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Diseases

Bad breath—is it really caused by the teeth, or by the stomach and liver?

Sources: 14 · Article: 20 923 characters

Henryk Różański lists many possible causes of bad breath: sinus and nasal problems, fungal infections, intestinal and metabolic disorders, and constipation.

  • Henryk Różański also links it to a coating on the tongue and to bacteria that break down sugars and amino acids, producing foul-smelling compounds.
  • For oral care, he suggests cleaning the tongue, using herbal rinses, and chewing cloves or cardamom.
  • He also mentions infusions and tinctures for rinsing, guaiacol preparations, and probiotics.

What the authors write

Henryk Różański

Henryk Różański lists sinus and nasal diseases, candidiasis, disruptions to the microbiome and digestion, constipation, parasites, and metabolic diseases among the possible causes.

„There are many causes of bad breath. The most common include: 1. Chronic inflammation of the paranasal sinuses (sinusitis), including sinubronchitis. 2. Foul-smelling atrophic rhinitis (rhinitis atrophica foetida).”Jest wiele przyczyn nieprzyjemnego zapachu z jamy ustnej. Do najczęściej spotykanych należą: 1. Przewlekłe nieżyty zatok przynosowych (sinusitis), w tym zespół zatokowo-oskrzelowy – sinubronchitis. 2. Cuchnący zanikowy nieżyt nosa rhinitis atrophica foetida.
Henryk Różański

Bacterial breakdown of amino acids can release amines and hydrogen sulfide, which Henryk Różański says contribute to bad breath.

„Some of these amines smell like slurry or rotting meat, and together with hydrogen sulfide and keto acids they produce an unpleasant odor from the mouth. Harmful bacteria break down sugars and amino acids very quickly, releasing aromatic acids and amines.”Niektóre z tych amin mają zapach przypominający gnojówkę, gnijące mięso, a w połączeniu z siarkowodorem i ketokwasami dają nieprzyjemny odór z jamy ustnej. Niewłaściwe bakterie powodują bardzo szybko rozpad cukrów i aminokwasów, uwalniając aromatyczne kwasy i aminy.
Henryk Różański

Henryk Różański identifies bacteria of the genus Prevotella as one possible cause of bad breath.

„It produces a brown heme pigment in feces. It is also found in the mouth. Bacteria of the genus Prevotella are generally responsible for bad breath and gum inflammation. Actinobacillus actinomycetemcomitans and Capnocytophaga can also have harmful effects.”W kale wytwarza brunatny barwnik hemowy. Jest również w jamie ustnej. Bakterie z rodzaju Prevotella generalnie są odpowiedzialne za nieprzyjemny zapach z ust i stany zapalne dziąseł. Podobnie niekorzystna jest Actinobacillus actinomycetemcomitans oraz Capnocytophaga.
Henryk Różański

A coating on the tongue can contribute to bad breath because bacteria and fungi grow in the grooves of the tongue.

„The surface of the tongue is a huge reservoir for all kinds of fungi and bacteria, and it is regularly coated with everything we eat and drink. Structurally, the surface of the tongue has papillae and grooves where microorganisms grow and various chemical reactions involving food particles take place.”Powierzchnia języka to ogromny rezerwuar najróżniejszych grzybów i bakterii oraz narząd, który pokrywany jest regularnie wszystkim co jemy i pijemy. Morfologicznie język na powierzchni zawiera brodawki i zagłębienia, w których rozwijają się mikroorganizmy i w których zachodzą różnorodne przemiany chemiczne cząstek pokarmowych.
Henryk Różański

Henryk Różański recommends regularly removing the coating from the tongue with a soft toothbrush.

„Regularly removing the coating from the tongue helps prevent bad breath. A soft toothbrush is best for this. After brushing your teeth, clean your tongue: put a little toothpaste and 1–2 drops of tea tree, wintergreen, lemongrass, citronella, or guaiac tincture on a soft toothbrush.”Regularne usuwanie nalotu z języka zapobiega powstawaniu nieprzyjemnych zapachów. Najlepiej używać do tego celu miękkiej szczoteczki. Po umyciu zębów przystępujemy do mycia języka: na miękką szczoteczkę nanieść nieco pasty i 1-2 krople olejku herbacianego, gaulteriowego, lemongrasowego, cytronelowego lub nalewki gwajakowej.
Henryk Różański

For brushing the tongue, Henryk Różański suggests using toothpaste with one or two drops of a chosen oil or guaiac tincture.

