7 Types of Bad Breath and What They Mean
Introduction
Throughout the United States, there are over 50 million people suffering from halitosis, or various types of bad breath. Many do not seek medical or dental assistance though, not least due to the social stigma linked to bad breath.
Foul-smelling breath isn’t all about poor dental hygiene. It’s often about much, much more than that. Here, we talk through some of the primary kinds of bad breath – what they mean from a more serious clinical perspective.
Many studies show that as many as 1-in-10 causes of bad breath are a consequence of causes outside the oral cavity. Bad breath can be a product of liver disease, kidney disease, upper respiratory tract infections and asthma, to name a few.
As part of your NAPLEX test, or other clinical pharmacy examination, you should have a thorough knowledge of these diagnostic indicators.
Whilst you may not be required to issue a formal diagnosis, knowing the patient’s history, in tandem with what odors are linked to specific disease states, can add tremendous practical and clinical detail to your armoury.
Let’s get started.
Types of Bad Breath
Below, we’ve tabulated many of the primary odors, their associated disease states, as well as other key clinical detail you are expected to know.
| Odor | Indication | Comments |
|---|---|---|
| Acidic | Asthma Cystic fibrosis | Acidic breath increases during acute attacks. Lung cancer is often described as “ammonia” or “musty”-like. |
| Fishy | Kidney disease Trimethylaminuria | In chronic kidney failure, urea levels can rise in saliva, giving rise to a fishy or ammonia-like odor. Trimethylaminuria is caused by an inability of the body to break down choline, leading to an build-up of trimethylamine. |
| Cheesy | Halitosis of nasal origin | Combination of bacteria, food, and other secretions. |
| Fruity | Diabetes type 2 | Low carb diets and result in fat breakdown, leading to ketone accumulation and a fruity smell. |
| Ammonia | Kidney disease | See “fishy” above. |
| Sweet, musty | Liver cirrhosis | In liver disease, the body accumulates dimethyl sulphide. The body tries to remove sulfur-based compounds from amino acid degradation. |
| Fecal | Bowel obstruction | Obstruction can cause fetalodor to reverse back through the GI tract into oral cavity. |
Conclusion
We often don’t think about breath as a diagnostic indicator. Yet, it remains a very powerful tool in the diagnostic process.
As we have learned, disease states have a direct impact on what compounds are produced, as well as how many of these compounds interact with saliva. Identifying halitosis is often just the start of the problem, as many of these disease states are long-term.
Halitosis can remain, at least for the duration of the disease.
NAPLEX Study Guide is the leading online platform to help you pass your NAPLEX exam, or other clinical pharmacy examinations. Check back to our blog soon for more great diagnostic tips to strengthen your knowledge in the months ahead.
