How to get rid of bad breath

Bad breath is a common problem that affects approximately one in three people. There is a medical term for bad breath - halitosis.

The appearance of an unpleasant odor may be a signal of health problems. In 90% of cases, halitosis is a consequence of poor hygiene or oral infections. Bad breath causes anxiety and embarrassment and makes it difficult to communicate with others, but it can be eliminated if the cause of its occurrence is identified and eliminated.

Causes of bad breath

The main cause of bad breath is the excessive proliferation of pathogenic bacteria in the oral cavity, which during their life processes release volatile gases with a characteristic unpleasant odor: hydrogen sulfide and methyl mercaptan. Plaque on the tongue, pieces of food stuck between teeth or in gum pockets are a consequence of poor hygiene and a breeding ground for microorganisms that spread a foul odor. In most cases, treatment by a dentist helps get rid of halitosis. Other causes of bad breath include:

food with a persistent pungent odor (garlic, onions, some spices). During the digestion of garlic, volatile sulfur compounds are formed, which enter the blood and are carried throughout the body, ending up in the lungs, larynx and mouth. They become the cause of unpleasant “garlic breath”, which disappears completely only after 72 hours;
smoking. Tobacco smoke itself has a persistent foul odor; in addition, it can provoke gum disease, which is a common cause of halitosis;
dry mouth. Saliva is necessary for natural cleansing of the oral cavity. It washes away food particles, preventing them from rotting, and contains antimicrobial substances that inhibit the growth of pathogenic microflora. With xerostomia (a pathological condition characterized by decreased secretion or absence of saliva), the number of bacteria in the mouth increases significantly, which contributes to the development of caries and halitosis. Xerostomia can be caused by taking certain medications (hypotensives, chemotherapy, antiparkinsonian, etc.), as well as uncontrolled diabetes mellitus. Saliva production also naturally decreases during sleep. This leads to an increase in the number of bacteria in the mouth (mainly on the surface and back of the tongue) and the appearance of stale breath in the morning. Drinking alcoholic beverages, coffee and smoking are other causes of bad breath due to dry oral mucosa;
diseases of the throat and nasopharynx. Bad breath can be caused by purulent plugs in the tonsils due to tonsillitis, bacterial or viral infections of the paranasal sinuses (sinusitis), chronic bronchitis and other diseases of the upper or lower respiratory system;
diseases of the digestive system (gastritis, reflux), liver, kidneys, diabetes;
fasting and low carbohydrate diets. They lead to the fact that the body, experiencing a lack of energy obtained from food, begins to burn accumulated fat reserves. When fats are broken down, ketone bodies are formed. These are by-products of fat metabolism, which are excreted from the body by the lungs and have an acetone odor.

Causes of bad breath

There is a whole list of factors that can affect the formation of an unpleasant odor in urine. Among the most common reasons are the following:

inflammation localized in the tonsils;
infectious pathologies affecting the respiratory tract;
insufficient hygienic oral care;
development of caries;
inappropriately composed daily menu;
dry mouth.

The development of caries affects the appearance of odor in the mouth

The development of bad odor in the mouth is also affected by taking medications, which include antihistamines, sedatives, decongestants and some other drugs. Such medications inhibit the process of salivation, which causes the throat and mouth to dry out, which causes a stink.

In some cases, the appearance of a bad odor is accompanied by the formation of plaque on the tongue, as well as an unpleasant taste when eating food. In cases where a person consumes food quite rarely, and also violates the drinking regime (the amount of liquid consumed is much lower than necessary), this negatively affects the functioning of the urinary system, which is expressed in the appearance of urine odor from the mouth.