„After brushing your teeth, clean your tongue: put a little toothpaste and 1–2 drops of tea tree, wintergreen, lemongrass, citronella, or guaiac tincture on a soft toothbrush. Melissa oil can also be effective. After gently brushing the tongue, rinse the mouth and throat with hydrogen peroxide diluted with water (1:1).”Po umyciu zębów przystępujemy do mycia języka: na miękką szczoteczkę nanieść nieco pasty i 1-2 krople olejku herbacianego, gaulteriowego, lemongrasowego, cytronelowego lub nalewki gwajakowej. Sprawdza się również olejek melisowy. Po delikatnym szczotkowaniu języka – jamę ustną i gardło wypłukać rozcieńczoną wodą utlenioną (1:1).
Henryk Różański

Henryk Różański lists infusions of sage, chamomile, yarrow, witch hazel, calendula, savory, or clove for rinsing an irritated mouth.

„In these situations, I recommend rinsing the mouth with an infusion of sage, chamomile, yarrow, witch hazel, calendula, savory, or clove. The pharmacy product Azucalen is also suitable (1 teaspoon per glass of water). Chewing cloves or cardamom also freshens the mouth, discourages smoking (after several weeks of chewing, it causes an aversion to nicotine), reduces inflammation, and inhibits the growth of bacteria and fungi in the mouth.”W tych sytuacjach zalecam płukać jamę ustną naparem z szałwii, rumianku, krwawnika, oczaru, nagietka, cząbru lub goździka przyprawowego. Dobry również preparat apteczny Azucalen (1 łyżeczka na szklankę wody). Także żucie goździka lub kardamonu dodaje świeżości jamie ustnej, zniechęca do palenia tytoniu (po kilku tygodniach żucia wywołuje wstręt do nikotyny) i usuwa stany zapalne oraz hamuje rozwój bakterii i grzybów w jamie ustnej.
Henryk Różański

According to Henryk Różański, chewing cloves or cardamom freshens the breath and inhibits the growth of bacteria and fungi in the mouth.

„Chewing cloves or cardamom also freshens the mouth, discourages smoking (after several weeks of chewing, it causes an aversion to nicotine), reduces inflammation, and inhibits the growth of bacteria and fungi in the mouth. These spices are readily available and release powerful disinfecting substances as they are chewed.”Także żucie goździka lub kardamonu dodaje świeżości jamie ustnej, zniechęca do palenia tytoniu (po kilku tygodniach żucia wywołuje wstręt do nikotyny) i usuwa stany zapalne oraz hamuje rozwój bakterii i grzybów w jamie ustnej. Przyprawy te są dostępne i uwalniają w trakcie żucia silne substancje odkażające.
Henryk Różański

Henryk Różański recommends infusions of California poppy, mahonia, barberry, or greater celandine to limit the production of foul-smelling amines and hydrogen sulfide in the large intestine.

„An infusion of California poppy (Eschscholzia californica, described on my website), mahonia, barberry (leaves or fruit), or greater celandine (Chelidonium majus) inhibits excessive amino acid breakdown in the large intestine and the release of foul-smelling amines and hydrogen sulfide.”Napar z maczka kalifornijskiego Eschscholzia californica (opisanego na moich stronach), napar z mahonii, napar z berberysu (liście, owoce) lub napar z glistnika (Chelidonium majus) hamują nadmierny rozkład aminokwasów w jelicie grubym i uwalnianie przykro pachnących amin oraz siarkowodoru.
Henryk Różański

For rinsing the mouth after brushing, Henryk Różański suggests infusions of several of the herbs mentioned, once a day or every other day.

