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Ask the Medical Expert Archives 2000-2004

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Bad Breath
November 2000

Q. I am a 31-year-old woman whom has recently experienced severely bad breath. I am in great oral health and have not recently had any sinus infections. Please tell me what tests I should have my family physician run to rule out cancer, kidney disease or liver disease. Also, is there anything else that I might be concerned about?

A. Determining the cause of bad breath can be more difficult than one might think. Starting with a general check-up from your doctor would be a good start, as several important health conditions may lead to odors from the mouth. Examples would include diabetes, kidney disease, sinus infection, and liver disease, in which alterations of metabolism lead to detectable odors as described.

In the majority of cases, general health is found to be good, and the cause has to do with certain bacteria in the mouth which lead to the odors. These bacteria, called anerobes, can escape normal brushing by residing in spaces between the teeth, or even on the back part of the tongue. Treatment for these conditions can be directed by your dentist or a periodontist as needed.

HELPFUL WEBSITES:

http://www.tau.ac.il/~melros/index.html

http://www.ada.org/consumer/faq/hot/breath.html

MEDICAL REFERENCES (usually available through the library of your local hospital):

Yaegaki K, Coil JM. Examination, classification, and treatment of halitosis; clinical perspectives. J Can Dent Assoc. 2000 May;66(5):257-61.

Cohen M. A new era in halitosis and periodontal treatment. Dent Today. 1998 Aug;17(8):88-9.

Read B. Halitosis research. J Can Dent Assoc. 2000 Jul-Aug;66(7):355. No abstract available.

Ingram CS. Treatment of halitosis. N Z Dent J. 1999 Jun;95(420):66. No abstract available.

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