What is halitosis and why does it occur
Bad breath, or halitosis, is a common problem faced by millions of people. Although in most cases the roots of the problem lie in dental factors and poor hygiene, sometimes this symptom signals deep-seated disorders in the body. Modern medical research shows that bad breath can be associated with the use of certain medications, metabolic shifts, or salivary gland dysfunction.
Understanding the true causes helps not only to get rid of social discomfort but also to identify hidden pathologies in time. It is important to conduct comprehensive diagnostics, excluding both local dental problems and rare systemic triggers.
Medication-related causes and systemic factors
Rare but clinically significant side effects of drug therapy can manifest as specific body and breath odors. For example, in medical practice, cases have been described where modern drugs for the treatment of diabetes mellitus and obesity (specifically, dulaglutide) led to the appearance of an unpleasant odor, which completely disappeared after discontinuation of the drug and returned upon resumption of intake [1]. This underscores the importance of a thorough pharmacological history.
- Use of glucose-lowering agents and other innovative drugs [1].
- Metabolic disorders and endocrine shifts [1].
- Infectious and inflammatory processes in the body [1].
The role of salivary glands and xerostomia
Saliva plays a key role in the natural cleansing of the oral cavity and the suppression of bacterial growth. A lack of saliva (xerostomia) directly contributes to the development of halitosis. Patients often face this problem after radioiodine therapy for the thyroid gland, which causes radiation damage and inflammation of the salivary glands in approximately 30% of adult patients [2, 5].
To restore saliva secretion and eliminate inflammatory substances in the ducts, specialized minimally invasive interventions such as sialocentesis are used, which effectively improve the condition of patients with post-radiation xerostomia [2].
Neurological features and false odors
Interestingly, complaints of bad breath or unusual taste sensations do not always have a physical source in the oral cavity. In patients with neurological disorders such as migraine, olfactory anomalies (phantosmia or olfactory hallucinations) may be observed [6, 7]. Patients may perceive persistent smells of rot or burning, which leads to anxiety, loss of appetite, and weight loss, even though there are no objective causes in the oral cavity [7]. Such conditions require the involvement of neurologists and detailed differential diagnosis.
Modern treatment methods and therapeutic approaches
Treatment of halitosis must be strictly interdisciplinary and depend on the root cause:
- Oral cavity sanitation and correction of hygiene habits.
- Adjustment of the medication regimen upon identification of drug-related odor triggers [1].
- Restoration of salivary gland function in xerostomia using sialocentesis or moisturizing protocols [2].
- Neurological treatment and correction of comorbid conditions in central olfactory disorders [6].
Timely consultation with specialists allows for an accurate diagnosis and helps restore the patient's self-confidence.
Sources
- 1. Dulaglutide-associated body odor with dechallenge and rechallenge in a patient with type 2 diabetes. PubMed
- 2. Preliminary study on the efficacy of xerostomia treatment with sialocentesis targeting thyroid disease patients given radioiodine therapy. PubMed
- 3. Red Ear Syndrome: A Case Report and Review of Literature. PubMed
- 4. Photobiomodulation Therapy for Symptom Management in Essential Palatal Myoclonus. PubMed
- 5. The Impact of Radioiodine (131I) Therapy of Thyroid Disease on Salivary Glands Function and Inflammation. PubMed
- 6. Olfactory abnormalities in patients with migraine: a narrative review. PubMed
- 7. Olfactory Hallucinations Leading to Weight Loss in a Patient with Migraine. PubMed
- 8. Erratum in Cardiorenal medicine. PubMed
Disclaimer: The information provided in this article is for reference purposes only and does not replace an in-person consultation with a medical specialist. If symptoms of halitosis appear, it is recommended to consult a dentist and a general practitioner.