„Rinses made with infusions of California poppy, Canadian bloodroot (Sanguinaria), barberry, greater celandine, bocconia (Macleaya), and other similar herbs should be used after brushing the teeth, once a day or every other day. A tincture can also be made from the raw materials (1:3) and used to rinse the mouth and throat after first diluting it with water (1 teaspoon per glass of water).”Płukanki naparem z maczka kalifornijskiego, krwiowca (krwicy) kanadyjskiego (Sanguinaria), z berberysu, z glistnika, z bokkoni = obrzanu (Macleaya) i in. podobnych ziół należy stosować po umyciu zębów 1 raz dziennie lub co dwa dni. Możliwe jest sporządzenie z surowców nalewki (1:3) i stosowanie jej do płukania jamy ustnej oraz gardła po uprzednim rozcieńczeniu wodą (1 łyżeczka na szklankę wody).
Henryk Różański

Henryk Różański says that a tincture made from these ingredients can be diluted with water and used to rinse the mouth and throat.

„Rinses made with infusions of California poppy, Canadian bloodroot (Sanguinaria), barberry, greater celandine, bocconia (Macleaya), and other similar herbs should be used after brushing the teeth, once a day or every other day. A tincture can also be made from the raw materials (1:3) and used to rinse the mouth and throat after first diluting it with water (1 teaspoon per glass of water).”Płukanki naparem z maczka kalifornijskiego, krwiowca (krwicy) kanadyjskiego (Sanguinaria), z berberysu, z glistnika, z bokkoni = obrzanu (Macleaya) i in. podobnych ziół należy stosować po umyciu zębów 1 raz dziennie lub co dwa dni. Możliwe jest sporządzenie z surowców nalewki (1:3) i stosowanie jej do płukania jamy ustnej oraz gardła po uprzednim rozcieńczeniu wodą (1 łyżeczka na szklankę wody).
Henryk Różański

Henryk Różański recommends a decoction of guaiac wood or drops of guaiac tincture as a remedy for bad breath.

„For bad breath, take 2–3 drops several times a day. When staying in places where there is a risk of mite attacks or bacterial and fungal infections (swimming areas, hotels), or insect bites, rub the tincture into the skin twice a day.”Przy nieprzyjemnym zapachu z ust zażywać kroplami (2-3 krople) kilka razy dziennie. Przy pobycie w miejscach, gdzie istnie ryzyko ataku roztoczy, infekcji bakteriami i grzybami (kąpieliska, hotele), ataku owadów, wcierać nalewkę w skórę 2 razy dziennie.
Henryk Różański

For rinsing the mouth and throat, Henryk Różański suggests guaiac tincture diluted in warm water.

„Use 1 tablespoon of guaiac tincture in a glass of warm water to rinse the mouth and throat. It can also be rubbed into the skin. Guaiac nasal drops (Gutta Guaiaci pro nasi): add 1–2 drops of guaiac tincture to 10–15 ml of saline solution (ready-made 0.9% solutions are available in pharmacies). Put the drops into the nose for sinusitis, a runny nose, bad breath, and unpleasant odor from the nasal cavity.”1 łyżka nalewki gwajakowej na szklankę wody ciepłej do płukania jamy ustnej i gardła. Ponadto do wcierania w skórę. Krople gwajakowe do nosa Gutta Guaiaci pro nasi: 1-2 krople nalewki gwajakowej na 10-15 ml roztworu soli fizjologicznej (dostępne gotowy roztwory w aptekach, 0,9%) – wkraplać do nosa przy zapaleniu zatok, katarze, nieprzyjemnym zapachu z ust i jamy nosowej.
Henryk Różański

Henryk Różański describes mixtures of propolis with guaiacol and essential oils as effective against bad breath.

„Effective against bad breath. Take 6–10 drops by mouth several times a day. I recommend it for flu, tonsillitis, and sinusitis. Propolis with guaiacol and essential oils II: pour 25 ml of guaiacol or 75 ml of guaiac tincture into 25 ml of liquid propolis, mix, add 5 drops of sandalwood oil and 5 drops of geranium oil, and mix again.”Skuteczny w zwalczaniu nieprzyjemnego zapachu z ust. Doustnie przyjmować 6-10 kropli leku kilka razy dziennie. Zalecam przy grypie, anginie, zapaleniu zatok. Propolis z gwajakolem i olejkami II: do 25 ml płynnego propolisu wlać 25 ml gwajakolu lub 75 ml nalewki gwajakowej, wymieszać, dodać 5 kropli olejku sandałowego i 5 kropli olejku geraniowego, wymieszać.
Henryk Różański

Henryk Różański lists Kanuka oil for gargling, at a dose of four drops per glass of warm water, and names bad breath as one of its uses.

