Americans are obsessed about how we smell and advertisers have perfected ways to reinforce our fears. They sell products for virtually every indentation and orifice on the body. The mouthwash business is huge because we seem especially concerned about bad breath. Hundreds of millions of dollars are spent on gargles, rinses, and breath mints and much of that money is wasted.
Although it is true that virtually everyone will wake up with a stale taste in the mouth, this is natural. It’s the result of bacteria building up overnight due to oral inactivity. This generally clears up with brushing your teeth, sipping your morning juice or talking.
For most people, dietary discretion and good dental hygiene forestalls any problem with bad breath. But there are those whose troubles persist. One reader informed us: “My daughter had halitosis but hers smelled almost like a chemical. Some days it was slight and other days it would knock out a horse. I knew it wasn’t ordinary bad breath so I took her to an allergist, who told us her large tonsils were catching food in their folds. First he ruled out diabetes, then went ahead and removed her tonsils. She hasn’t had a problem since.”
Then there was Stan. He told us that after years of suffering with heartburn and ulcers he was treated for Helicobacter pylori (H. pylori). This bacterial infection is believed ot be responsible for many persistent ulcers. After a successful antibiotic program, Stan was astonished to find that his long-standing bad breath had disappeared. His dog used to retreat when Stan got close and his girlfriend would complain bitterly. Stan was delighted about an unexpected bonus in curing his ulcers–his dog and his girlfriend no longer backed off.
There is a blood test for Helicobacter pylori to see if this infection is lurking in the digestive tract. If bad breath is not caused by this germ, specialists to consult include a dentist, a periodontist or an ear, nose and throat specialist. A thorough diagnostic workup is essential to rule out diabetes, liver disease or kidney failure. Infection could also be the culprit. Gum disease, tonsillitis, sinus infection or a lung problem may all contribute. The tonsils may also trap food that could decay, causing an unpleasant odor. It will take persistence and determination to find the cause so true bad breath can be treated effectively.

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  1. Michele
    New Mexico

    This was a very informative post. I, too, had my tonsils removed (which I think made things worse. Apparently, they are supposed to help fight off germs and infection.) I have gone to a gastroenterologist, visited the Ayurvedic doctor, had my roots cleaned by a periodontist, my dentist said my oral hygiene is great, I use expensive mouth products and a tongue scraper, and still no change. I am even contemplating a hypnotist and or a Native American shaman. Haha

    I have not checked for lung infection, or H pylori. In fact, a couple of doctors I have been to say they do not notice anything. This, however, is not true because we who have this issue are treated differently, made fun of, pointed out, told eww when talked to, it’s as if we have leprosy or something. (I know those of you reading this understand this pain.)

    It is really something that I would like to figure out and fix. My problem has only been for the past five years. When I started smoking. I have since quit. The smell literally smells like poo. Like a bad rotting inside of me. I would take the metallic smell over poo any day.

    I hope everyone finds their cure. If you do, please post so I can be led in the right direction.

  2. LS

    I have been suffering with bad breath as far back as age 10. I am now 38! I finally got over the embarrassment of bringing it up to my doctor and she gave me sinus medicine and finally after persistence I received an authorization to see an ENT. He noticed I was getting food stuck in my tonsils. At the age of 37 I had my tonsils removed which was the most painful post-op experience ever. I thought it would be worth it, but it didn’t cure anything. I don’t know what to do and it totally affects my life on a daily basis. I don’t like to get too close to my husband or kiss him unless I have gum in my mouth or have just brushed & rinsed. I even tried a tongue scraper and that didn’t help either. I don’t know what to do…..

  3. Dentist Amarillo

    Nice write-up. Persistent bad breath can be sign of bacterial infection, serious tooth decay or gum disease. It can also be the symptom of a health problem, such as diabetes, sinus infection or hormonal change. Regular brushing and flossing alone cannot completely remove bacteria and nasty smell in your mouth. It can only be done by your dentist. Thus, visiting your dentist for professional cleaning and check-up is important.

  4. GM

    I take medicine for acid reflux. I have noticed that my tongue stays white and my mouth is dry a majority of the time. I have a sour taste when I eat or drink anything. I have pretty much limited myself to drinking water because that is the only thing that doesn’t really affect the smell or taste. I’m constantly chewing gum, but I really don’t think that helps because of the people’s reactions.
    I have great oral hygiene, but the problem still persists. I’m going to try to find another doctor because it seems to be getting worse. Maybe the white tongue (Candida?) has something to do with it. Candida is related to yeast that can also be caused by too many antibiotics or diet. Any help would be appreciated.

  5. DT

    What about a tongue scraper?? Ever try it?

  6. mh

    I too have been suffering from severe halitosis for many years now. I have tried every remedy recommended, I have excellent oral health and have gone through all kinds of internal tests. Nothing turned up. I was also treated for H-Pylori but that did not help either. It is extremely embarrassing and I am leading a very low quality life. I wish there were some help out there.

  7. bdb

    I suffer from severe halitosis and have not been able to find out the cause. I have seen my dentist whom I visit every 3 months for the past 7 years and I have excellent dental hygiene. I had my general practitioner tested me for everything we could imagine and she diagnosed me with H-Pylori and treated it however I still have severe halitosis. She referred me to a gastroenteroligist who performed an endoscopy and could not find anything wrong. My next visit will be to an ENT specialist to see if he can find out the cause. It is a very embarrassing problem to have and I just want it to go away.

  8. Dentist Hayward

    True, bad breath is not only due to poor dental hygiene but also can be a result of various medical conditions. Some people act upon it instantly by going to their dentist, but if the dentist dismisses the cause as that of poor dental practices, they should go to a physician to get diagnosed.

  9. D.A.

    Very informative post. Indeed, bad breath is not just having poor dental health, but can be a sign of a certain health condition. I think it is better to see a doctor to see if you have lung or digestive problems which causes bad breath.

  10. maria

    I just want to know what I can do for my tonsils that swell often and cause bad odor. The specialist wants to take them out. I am 65 and I don’t get fever or pain just swelling and bad odor, can I use a remedy to stop the swelling? It really bothers me. Is there something that can shrink the tonsils? I use Listerine and it helps a little, but for couple of hours is all. Thanks I really like your site I use often and I give the name to my friends, it is very useful and informative.

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