Kidney pathologies

The most disgusting manifestation of diseases of this nature is the smell of urine from the mouth, which most closely resembles the specific aroma of ammonia. If there are abnormalities in the functioning of the kidneys (failure of these organs or diseases of an infectious nature), in addition to the appearance of an unpleasant odor from the mouth, a person begins to feel worse, mental and physical activity decreases, and a general malaise appears, causing constant discomfort. The problem occurs when:

Pyelonephritis. This is the process of inflammation in the kidneys.
Urolithiasis. The formation of oxalates and urates, which interfere with the outflow of fluid from the body.
Kidney failure. The kidneys lose their ability to accumulate and remove fluid, which often leads to a malfunction of all body systems.

Urolithiasis disease

In cases where the progress of the disease is at one of the last stages, the smell of urine from the mouth of a child or adult intensifies and is very pronounced. In kidney diseases, this is primarily due to the fact that the tubules of these organs are damaged, which causes deviations in the process of protein metabolism. In this case, the uremic smell becomes a herald of a metabolic disorder in the human body, due to which waste products leave the body through the respiratory tract. At the same time, despite the pronounced smell of ammonia, there are completely no toxic compounds in the air exhaled by a person. Therefore, if your breath begins to stink and the smell cannot be removed with standard hygiene products, you should immediately consult a doctor.

Infections

In a predominant number of cases, respiratory tract diseases that are caused by bacteria or viruses (these primarily include sore throat, influenza and ARVI), that is, infectious in nature, lead to an increase in the level of ammonia and urea in the patient’s blood, which is caused by metabolic disorders substances. In addition, due to damage to the mucous membranes, which dry out over time, the production of saliva, as well as the bactericidal enzyme lysozyme, decreases, which is why the proliferation of microorganisms that influence the appearance of an unpleasant odor flourishes.

When infectious diseases occur in the oral cavity, due to which the smell of urine appears from the mouth, the characteristic signs of the pathological process are redness, swelling and bleeding of the gums, especially after hygiene procedures using a toothbrush or dental floss. Often this condition is accompanied by the formation of purulent discharge between the teeth, as well as the appearance of an abscess (abscess) in the mouth. The teeth begin to become loose, and in the most advanced cases they even fall out. Ulcerative wounds also appear on the tongue or gums.

Pathological processes of an infectious nature located in the respiratory tract are mainly expressed by redness of the throat, swollen lymph nodes in the neck, increased body temperature, signs of chills, green or yellow nasal discharge, as well as a cough accompanied by sputum.

High sugar levels (diabetes)

Among all diseases of the endocrine system, diabetes mellitus, which is often accompanied by abnormalities in the metabolic process in the body (and we are not just talking about carbohydrates), can cause the appearance of urine odor from a person’s mouth. In most cases, a fruity aroma is detected from the patient’s mouth, but in the most severe cases (for example, with hyperglycemic coma) in people suffering from diabetes, a strong odor of ammonia or acetone is observed in the mouth. In this case, the patient experiences dry mouth, unquenchable thirst, due to which the amount of fluid consumed and excreted increases, and also sometimes loses consciousness.

Elevated sugar levels

This disease is one of the most dangerous, which can be manifested by the appearance of an uncharacteristic odor from the mouth. Due to too few symptoms, the patient’s condition gradually becomes critical, and the smell of urine from the mouth becomes a sign of the development of coma. In this case, the patient experiences an excessive amount of glucose excreted by the organs of the urinary system. General weakness and nausea also become characteristic symptoms in this case. Similar clinical manifestations are also characteristic of other diseases of a systemic nature, including those affecting the liver, kidneys, lungs and other organs.

Poor nutrition

Lack of balance in the daily diet also affects the appearance of bad breath. As is known, urea and ammonia are products of the breakdown of proteins, which is why when using a protein diet, in which there are practically no fats and carbohydrates, an increased amount of such substances enters the blood. That is why most nutritionists recommend creating a menu that maintains the proportions of proteins, fats and carbohydrates. In this case, an important role is played by the presence of physical activity, which helps to activate the metabolic process (if there is a lack of it, you should do basic exercises from the school course).