„Uses: psoriasis, bacterial diseases, fungal diseases, excessive sweating of the feet, muscle pain, joint pain, sprains, nervous muscle tension, excessive muscle tension after exercise, bad breath, insect bites, acne, herpes, and repelling insects (mosquitoes). Directions: rub in or inhale. For gargling, use 4 drops per glass of warm water.”Zastosowanie: łuszczyca, choroby bakteryjne, choroby grzybicze, nadmierna potliwość stóp, bóle mięśni, bóle stawów, zwichnięcia, nerwowe napięcie mięśni, nadmierne napięcie mięśni po treningu, nieprzyjemny zapach z ust, ukąszenia owadów, trądzik, opryszczka, odstraszanie owadów (komarów). Sposób użycia: wcieranie, inhalacje. Do płukania gardła 4 krople na szklankę ciepłej wody;
Henryk Różański

Henryk Różański recommends a mouthwash based on plant extracts and probiotics containing Lactobacillus.

„To displace harmful bacteria from the digestive tract, I recommend taking probiotics containing Lactobacillus. Lacidofil (Lallemand) capsules and Trilac (Allergon) capsules are good options. The probiotic introduces beneficial bacteria that acidify the digestive tract.”Dla wyparcia niekorzystnych bakterii z przewodu pokarmowego polecam zażywać probiotyki, zawierające Lactobacillus. Dobre są Lacidofil (Lallemand) – kaps. i Trilac (Allergon) – kaps. Probiotyk wprowadzi bakterie korzystne, zakwaszające środowisko przewodu pokarmowego.
Henryk Różański

Henryk Różański says that apple vinegar diluted with water can be used for a coated tongue, and that a more diluted solution can also be used as a rinse for oral candidiasis and gum inflammation.

„Apple vinegar—Acetum Dentariae, preferably made with apple or wine vinegar: take 1 teaspoon in water on an empty stomach for yeast infection of the digestive tract or a coated tongue; also use 1 tablespoon per glass of water for compresses and rinsing, for example, for candidiasis of the mouth and throat or gum inflammation.”Ocet żywcowy – Acetum Dentariae ,najlepiej na occie jabłkowym lub winnym: 1 łyżeczka w wodzie na czczo przy drożdżycy przewodu pokarmowego, obłożonym języku; nadto 1 łyżka na szklankę wody do okładów i płukania, np. przy kandydozie jamy ustnej i gardła, zapaleniu dziąseł.

Research from PubMed · Europe PMC

We selected 7 studies with the best, positive results. This is a selection, not a full review of all research.

Total number of studies on this topic in PubMed: 66.

A mouth rinse with licorice extract reduced bad breath and, in people with pseudo-halitosis, reduced the bacteria that cause it.

Aim of the study: This study was conducted in order to determine the effect on halitosis and the antibacterial effect against halitosis-causing bacteria of the mouthwash made of the natural material, Glycyrrhiza uralensis (G. uralensis) extract.

Results: The prevalence of halitosis decreased in the G. uralensis extract gargle group compared to the saline gargle group at Treatment and After 5 Days. In cases with pseudo halitosis, there was a significant decrease in halitosis-causing bacteria when G. uralensis extract gargle was applied (p < 0.05). It was identified that using a mouthwash made with G. uralensis extract is effective for halitosis improvement and reduction of halitosis-causing bacteria. Therefore, using a mouthwash containing G. uralensis extract, it will be effective in improving bad breath and oral hygiene will be possible.

Money for the studygovernment, public institutions · National Research Foundation of Korea, National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT)
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studystudy with random allocation to groups (RCT)
Participants60

“Not stated” does not mean nobody paid — the database does not always record it.

