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19 years
I've been feeling a distasteful taste in my mouth for three days. What are the causes and solutions?
Sep 24, 2014

Dr. Zakia Dimassi Pediatrics
Bad breath, or halitosis, is defined as a frequent or persistent unpleasant breath odor. The bad odor most often results from fermentation of food particles by bacteria found in the mouth, producing volatile sulfur compounds such as hydrogen sulfide and methyl mercaptan. The culprit bacteria usually hide in areas of periodontal (the bone that holds the tooth) disease, especially if there is ulceration or necrosis (dead tissue). In patients who do not suffer from periodontal conditions, these bacteria may proliferate on the dorsal posterior tongue.
There are also cases where food accumulates in the creases of tonsils: in this scenario, you need to gargle after every meal to avoid this from happening.
Factors that promote the overgrowth and multiplication of causative bacteria include decreased salivary flow (eg, due to parotid disease, or use of anticholinergic medications such as antihistamines), salivary stagnation, and increased salivary pH (i.e., the medium of the oral cavity becomes less acidic than it normally is, which contributes to bacterial proliferation as acid usually kills bacteria).
Some foods or spices, after digestion, release the odor of that substance to the lungs; the exhaled odor may be unpleasant to others. For example, the odor of garlic is noted on the breath by others 2 or 3 h after consumption, long after it is gone from the mouth.
A good 85% of cases of halitosis result from oral conditions, including
bacteria on dorsum of tongue, producing malodorous tongue scrapings in the context of healthy oral tissue
A variety of systemic and extra-oral conditions account for the remainder
The most common causes overall are the following:
• Gingival (gum) or periodontal disease: oral disease, often including bleeding and/or pus discharge that can be detected upon examination and is often associated with a history of poor oral hygiene
• Smoking
• Alcoholic beverages
• Ingested foods that have a volatile component
• Sinus infection: the hallmark symptoms are thick nasal discharge, facial pain/tenderness, headache, post-nasal drip of mucus
• Zenker diverticulum (an esophageal diverticulum, a pouch that protrudes outward in a weak portion of the esophageal lining. This pocket-like structure can appear anywhere in the esophageal lining between the throat and stomach, and food can collect in this ouch) or gastroesophageal reflux disease (GERD): undigested food regurgitated when lying down or bending over
Gastrointestinal disorders rarely cause halitosis because the esophagus is normally collapsed. It is a common false notion that breath odor reflects the state of digestion and bowel function.
Other breath odors:
Several systemic diseases produce volatile substances detectable on the breath, although not the particularly foul, pungent odors typically considered halitosis. Notably, diabetic ketoacidosis, where ketones build up in the blood because the body fails to metabolize sugar, produces a sweet or fruity odor of acetone.
Get a routine check-up by a physician in order to pin down the cause of halitosis; if you do not brush your teeth and floss regularly, start doing so, morning and night. If you smoke and/or drink too much coffee, cut down on those. Also avoid alcoholic beverages. If your gums bleed or you have dental problems, consult a dentist to eliminate those problems and thus get rid of the bad breath odor.
If you have symptoms of GERD (burning sensation that travels up from your stomach to your throat, food regurgitation through mouth and/or nose, sour or bitter mouth taste in the morning etc.), you will need to:
- Sleep with head elevated 45 degrees
- Avoid: caffeine, chocolate, spices, tomato sauce, fatty foods (especially deep fried foods), carbonated beverages, and tobacco smoking
- Consult a doctor and start a proton pump inhibitor