. This also applies in particular if bad breath occurs suddenly for no apparent reason or if other symptoms are added, such as breathing difficulties, headache, pain in the limbs and stomach or cough.

A doctor will assess possible causes of the problem through specific questions and initial examinations. If necessary, he will refer his patient to the appropriate specialist. This could be a dentist, an ear, nose and throat specialist or an internal medicine specialist (internist).

Fear of bad breath: is it all just imagination?

As careless as some people may be with their oral care, others are overly sensitive to their supposed smells. They are firmly convinced that they have bad breath, but neither those around them nor their doctor can confirm it. This belief can be so pronounced that it is an expression of a pathological perception disorder, a so-called pseudo-halitosis or halitophobia. In addition to mental disorders, certain brain tumors can also cause such olfactory impressions.

If the doctor fails to dissuade those affected from their imagination and to calm them down, it is the job of a psychiatrist or a neurologist to investigate the disorder and initiate appropriate therapy.

The main causes of bad breath at a glance

– Bad breath from your mouth

• Garlic, onions, and other foods that affect saliva and oral mucosa
• Alcohol, coffee and other drinks that affect saliva and the lining of the mouth
• Smoke
• Food residue in your mouth
• Some drugs that contain nitrates or sulfur
• Hunger, malnutrition
• Reduced salivation, dry mouth (night rest, mouth breathing, snoring, fasting, signs of aging, medication)
• Inadequate oral hygiene, irregular, careless brushing of teeth
• Bacterial coating on the tongue
• Heavy plaque, tartar
• Badly fitting dentures, inlays, implants, tongue piercings
• Dental diseases, inflammation of the gums (periodontitis, gingivitis)
• Salivary gland diseases (Sjogren’s syndrome and others)
• Inflammation of the oral mucosa, mouth rot (aphthous stomatitis, gingivostomatitis)
• Fungal infections in the mouth (oral thrush, candidiasis)
• Tonsillitis
• Pfeiffer’s glandular fever
• Abscesses in the oropharynx (peritonsillar abscess)
• Oropharynx tumors
• Diphtheria
• Syphilis

– Bad breath from your mouth and nose

• Food such as garlic, onions, alcoholic beverages, the metabolic products of which are released with the breath, among other things
• Poisoning (with phosphorus – the breath smells of garlic – and other poisons such as arsenic or selenium)
• Chronic sinusitis, nasal polyps
• Chronic runny nose with olfactory disorders due to dry nasal mucous membranes (overuse of decongestant nasal sprays, drops, drug abuse, after radiation treatment, nose operations)
• Nasopharyngeal tumors
• Respiratory diseases (purulent bronchitis, bronchiectasis, pneumonia, lung abscess)
• Esophageal diseases (constrictions, Zenker’s diverticula, disorders of the mobility of the esophagus, tumors)
• Heartburn, reflux disease
• Diaphragmatic hernia (hiatal hernia)
• Foreign bodies in the upper digestive tract
• Stomach diseases (narrowing of the stomach outlet, stomach ulcers, stomach cancer)
• Intestinal obstruction
• Food allergies, intolerances, celiac disease
• Essential halitosis (bad breath with no demonstrable cause)
• Diabetic coma (ketoacidosis, the breath smells of acetone)
• Kidney failure (the breath smells like ammonia or urine)
• Liver failure (hepatic coma, the breath smells sweet)

The list of possible physical illnesses which, in addition to the key symptoms that are characteristic of them, can also trigger bad breath, seems long. It must not hide the fact that anyone struggling with bad breath should first check their oral hygiene and eating habits. The best thing to do is to get advice from your dentist and family doctor. Bad breath is not only a nuisance for other people. It can also indicate disease processes. It is therefore important to investigate the causes and take appropriate measures to restore healthy conditions in the mouth.

Even so colonic can’t help you with your bad breath directly, it certainly can help with your digestion and related issues that could contribute to your bad breath.