Rinsing the mouth with amla fruit extract lowered the levels of sulfur compounds responsible for bad breath.

Aim of the study: To assess the efficacy of Phyllanthus emblica extract in alleviating halitosis and reducing the inflammatory response to halitosis-related bacteria.

Results: PE extract dose-dependently inhibited the growth of F. nucleatum (50% inhibition concentration [IC50]=0.079%), P. gingivalis (IC50=0.65%), and S. moorei (IC50=0.07%) and effectively prevented bacterial aggregation. Furthermore, VSC contents decreased significantly at 3, 6, and 12 h after rinsing with 5% PE compared with those in the control. Long-term use of mouthwash containing 5% PE for 28 days led to a significant decrease in VSC contents. PE attenuated the F. nucleatum- or P. gingivalis-stimulated mRNA expression and protein release of interleukin (IL)-6 and IL-8 in TR146 cells. It also suppressed IL-8 and prostaglandin E2 secretion and TLR2 mRNA expression in F. nucleatum-induced OMEMs. Our findings support the use of PE in oral care products to alleviate halitosis and it may reduce inflammation.

Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studystudy with random allocation to groups (RCT)

“Not stated” does not mean nobody paid — the database does not always record it.

A mouth rinse made from smoke tree flowers reduced hydrogen sulfide levels and total volatile sulfur compound levels in the breath of adolescents.

Aim of the study: Background/Objectives: This study evaluated the effectiveness of Cotinus coggygria (Smoke Tree) Flower Water mouthwash in reducing halitosis and improving oral hygiene parameters among adolescents undergoing fixed orthodontic treatment. Methods: A double-blind, randomized, placebo-controlled, parallel-group clinical trial was conducted with 30 individuals undergoing treatment with fixed orthodontic appliances.

Results: coggygria group. The Gingival Index decreased from 2.0 to 1.3 (p < 0.001; 95% CI: -0.7 to -0.2), and the Plaque Index (PI-M) decreased from 1.6 to 1.0 (p = 0.001; 95% CI: -0.7 to -0.3). Conclusions: Cotinus coggygria mouthwash appeared to be an effective adjunct for managing halitosis and improving oral hygiene parameters in adolescents undergoing fixed orthodontic treatment. No adverse effects were reported.

Money for the studynot stated
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studystudy with random allocation to groups (RCT)
Participants30

“Not stated” does not mean nobody paid — the database does not always record it.

In dogs with periodontal disease, ashitaba gel reduced bad breath and improved gum health.

Aim of the study: Ashitaba (Angelica keiskei) is a perennial herb native to Japan, traditionally consumed as a health-promoting food and herbal medicine. This study evaluated the antimicrobial, anti-halitosis, and anti-inflammatory effects of Ashitaba extract on canine periodontal disease (PD) caused by Porphyromonas gulae (P.

Results: gulae-induced pro-inflammatory cytokine secretion (IL-1β, IL-6, TNF-α) by up to 90% in murine, canine, and human macrophage and gingival cell lines. In vivo, daily oral application of 0.05% Ashitaba-extract gel for four weeks, with or without tooth brushing, significantly improved gingivitis scores (by 40-60%), reduced halitosis levels, and decreased P. gulae DNA detection and enzymatic activity in dogs with PD. These findings demonstrate that Ashitaba extract possesses potent bactericidal, anti-halitosis, and anti-inflammatory properties, supporting its potential as a natural adjunctive therapy for the prevention and management of canine periodontal disease.

Money for the studynot stated
Do the authors have ties to companies?yes — the authors reported it
Did a manufacturer help with the study?YES
Type of studyanimal study

“Not stated” does not mean nobody paid — the database does not always record it.

The study indicates that bad breath is linked to the bacterial breakdown of proteins and the production of volatile sulfur compounds.

Aim of the study: Halitosis is caused by a bacterial proteolytic process that induces the production of volatile sulfur compounds, odor-causing gases. The aim of this study was to determine the clinical oral hygiene state and oral microbiome pattern of halitosis patients with periodontitis and gingivitis.