Gastritis or pancreatic diseases

Diseases of the gastrointestinal tract (in a predominant number of cases this is gastritis, but duodenitis, intestinal dysbiosis and cholecystitis are also noted) also affect the formation of unpleasant odor from a person’s mouth. However, it may not only be the smell of urine. The real stench of hydrogen sulfide, more often used to describe rotten eggs, indicates the processes of rotting proteins in the body. Its cause is deviations in the digestion process, which is why such a aroma becomes persistent. This manifestation most often becomes a sign of the development of gastritis with low acidity or stomach ulcers.

If the patient has a sour smell, which is accompanied by the same taste in the mouth, we are talking about the development of gastritis with high acidity. A similar sign of this disease often appears at one of the early stages of the disease, when it is not accompanied by other signs of the development of the pathological process.

Dehydration

The appearance of urine odor in the mouth is most often observed in children who do not take in enough liquid during the day, which causes dehydration, which is accompanied by the appearance of an unpleasant odor during breathing. In this case, parents should also pay attention to the condition of their child’s teeth and gums, since the development of caries and stomatitis (and other infectious diseases localized in the oral cavity) can cause a change in the aroma of exhaled air.

What causes sour breath?

The most common cause of sour breath is acid reflux. This is a pathology of the gastrointestinal tract, accompanied by heartburn, pain in the lower abdomen, and less commonly, belching. Symptoms of acid reflux occurring more than twice a week are already characterized as gastroesophageal reflux disease (GERD) and must be treated. The main cause of reflux is a weakening of the lower esophageal sphincter, a valve-like muscle that forms a barrier between the esophagus and the stomach. Normally, the sphincter opens when swallowing food and then closes tightly. With reflux, it remains open, allowing gastric juice mixed with bile and pieces of undigested food to flow back into the esophagus. This causes heartburn, a bitter or sour taste in the mouth, and bad breath that gets worse with belching.

In some cases, a person with GERD may feel their own bad breath without even opening their mouth. The sharp sulfuric acid smell of bile from the esophagus can even be heard through the nose. Less commonly, sour breath can be a symptom of peptic ulcer of the stomach and duodenum, accompanied by increased acidity of gastric juice.

Bad breath due to gastrointestinal diseases

Bad breath in some cases can be a consequence of gastroenterological diseases. Most often, halitosis is provoked by gastroesophageal reflux (a pathological condition in which gastric contents enter the esophagus), as well as infection of the mucous membrane of the stomach and duodenum by the bacterium Helicobacter pylori. It can cause gastritis, ulcers and stomach cancer. In addition, the bacterium may also be present on the oral mucosa, which is also a cause of halitosis. There may not be any signs of gastrointestinal diseases.

The study, published in the journal Medical Principles and Practice, involved 18 patients with halitosis and confirmed H. pylori infection. 4–6 weeks after a course of antibacterial treatment, bad breath disappeared in 16 people. This study confirmed the relationship between Helicobacter pylori and halitosis.

Much less commonly, halitosis occurs due to intestinal obstruction. This is a health-threatening condition where food is unable to move through the digestive tract due to a blockage in the small or large intestine. Symptoms of the pathology: bloating, constipation, abdominal cramps, nausea, vomiting and fecal odor from the mouth. If you have these symptoms, you should immediately consult a doctor.

Ammonia odor in a child

In cases where a baby or an older child has an unpleasant stench from the mouth every day, and sometimes even smells of ammonia or urine, most often we are talking about non-compliance with the rules of personal hygiene or a violation of the drinking and eating regime, which can be easily corrected. However, parents do not need to ignore such a change in the child’s condition, especially if it is accompanied by a deterioration in the baby’s well-being and the appearance of complaints. In this case, you should immediately consult a doctor to rule out the development of diseases of the gastrointestinal tract, kidneys or diabetes.

How to remove bad breath from reflux?

