Halitosis—or what we more commonly know as bad breath—has become a critical personal issue due to how it affects one’s self-confidence and the way one interacts with others. It is also often left untreated due to the embarrassing nature of this condition. People who have bad breath tend to feel too ashamed to admit it or seek the help of an oral healthcare professional.
You may experience having bad breath following a meal that consists of food with strong unpleasant odour or when food particles were left in your mouth after not brushing your teeth for a period of time. Similarly, hours of mouth inactivity like what happens when you are asleep results in oral malodour typically called morning breath.
These are all normal and harmless cases of bad breath.
On the other hand, chronic halitosis may be more serious as it could be a symptom of other health issues that affect more than just your oral cavity and should carefully be examined.
Bad Breath is a Multidisciplinary Matter
Halitosis mainly involves the oral cavity, therefore, dentists and periodontists are the primary medical specialists who encounter this issue. However, because bad breath could also be indicative of more complex health problems concerning other anatomical structures of the body, you may also need to see your ENT doctor, gastroenterologist, and endocrinologist, including your family physician.
Causes of Chronic Bad Breath Correlated to Gut Health
Good oral hygiene is your best defence against ordinary bad breath. Brushing your teeth and tongue twice a day, flossing daily and gargling with mouthwash often can greatly improve the overall health (and smell) of your oral cavity.
However, if the root of the problem does not lie within your mouth, it is only logical to look deeper into your gastrointestinal tract to find out what is really causing the unpleasant smell in your breath.
1. Gastro-oesophageal Reflux Disease (GERD)
Chronic acid reflux or heartburns are characteristic of GERD. Acid reflux happens when substances inside your stomach such as undigested food, bile and digestive enzymes flow backward into your oesophagus. Persistent heartburns may contribute to the awful stench in your breath as the combination of all the contents in your stomach rising up your oesophageal canal could result in a foul-smelling mixture of substances. This leaves a bad taste in your mouth that is released when you open it, especially when you belch.
In most cases of acid reflux, it is not high levels of gastric juice that is usually the culprit, but low amounts of it. Insufficient production of stomach acid could be your body’s response to stress or a result of getting older. This could lead to the poor digestion of the food you eat and an increase in the levels of bad bacteria like Helicobacter pylori (H. pylori) in your gut.
2. Imbalance of Gut Bacteria
Dysbiosis or microbial imbalance in your GI tract may also be the reason for your bad breath. Small intestinal bacterial overgrowth (SIBO) and excessive amounts of H. pylori in your gut contribute to the breakdown of sulphur that releases a rotten smell, which has a tendency to come out through your mouth.
3. Irritable Bowel Syndrome (IBS)
IBS is a long-term disorder of the large intestine characterised by bloating, abdominal pain, gas, diarrhoea, and/or constipation. This condition may vary in each individual in the sense that certain symptoms may manifest more often, while some won’t even show up at all. For instance, some people may experience loose bowel movement, while others find it difficult to pass stool. Either way, both situations may be associated with halitosis.
In the case of diarrhoea, if the food passes through your GI tract too quickly, chances are you will also suffer from poor digestion and nutrient malabsorption, which can result in bad breath. Additionally, dehydration can cause your mouth to become dry and your breath to stink.
Constipation may also be the explanation as to why there’s a nasty taste in your mouth and an awful smell in your breath. The sluggish movement of waste products in your gut makes it more susceptible to bacterial attacks that can adversely affect your entire GI tract from end to end. Moreover, the longer the stool stays in your system, the more it attracts toxins that get drawn back into your liver, contributing to the unpleasant odour in your mouth.
4. Toxin Overload
Too many toxins in your body from the food you eat, the kind of products you use and your overall lifestyle (especially if you smoke and/or drink, etc.) can be partly responsible for your bad breath. Harmful chemicals in your system can take a toll on organs that carry out detoxification, specifically your GI tract, liver and skin. If these organs become overworked, they will be unable to properly rid your body of toxins, and this dysfunction can be evident in the stuff your body expels—including your breath.
Going back up your GI tract, a condition called xerostomia or dry mouth creates a similar effect to morning breath where overnight mouth inactivity leads to bad breath until you have performed your oral hygiene routine.
In the case of xerostomia, the drying of the mouth is a result of a decreased production of saliva associated with stress, a symptom of a disease, radiation therapy or a side effect of medication. Saliva helps in cleansing your mouth by preventing food particles from sticking to your tongue and the walls of your oral cavity. If you produce very little saliva, these food particles will remain and decay in your mouth, causing an unpleasant smell.
Bad breath may be linked to gut health in several ways. If you feel you have halitosis, do not hesitate to get in touch with an oral health expert to assist you in identifying the possible causes of the unpleasant odour in your mouth.
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- Halitosis: the multidisciplinary approach – NCBI / International Journal of Oral Science
- Bad breath: What causes it and what to do about it – Harvard Health Publishing
- How Your Gut Connects to Your Breath – Be Well
- The Different Kinds of Bad Breath, Part 4: Stomach Breath – Huffpost
- 8 ways your digestion could be contributing to bad breath | What could your bad breath mean? – A. Vogel