Different Types of Bad Breath

A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a characteristic sign of ketoacidosis (such as diabetic ketoacidosis - Diabetic ketoacidosis is a complication of diabetes mellitus caused by the buildup of by-products of fat metabolism (ketones), which occurs when glucose is not available as a fuel source for the body), a potentially life-threatening condition.
A fecal odor to the breath (the breath smells like feces) can occur with prolonged vomiting , especially when there is a bowel obstruction (Intestinal obstruction involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through). It can also occur temporarily if the person has a nasogastric tube in place (a tube placed through the nose or mouth to the stomach to drain the stomach contents).

The breath may have an ammonia-like odor (also described as urine-like or "fishy") in people with chronic kidney failure .

Common Causes: If previously normal breath turns into halitosis, causes could include:

• Food or beverages consumed (such as cabbage, garlic, raw onions, or coffee)
• Vitamin supplements (especially in large doses)
• Poor dental hygiene
• Dentures
• Cavities
• Tobacco smoking
• Alcoholism
• Throat infection
• Sinusitis ( Sinusitis refers to inflammation of the sinuses. This is generally caused by a viral, bacterial, or fungal infection.The sinuses are air-filled spaces around the forehead, cheeks, and eyes that are lined with mucous membranes. Healthy sinuses are sterile (meaning that they contain no bacteria or other organisms) and open, allowing mucus to drain and air to circulate. When inflamed, the sinuses become blocked with mucus and can become infected. Each year, over 30 million adults and children get sinusitis. Sinusitis can be acute (lasting anywhere from 2 to 8 weeks) or chronic, with symptoms lingering much longer)
• Lung infection
• Gum disease ( gingivitis , gingivostomatitis )
• Abscessed tooth A tooth abscess is a collection of infected material (pus) resulting from bacterial infection of the center (pulp) of a tooth)
• Impacted tooth ( An impacted tooth is when a tooth fails to fully emerge through the gums)
• Foreign body in the nose (in children)
• Often (but not always) there is a white, yellowish, or bloody discharge from one nostril
• Drugs
• Paraldehyde
• Triamterene and inhaled anesthetics
• Insulin - injection

Diseases that may be associated with breath odor (not presented in order of likelihood -- some are extremely unlikely):

• Acute necrotizing ulcerative gingivitis
• Acute necrotizing ulcerative mucositis
• Acute renal failure ( Acute renal failure is sudden loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes )
• Bowel obstruction (can cause breath to smell like feces)
• Bronchiectasis ( Bronchiectasis is an abnormal destruction and dilation (widening) of the large airways. A person may be born with it (congenital bronchiectasis) or may acquire it later in life as a result of another disorder)
• Chronic renal failure (can cause breath to smell like ammonia )
• Diabetes (fruity or "sweet chemical" smell with ketoacidosis )
• Esophageal cancer
• Gastric carcinoma
• Gastrojejunocolic fistula (fruity-smelling breath) - ( A fistula is an abnormal connection between an organ, vessel, or intestine and another structure. Fistulas are usually the result of trauma or surgery, but can also result from infection or inflammation)
• Hepatic encephalopathy ( Hepatic encephalopathy is brain and nervous system damage that occurs as a complication of liver disorders. It is characterized by various neurologic symptoms including changes in reflexes, changes in consciousness , and behavior changes that can range from mild to severe)
• Diabetic ketoacidosis
• Lung abscess ( Aspiration pneumonia is an inflammation of the lungs and bronchial tubes caused by inhaling foreign material, usually food, drink, vomit , or secretions from the mouth into the lungs. This may progress to form a collection of pus in the lungs)
• Ozena , or atrophic rhinitis ( Ozena is a disease of the nose characterized by a wasting away of the bony ridges and mucous membranes inside the nose along with nasal crusting, discharge, and a very bad smell (often present in various forms of rhinitis ). Ozena may occur following prolonged nasal swelling .
• Periodontal disease ( Periodonditis is a dental disorder that results from progression of gingivitis, involving inflammation and infection of the ligaments and bones that support the teeth)
• Pharyngitis ( Pharyngitis is an inflammation of the pharynx that frequently results in a sore throat . It may be caused by a variety of microorganisms)
• Zenker's diverticulum ( Diverticulitis is inflammation of an abnormal pouch (diverticulum) in the intestinal wall, usually found in the large intestine (colon). The presence of the pouches themselves is called diverticulosis)