Medication treatment, as well as making some changes to your usual lifestyle, can help prevent sour breath from developing with GERD. First of all, you need to stop smoking. Nicotine causes the sphincter muscles in the lower esophagus to weaken, which is the main cause of stomach acid refluxing into the esophagus. In addition, smoking itself causes bad breath and increases the risk of developing cancers of the throat, esophagus, stomach, pancreas, liver and colon. How to prevent bad breath from reflux:

do not lie down immediately after eating - in a horizontal position, gastric juice flows into the esophagus, and the longer it stays there, the more irritated its mucous membrane is. You must wait at least 2–3 hours;
Place a wedge-shaped pillow under your head to elevate your upper body while you sleep. This way the esophagus will be located above the stomach and gastric juice will not flow back and irritate its walls;
eat small meals throughout the day;
Maintain a normal weight to avoid pressure on the stomach. Obesity increases the risk of hiatal hernia, which can worsen GERD symptoms;
Chew gum to freshen your breath and reduce the risk of heartburn.

Changing your diet can also relieve symptoms of GERD and prevent bad breath. Many foods can reduce the tone of the sphincter muscles of the lower esophagus and increase the acidity of gastric juice, thereby exacerbating the problem. Foods and drinks to avoid if you have GERD:

alcohol;
coffee and tea containing caffeine;
onion and garlic;
citrus fruits and juices from them;
carbonated drinks;
tomato juice;
mint;
spicy food;
chocolate;
fatty and fried foods.

Include more fiber-rich foods in your diet. These are pears, apples, avocados, artichokes, lentils, beans, broccoli, bananas, carrots and beets. They help improve digestion and avoid halitosis. Consume natural sourdough yogurt without fillers and milk, and drink enough water. Drug therapy for GERD involves the use of several types of drugs that reduce the production of hydrochloric acid or neutralize it:

histamine blockers;
proton pump inhibitors;
calcium carbonate, aluminum or magnesium hydroxide.

Only a doctor can prescribe medications. Self-medication can be harmful to health.

How to eliminate unpleasant odor from the stomach?

The first step in dealing with bad odor caused by stomach problems should be to determine its true cause. To do this, you need to make an appointment with a gastroenterologist, since attempts at self-medication can harm your health. After examining the gastrointestinal tract, the doctor will prescribe a treatment regimen that will help solve the problem of bad breath. Taking probiotics (beneficial microbial cultures that improve the functioning of the digestive system) also helps normalize the acid balance of the stomach and reduce the number of pathogenic bacteria.

Questions for the pediatrician

Yargina Olga Anatolyevna,

pediatrician, gastroenterologist, doctor of the highest category, candidate of medical sciences. Work experience: 18 years

ꟷ After a year, the child began to notice a strange reaction to temperature. When he gets sick, he is very damp, his forehead is cold, and I measure the temperature at 37.5. And my forehead is just icy. Is it dangerous and what is it anyway? Child 1.5 years old

O.A.:

There are two types of fever. The so-called “white” and “red” fever. They differ precisely in the color of their skin. In the first type, the skin is pale and cold, in the second it is red and hot. This is due to the ability of blood vessels to expand or spasm in response to a rise in temperature. Moreover, the white type is less common and the temperature drops more severely. With the “white” type of fever, it makes sense to add an antispasmodic (for example, no-shpa) to the antipyretic drug, which will relieve vascular spasm and make it easier to bring down the temperature.

ꟷ My daughter is 2.5 years old. Since the first year she has suffered from constipation. It started at about 5 months, constant gas tubes. Now we periodically take courses of Duphalac or Hilak Forte. It gets better for a while, then they come back again. He poops once every three days, and then often after a suppository or microlax. The feces are very thick, sometimes hard, and the process is painful. He eats vegetables, fruits, sour milk, and soups. But he drinks little water, half a liter a day at most, and eats in very small portions. I am not registered with a gastroenterologist yet, but I went there once for a fee. She also has atopic dermatitis, and constipation seems to affect the deterioration of her skin condition.

O.A.:

Together with a gastroenterologist, you need to analyze the diet and draw up a sample menu for the child. Conduct an examination.

