Systemic causes, diet and habits
This type of halitosis is known as “blood-borne halitosis”. Malodour compounds originating in different organs (for example, the kidneys and liver) are transported via the blood to the lungs, where they volatise (evaporate) and cause halitosis. Some systemic diseases, metabolic disorders and certain foods and medicines can be responsible for “blood-borne halitosis”.
Certain foods can lead to the development of halitosis. The foods with the highest risk are garlic, onion, alcoholic beverages, cheese, fatty foods, olives, eggs, condiments, mayonnaise, oil, chocolate, milk, butter, cream, salami, ham, red cabbage, cauliflower, broccoli, artichoke and sardines. At this point, we should point out a type of halitosis brought on by the gastroesophageal reflux that can be activated by specific foods, and which has no relationship with the pulmonary or systemic tracts.
After food is ingested, VOCs and VSCs are found to mainly originate in the mouth, and only at a subsequent stage (approximately one hour later) do the most predominant compounds enter the gut-blood-lung axis. It has been verified that some spicy foods can cause bad breath and unpleasant aftertastes up to 72 hours after their ingestion. In addition to the blood-lung axis, we can also verify the existence of an alternative axis, or blood-saliva axis, with the latter having notable implications for dysgeusia (distorted sense of taste).
Tobacco and alcohol
The frequent intake of alcohol affects halitosis, which may be due to the fact that ethanol is a dehydrating agent (and causes intraoral VSCs and VOCs to become volatile), or due the catabolic by-products of ethanol released by the lungs via the bloodstream.
Smoking can also bring on halitosis. However, the effect on the breath (the tobacco smell) disappears after a short period of time (2-3 hours). Nevertheless, smoking is a risk for other conditions that can cause halitosis, or the sensation of halitosis, such as periodontal disease, xerostomia (dry mouth), dysgeusia (distorted sense of taste), lung cancer and others.
Diseases that can cause halitosis
There is a systemic pathway (encompassing various organs) for bad breath which involve three organs closely connected to each other by the digestive process: the intestines, the blood and the liver.
The menstrual cycle and bad breath
A few decades ago, it was also found that some women, during menstruation, show average levels of VSCs in their exhaled breath. This is due to the absorption of VSCs stemming from bacterial reactions to blood substrates, which are then absorbed by the mucous linings of the vagina and released through exhaled air.
Medications and bad breath
Whether administered topically or systemically, medications can affect the breath. Bad breath more often results from systemic administration, after the ingestion or perfusion of certain drugs that release or produce malodour compounds (which are then expelled via the lungs). In most cases, these drugs contain sulphur compounds. This is the case with dimethyl sulphoxide (DMSO), disulfiram, amyl nitrate, isosorbide dinitrate and various other cytotoxic medicines.
|Suplatast tosylate (anti-allergenic)||Asthma|
|Noxytioline (topical antimicrobial)||Periodontitis|
Other drugs can indirectly cause halitosis as they bring about changes in the oral ecosystem. A textbook example is a group of commonly used drugs that influence salivary flow (xerostomic agents) such as amphetamines, omeprazole, anticholinergics, ondansetron, antihistamines, selective serotonin reuptake inhibitors, thiabendazole, antineoplastics, didanosine, tricyclic antidepressants, levodopa (L-DOPA), among others. A number of other medicines also have adverse effects, such as gingival hyperplasia (Phenytoin, cyclosporine, nifedipine, etc.) coated tongue, gastroesophageal reflux, etc. It has also been proven that some creams and lotions applied to the skin can cause changes to the breath.
The Breath Institute has discovered, on the basis of the latest international research, that there are over 80 possible causes of halitosis.
1. The composition of halitosis (bad breath)
2. Causes of halitosis (bad breath)
2.1 Oral causes
2.2 Respiratory causes
2.3 Digestive causes
2.4 Systemic causes, diet and habits
2.5 Neuropsychological causes
We identify the most effective clinical methods when diagnosing precisely the halitosis’ origin, so that you can chose the best treatment.