Bad Breath--Nothing Good About It!

[Queerwitch]

One of my best friends has absolutely disgusting breath. It's sad because I love him and he's a great guy. And less-scrupulous people will even make remarks to him in front of others. And of course, he's beyond embarassed to be around cute guys because of this...

He brushes, he gargles, he gets dental check-ups, and nothing works, which frustrates him to no end. Unless he is willing to constantly have minty-flavored gum or hard candy in his mouth, there seems to be no solution.

My guess is there's something internal going on. Diet? Infection? (My Dad had infected tonsils, which made his breath really gamey until they were removed.)

Does anyone have a clue as to what causes this, and what the solution may be?

 

[Corny]

the infected tonsils are what comes to my mind, too.

 

[Queerwitch]

I've seen tongue scrapers in his bathroom. I just saw him a couple days ago. He's had this problem for years and has learned to pop mints whenever he goes out. I just hate what it's done to his self-esteem. Maybe a referral to an ear, nose & throat specialist would be a good thing? I don't know if dentists deal with tonsils if that is the issue. Thanks, guys.

 

[looseliam]

the infected tonsils are what comes to my mind, too.

This came to mind as well - tonsil stones accumulations of anaerobic bacteria. They can be rather nasty/smelly.

 

[Corny]

They can be rather nasty/smelly.

my ex had eppstein barr. this is about the worst smell that you can imagine coming out of someone's mouth. and you will smell it when he is talking - even if you are a meter away.

 

[RaKroma]

If dentists said his teeth and gums are healthy then he needs to be evaluated by ENT and gastroenterologist. It is either something wrong with his tonsils or overproduction of mucous causing post nasal drip that accumulates in back of throat and tongue area that can be fixed with nasal sprays like Astelin. If something is wrong with his tonsils where he has crypts that collect food or tonsil stones, then CO2 carbon laser treatment or tonsil removal will resolve it. If it's not ENT related then other possible issues can be something like chronic acid reflux, esophageal ring not working properly making stomach gases escape etc..

 

[AlmondMilk]

Does he floss daily? Apparently at least 3 times a week is good enough to disturb any bacteria growth, but daily is a better solution. You never mentioned it

 

[KatTheGreat]

According to your description, his oral hygiene is ok, so I don't think there is anything wrong with his teeth/gums/mucous membranes in the mouth. He should really see a specialist. The best answer was given by RaKroma, there is definitely something going on beyond the oral cavity.

 

[JayHawk]

According to your description, his oral hygiene is ok, so I don't think there is anything wrong with his teeth/gums/mucous membranes in the mouth. He should really see a specialist. The best answer was given by RaKroma, there is definitely something going on beyond the oral cavity.

This...

Tonsils
In general, putrefaction from the tonsils is considered a minor cause of bad breath, contributing to some 3–5% of cases. Approximately 7% of the population suffer from small bits of calcified matter in tonsillar crypts called tonsilloliths that smell extremely foul when released and can cause bad breath.[8][13]
[edit]Esophagus
The Cardia, which is the valve between the stomach and the esophagus, may not close properly due to a Hiatal Hernia or GERD, allowing acid to enter the esophagus and gases escape to the mouth.[14] A Zenker's diverticulum may also result in halitosis due to aging food retained in the esophagus.
[edit]Stomach
The stomach is considered by most researchers as a very uncommon source of bad breath (except in belching). The esophagus is a closed and collapsed tube, and continuous flow (as opposed to a simple burp) of gas or putrid substances from the stomach indicates a health problem—such as reflux serious enough to be bringing up stomach contents or a fistula between the stomach and the esophagus—which will demonstrate more serious manifestations than just foul odor.[2]
In the case of allyl methyl sulfide (the byproduct of garlic's digestion), odor does not come from the stomach, since it does not get metabolized there.[15]
[edit]Systemic diseases
There are a few systemic (non-oral) medical conditions that may cause foul breath odor, but these are extremely infrequent in the general population. Such conditions are:[16][17]
Fetor hepaticus: an example of a rare type of bad breath caused by chronic liver failure.
Lower respiratory tract infections (bronchial and lung infections).
Renal infections and renal failure.
Carcinoma.
Trimethylaminuria ("fish odor syndrome").
Diabetes mellitus.
Metabolic dysfunction.[18]
Individuals afflicted by the above conditions often show additional, more diagnostically conclusive symptoms than bad breath.

He should investigate the source with a professional.