ꟷ My son is 2 years old, height 81 cm, weight 10 kg. Over the year I have gained 1 kg and 7 cm, of which in the last six months I have gained 300 grams and 2 cm. This worries me very much, the child is very small. He eats well, everything he should for his age, his appetite is good, but that’s all he’s not growing. At 2 years old we will go for a medical examination, of course, please advise who to contact, what to examine? Birth weight 3300, height 51 cm. And the eldest daughter is also thin at 7.5 years old, height 125 cm and weight 20.5 kg, but she eats poorly and selectively. Which doctor should I contact? Thank you!

O.A.:

The child's weight and height are assessed using centile tables. This is the percentage of variation in anthropometric data for a given age and gender. Simply put, what is the most common weight and height for children at this age and how much it can deviate, while being the norm.

According to these very tables, your son ends up in the first corridor. This is the lower limit of normal. Because His appetite is good, it can be assumed that in the future it may increase sharply. But to be completely sure, it is better for you to contact an endocrinologist and have hormone tests done, and be examined by a gastroenterologist.

And your daughter, according to her parameters, falls into the 3rd corridor, which is the very middle of the norm. Happiness and health to you and your children!

ꟷ The child is 1.8. From time to time I smell ammonia from my breath. Appears and disappears for no apparent reason. What could this be from? What tests should I take? Which doctor should I contact?

O.A.:

A very important point: does the smell appear on an empty stomach, or during the day? In most cases, this is due to diseases of the oral cavity. But it can also be a symptom of more “dangerous” diseases, such as diabetes or kidney disease. This symptom also occurs when taking certain medications and vitamins. In your case, you need to contact an experienced pediatrician and ENT doctor.

ꟷ Tell us about the dangers and benefits of sugar and salt for children? What tactics should you follow to prevent your child from becoming a sweet tooth and glutton?

O.A.:

The principle of a reasonable approach to feeding children is always important. A child cannot be deprived of this or that product without reason. Is sugar harmful? This is one of the myths. Sugar itself is neither harmful nor beneficial. The body needs glucose to function properly. But it is worth remembering that glucose and refined sugar are not always identical. Glucose (plus useful microelements) can be obtained from honey, fruits, and dried fruits. But an excess of pure sugar with empty calories is still harmful - it slows down metabolism, impairs digestion, slowing down the production of gastric juice and can provoke allergies and skin rashes with inflammation.

Salt is also called sodium chloride (NaCl). It consists of 40% sodium and 60% chloride. Salt is the most important dietary source of sodium, and the words “salt” and “sodium” are often used interchangeably. Some types of such dietary supplement may include some amount of zinc, calcium, iron and potassium.

The minerals in salt act as important electrolytes in the body. They help the body regulate fluid balance. Some amount of sodium is naturally found in most foods. It is advisable to use iodized salt in your diet.

But high salt intake causes a range of health problems.

A competent pediatrician will always help you create a rational menu for your child, based on the baby’s age and physical activity, since the quantitative and qualitative nutrition of children differs from the needs of adults.

Properly structured nutrition is of great importance for the normal physical and neuropsychic development of children, increases ability to work and academic performance, endurance, resistance to adverse environmental influences, infectious and other diseases.

A lack or excess of food often causes diseases of the gastrointestinal tract, metabolic disorders, excessive weight gain, even the development of obesity, or, conversely, leads to weight loss, etc. Defects in the nutrition of children do not always immediately affect their health. More often they appear later, in the course of life, under unfavorable external conditions, illnesses, increased workload at school, and sometimes in more mature years.

ꟷ The child takes courses of canephron, nitroxaline, and neuromidin as prescribed by the urologist. But almost every day he takes some kind of drug. What diet to follow so as not to burden the gastrointestinal tract? In the morning the child has bad breath. The child is 2 years old.

O.A.:

What is your child's diagnosis? Besides bad breath in the morning, is there anything bothering you?

How to remove the smell of acetone from your mouth?

