Bad breath

It is one of the hardest things to say to somebody that their mouth smells.
I've got a friend with the same problem and try as I may, I find it very unfair to tell him that he has mouth odour. The sad bit is that he is a forceful speaker and moves very close to your face to make his point.
I just wish I was bold enough to tell him outright but ….Let somebody else tell him.

Bad breath is a common sign of poor oral hygiene, eating certain foods, using tobacco products, or even dry mouth. The medical term for bad breath is halitosis. Bad breath results from sulphur compounds released by bacteria in the mouth, breath odours, or salivary gland dysfunction.

Poor oral hygiene is a common cause of bad breath. Without brushing and flossing daily, food particles remain in the mouth, tongue, and between the teeth. These food particles collect bacteria, causing bad breath. Infections of the gums (gingivitis) and salivary glands can both result in bad breath. Other common causes include dry mouth and smoking or chewing tobacco.

Certain medical disorders can cause bad breath, such as sinusitis and bronchitis. Gastrointestinal disorders may result in breath that smells like faeces; this may indicate a bowel obstruction. Breath with a fruity odour may be a sign of diabetic ketoacidosis, a potentially life-threatening condition. Liver failure may be indicated if breath has an ammonia-like odour.

Bad breath alone is rarely a result of a serious problem. However, you should seek immediate medical care  if you experience bad breath along with other serious symptoms, such as high fever, difficulty breathing, or prolonged vomiting.

If your bad breath is persistent or causes you concern, seek prompt medical care.

Other symptoms might occur with bad breath

Bad breath may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Oral symptoms that may occur along with bad breath

Bad breath may accompany other symptoms affecting the mouth including:

• Bleeding gums
• Bright red or red-purple appearance to gums
• Dry mouth
• Gum tenderness
• Mouth or facial pain, especially when eating
• Mouth sores
• Receding gums
• Redness over the side of the face or the upper neck
• Sores that contain pus
• Sore throat
• Swollen gums

Bad breath may accompany symptoms related to the respiratory system and other body systems including:

• Fatigue
• Fever
• Headaches
• Pain, tenderness, swelling and pressure around the eyes, cheeks, nose or forehead
• Postnasal drip
• Sore throat
• Stuffy nose or nasal congestion

Gastrointestinal system symptoms that may occur along with bad breath

• Abdominal gas or bloating
• Indigestion
• Heartburn, or gastroesophageal reflux disease 
• Nausea with or without vomiting

Diabetes symptoms that may occur along with bad breath

Bad breath may accompany symptoms related to diabetic ketoacidosis including:

• Confusion
• Frequent urination
• Difficulty breathing
• Dry or flushed skin
• Nausea with or without vomiting
• Thirst or a very dry mouth

Liver symptoms that may occur along with bad breath

Bad breath may accompany symptoms related to liver failure including:

• Confusion
• Dark urine
• Fatigue and weakness
• Loss of appetite
• Nausea with or without vomiting
• Persistent itching
• Swelling of the feet and ankles

Serious symptoms that might indicate a life-threatening condition

In some cases, bad breath may be a symptom of a life-threatening condition that should be evaluated immediately in an emergency setting. Seek immediate medical care if you, or someone you are with, have any of these life-threatening symptoms including:

• Breath that smells like faeces
• Difficulty thinking clearly
• High fever 
• Prolonged vomiting
• Rapid breathing  or shortness of breath

Causes of bad breath

Bad breath results from the action of bacteria that cause the breakdown of food particles in your mouth. Eating foods, such as onions and garlic, are a common source of bad breath. Chemicals from these foods are absorbed into the bloodstream, carried to your lungs, and exhaled.

Infections of the mouth and gums can cause bad breath and are often associated with poor oral hygiene. If the mouth and teeth are not cleaned daily, plaque forms on the teeth, irritates your gums (gingivitis), and may result in tooth decay.

Dry mouth is a common source of bad breath, occurring at night from mouth breathing and decreased saliva. Saliva cleanses the mouth and removes foreign particles. Medications and tobacco use, both of which cause dry mouth, may lead to bad breath. Bad breath also results from infections in the upper respiratory tract, including sinusitis, pharyngitis, laryngitis, and postnasal drip.

Other cases of bad breath are the result of underlying diseases. Some cancers and metabolic disorders cause a distinctive breath odor as a result of chemicals they produce. Diabetic ketoacidosis and liver failure can lead to unusual and distinctive changes in breath. Chronic reflux of stomach acids (gastroesophageal reflux disease, or GERD) has additionally been associated with bad breath.

Food or substance causes of bad breath

Bad breath may be caused by foods and substances including:

• Garlic
• Onions
• Spices
• Tobacco

Dental causes of bad breath

Bad breath can also be caused by dental conditions including:

• Gingivitis (infection of the gums)
• Periodontitis (infection of the gum line involving the teeth and bones)
• Poor dental hygiene
• Reduced saliva
• Tooth decay
• Unclean dentures

Disease causes of bad breath

Some diseases and conditions may be associated with bad breath including:

• Bronchitis
• Gastroesophageal reflux disease
• Salivary gland infections
• Sinus infections

Serious or life-threatening causes of bad breath

In some cases, bad breath may be a symptom of a serious or life-threatening condition that should be evaluated immediately in an emergency setting. These include:

• Bowel obstruction
• Diabetic ketoacidosis
• Liver failure

The potential complications of bad breath

If not properly treated, some infections and diseases resulting in bad breath can lead to serious complications including:

• Bowel obstruction
• Diabetic ketoacidosis (life-threatening complication of diabetes)
• Kidney failure
• Liver failure

Tips to Reduce or Eliminate Mouth Odour

Brush your teeth and rinse your mouth thoroughly after every meal to remove food particle from the mouth.

When you are brushing your teeth, also brush your tongue. The tongue is covered with thousands of tiny hairs that can trap bacteria.

Chew sugarless gum or suck on sugarless lozenges to increase the flow of saliva.

If your mouth is dry, drink plenty of water. Try swooshing it around in your mouth for at least twenty seconds to loosen any food particles the bacteria can feed upon.

Avoid breath mints and mouthwashes that contain alcohol. Instead of helping, they can make things worse. They only temporarily cover the smell and tend to dry the mouth, creating a more favorable environment for bacteria.

Snacking on vegetables such as raw carrots can keep plaque from forming.

Avoid alcohol and caffeine consumption, which can dry the mouth.

Quit smoking. Tar and nicotine can build up on the surface of the teeth, tongue and cheeks. It can also dry the mouth and inhibit saliva flow.

A few drops of peppermint or tea tree oil can be applied to the tongue or toothbrush to help freshen the breath. In addition to its refreshing nature, their antibacterial properties will kill the bacteria found in the mouth.

If you are going to an important meeting or on a big date, avoid foods that can cause bad breath, such as onions and garlic.

Chlorophyll is a natural breath freshener and is found in leafy green vegetables like parsley.

Baking soda has a long history of being used to maintain good oral health and for fighting bad breath.

A mixture of 50% hydrogen peroxide and 50% water can be swooshed around in the mouth and used as a mouthwash. Hydrogen peroxide can kill many of the bacteria that can cause bad breath.

Have regular check-ups with your dentist to rule out gum disease and to correct any faulty restorations, overhanging fillings or leaking crowns, all of which can trap food in the mouth.