Results: On the dorsum of the tongue, six bacterial genera were isolated from periodontitis cases and seven genera were detected from gingivitis patients. On subgingival, 10 and 15 genera were identified from periodontitis and gingivitis, respectively. Fusobacterium, Propionibacterium, Eubacterium and Lactobacillus were the most prevalent among periodontitis cases while Porphyromonas was the most prevalent in gingivitis patients. In conclusion, although OHI-S and DMFT are different between periodontitis and gingivitis, overlapping of bacterial genera was detected between periodontitis and gingivitis cases.

Money for the studygovernment, public institutions · Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studyobservation of people
Participants10

“Not stated” does not mean nobody paid — the database does not always record it.

The review indicates that bad breath usually results from sulfur-producing bacteria, and that periodontitis can make it worse.

Aim of the study: Oral malodor, a common oral symptom, is primarily caused by the metabolic activities of oral microorganisms. The characteristic odors mainly originate from volatile sulfur compounds produced and released by oral bacteria (such as Fusobacterium nucleatum and Porphyromonas gingivalis) through specific enzymatic systems that break down sulfur-containing amino acids in saliva, gingival crevicular fluid, and food debris.

Results: Research indicates that various factors, including periodontitis, fungal infections, smoking, and obesity, can worsen oral malodor by altering the oral microenvironment. For prevention and treatment, novel interventions such as plant extracts, antimicrobial peptides, and probiotics demonstrate superior microbiological safety compared to traditional antimicrobial drugs. These approaches specifically inhibit pathogenic bacteria, disrupt biofilm structures, and regulate oral microbial balance. This review summarizes relevant research advances to provide new theoretical foundations and practical directions for the precise prevention and treatment of oral malodor.

Money for the studygovernment, public institutions · 国家临床重点专科能力建设项目(牙周病科,2023)资助
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studydiscussion of other studies

“Not stated” does not mean nobody paid — the database does not always record it.

The review suggests that herbal mouthwashes may be an alternative to synthetic mouthwashes for reducing bad breath.

Aim of the study: The aim of the review was to critically appraise the various pros and cons of the synthetic and herbal agents used in mouthwashes against halitosis and facilitate users to choose appropriate mouthwashes according to their need. Oral Malodour (OMO) or halitosis is a global epidemic with social and psychological impact.

Results: Alcohol and Chlorhexidine are common agents in synthetic mouthwashes, while Tannins and Eugenol are derived traditional herbal extracts. Each agent signifies some unique properties distinguishing them from others. Herbal ingredients are gaining the attention of the profession due to its mild side effects and competitive results. Herbal mouthwashes can be a safer choice in combating OMO, as an alternate to synthetic mouthwashes.

Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studydiscussion of other studies

“Not stated” does not mean nobody paid — the database does not always record it.

Perspectives and opinion materials

The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.

Orthomolecular Medicine News Service Opinion material
„Yale Journal of Biology and Medicine 89:325-330. PMID: 27698616 44. Rowan S, Taylor A (2018) The role of microbiota in retinal disease. Advances in Experimental Medicine and Biology 1074:429-435. PMID: 29721973 45. Cantore S, Ballini A, De Vito D et al. (2018) Clinical results of improvement in periodontal condition by administration of oral probiotics. Journal of Biological Regulators and Homeostatic Agents 32:1329-1334. PMID: 30334434 46. Inchingolo F, Dipalma G, Cirulli N et al. (2018) Microbiological results of improvement in periodontal condition by administration of oral probiotics.”Yale Journal of Biology and Medicine 89:325-330. PMID: 27698616 44. Rowan S, Taylor A (2018) The role of microbiota in retinal disease. Advances in Experimental Medicine and Biology 1074:429-435. PMID: 29721973 45. Cantore S, Ballini A, De Vito D et al. (2018) Clinical results of improvement in periodontal condition by administration of oral probiotics. Journal of Biological Regulators and Homeostatic Agents 32:1329-1334. PMID: 30334434 46. Inchingolo F, Dipalma G, Cirulli N et al. (2018) Microbiological results of improvement in periodontal condition by administration of oral probiotics.

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