The smell of acetone on the breath usually appears when the body switches to the mode of burning accumulated fat due to the lack of carbohydrates from food to support all vital processes. This is a common side effect of low-carb or keto diets, but it is not harmful to your health. Breath with the smell of acetone or rotten apples disappears on its own a couple of weeks or a month after starting the diet, when the body fully adapts to the transition to a new source of energy.

In other cases, a sweetish fruity odor from the mouth may be a sign of an acute complication of type 1 diabetes - ketoacidosis. This dangerous health condition is caused by high levels of ketone bodies in the blood due to a lack of insulin. Symptoms of ketoacidosis:

strong thirst;
frequent urination;
labored breathing;
stomach ache;
nausea, vomiting;
confusion.

If these signs are present, you should urgently call an ambulance, since without timely treatment the patient may fall into a diabetic coma and die. Regular monitoring of blood sugar levels will help prevent the development of ketoacidosis in the future.

The following tips will help minimize keto breath while dieting:

increase your water consumption. Ketones are excreted not only by the lungs, but also in the urine. Dehydration increases their concentration in the body and increases the unpleasant odor;
eat less protein. When it breaks down, ammonia compounds are formed - another metabolic byproduct with a strong, unpleasant odor, which is excreted through the lungs and urine;
Maintain oral hygiene: brush your teeth twice a day, use dental floss and mouthwash;
Sugar-free mints or chewing gum will help freshen breath and increase the production of saliva, which has an antimicrobial effect and neutralizes bad odors;
increase your daily carbohydrate intake.

How to get rid of a terrible smell

In order to eliminate such a symptom, which does not bring anything pleasant with it, the factor causing bad breath should be eliminated. First of all, restoring a normal state begins with performing basic hygienic procedures aimed at cleansing the oral cavity of bacteria (in this case, regular brushing of teeth is considered the most effective method). It is important to understand that the surface of the teeth should be cleaned not only from the outside, but also from all the rest. In cases where food particles remain in hard-to-reach places, dental floss is used. If the patient has not followed the rules of hygiene for a long time, which is why his teeth are in an unsuitable condition, it is necessary to consult a dentist for advice. In addition, preventive examinations should be carried out at least once a year.

In cases where the strong smell of urine from the mouth is caused by drying out of the mucous membranes, you should not only normalize your drinking regimen, but also make an appointment with a doctor to determine the exact cause of this condition. Often the culprit for the occurrence of such a symptom is the development of pathological processes in the body, the timely detection of which will ensure the appointment of adequate treatment and a speedy recovery. If, after putting the daily diet and drinking regime in order, the smell of urine from the patient’s mouth does not leave the patient, and he is accompanied by a deterioration in his health, he should think about visiting the clinic. First of all, the doctor will direct the patient to undergo tests that will reveal the level of urea and sugar in the blood, which is necessary to continue diagnostic procedures and begin therapeutic measures.

What to do if your breath stinks?

The fight against bad breath should begin with a visit to the dentist, since most often halitosis is a consequence of poor oral hygiene and the resulting diseases of the gums and teeth. If the doctor does not find any problems, then the cause probably lies in gastrointestinal diseases, and you need to visit a gastroenterologist. Following these recommendations will help get rid of halitosis:

Brush your teeth thoroughly at least twice a day (especially after meals), using a toothpaste containing fluoride, as it helps strengthen the enamel. Using a toothpaste or mouthwash with antibacterial ingredients kills bacteria in the mouth that causes bad odor;
floss at least once a day to remove food particles stuck between your teeth;
clean the surface of your tongue daily with a special scraper or toothbrush to remove plaque, which is a breeding ground for pathogenic bacteria;
Clean your removable dentures regularly (at least once a day or as directed by your dentist);
avoid dry mouth - drink more clean water, chew sugar-free gum to stimulate saliva production;
Avoid consuming garlic, onions, hot spices, alcohol and coffee. Limit your sugar intake - it promotes the growth of microbes, which turn it into acid, which destroys tooth enamel;
change your toothbrush every three months;
Get a routine check-up with your dentist every six months.