Dieting, including intermittent fasting and low-carb diets, can offer various health benefits, but it can also lead to an unwanted side effect: bad breath, also known as halitosis. This article explores the causes of bad breath during dieting and provides practical solutions to manage and prevent it.
Understanding Halitosis
Halitosis is a term used to describe an unpleasant odor emanating from the mouth. It can be a source of social embarrassment and anxiety for many individuals. While often stemming from poor oral hygiene, certain dietary changes and restrictions can also contribute to its development. Halitosis is a serious concern for the patient as it could lead to social embarrassment and leave the individual reclusive or occasionally even stigmatized.
Causes of Bad Breath During Dieting
Several factors associated with dieting can contribute to bad breath:
Ketosis
Low-carb diets, such as the Keto and Atkins diets, can lead to ketosis. When carbohydrate intake is restricted, the body begins to burn fat for energy, producing ketones as a byproduct. These ketones, including acetone, acetoacetate, and beta-hydroxybutyrate, are released through the breath, causing a distinct, often fruity or acetone-like odor. The good news is that if your breath stinks, you're probably doing a good job of sticking to that low-carb diet.
Increased Protein Intake
The sudden transition from carbohydrates to proteins changes how the body metabolizes food. The breakdown of protein creates ammonia. A sudden increase in dietary protein will only exacerbate this effect, increasing the amount of ammonia in your urine as well as your stomach gasses.
Read also: Following the Breath Test Diet
Reduced Saliva Production
Dieting, especially fasting or severely calorie-restricted diets, can reduce saliva flow. Saliva is crucial for washing away food particles and neutralizing acids in the mouth. A dry mouth allows odor-causing bacteria to thrive, leading to unpleasant breath.
Dehydration
Many diets involve reduced fluid intake, which can lead to dehydration. Dehydration further reduces saliva production, exacerbating dry mouth and bad breath.
Infrequent Eating
Skipping meals or prolonged fasting can also contribute to bad breath. Eating regular meals encourages good saliva production, so skipping can decrease that, often leading to dry mouth. Without regular food intake, the mouth produces less saliva, allowing bacteria to flourish.
Specific Foods
Certain foods commonly consumed during diets can worsen breath odor. These include:
- High-protein foods: These foods, if not properly digested, can release sulfurous gases.
- Sulfur-rich foods: Foods like garlic and onions contain sulfur compounds that are absorbed into the bloodstream and expelled through the lungs, causing persistent bad breath.
Nutritional Deficiencies
Deficiencies in certain key nutrients don’t necessarily cause bad breath by themselves, rather they can cause other oral health issues which then cause halitosis. By way of a few examples from this paper, deficiencies in B6 are connected to periodontal disease (advanced-stage gum disease), and periodontal disease can lead to bad breath (in the form of bacteria build-up and tooth decay). A lack of iron or enough daily calories can cause salivary gland dysfunction, meaning you produce less saliva. Saliva is the body’s natural cleaning system for the mouth, and a loss of it can lead to an increased risk of disease, infection and smells.
Read also: Understanding Keto Breath
Solutions for Managing Bad Breath During Dieting
Fortunately, bad breath from dieting is often manageable with the right strategies:
Stay Hydrated
Drinking plenty of water is crucial when dieting. Water helps keep the mouth moist, promotes saliva production, and washes away food particles and bacteria. Aim to drink water consistently throughout the day, especially after meals.
Maintain Oral Hygiene
Regular brushing and flossing are essential for removing food particles and bacteria that cause bad breath. Use a fluoride toothpaste and brush your tongue to eliminate odor-causing buildup.
Use Mouthwash
An alcohol-free mouth rinse can help eliminate bacteria and freshen breath. Choose alcohol-free options, as alcohol can dry out your mouth.
Chew Sugar-Free Gum
Chewing sugar-free gum stimulates saliva flow, helping to prevent halitosis. Choose gum with xylitol, as it can also inhibit bacterial growth.
Read also: Understanding Keto Breath Analyzer Accuracy
Use a Tongue Scraper
A tongue scraper removes bacteria and food particles that contribute to bad breath. Using it daily, especially in the morning, can significantly reduce odor.
Adjust Your Diet
Making smart food choices can help neutralize odors:
- Include fresh fruits and vegetables: These can help neutralize odors and stimulate saliva production. Crunchy, fibrous fruits and vegetables like apples, carrots, and celery help to dislodge stuck food particles and stimulate saliva production - essentially, helping to clean the mouth naturally.
- Opt for slow-absorbing carbohydrates: Choose carbohydrates like those available in strawberries, cherries, red fruits, vegetables, and brown rice.
- Incorporate fiber-rich foods: Foods richer in fiber provide more vigorous chewing and promote salivary production. Choose leafy vegetables (spinach, lettuce), carrots, asparagus, tomatoes, eggplant, and fruits in general (especially with peel).
Avoid Dehydrating Beverages
Caffeinated and alcoholic beverages contribute to dehydration, leading to dry mouth and bad breath. If you consume them, drink water afterward to stay hydrated.
Eat Regularly
Make five meals a day (in small quantities and spread throughout the day). A handful of nuts is enough to avoid abrupt hypoglycemia and stimulate the renewal of saliva.
Consider Breath-Improving Foods
Some foods are known to help improve the freshness of your breath, and consuming these could help you manage the effects of halitosis as a result of any diet you’re on. For example, crunchy, fibrous fruit and veg (think apples, carrots and celery) help to dislodge stuck food particles and stimulate saliva production - essentially, helping to clean the mouth naturally. Yoghurt may also help. Researchers from Tsurumi University found that eating sugar-free, traditional yoghurt can help reduce levels of smelly compounds in the mouth. Ginger may also help by doing the same thing.
Consult a Dentist
If bad breath persists despite good oral hygiene habits and dietary adjustments, a dental checkup may be necessary. A dentist can identify underlying issues, such as gum disease or tooth decay, and recommend appropriate solutions.
Specific Diet Considerations
Keto and Low-Carb Diets
The keto diet is designed to get the body burning fat instead of glucose, prioritising fatty foods over carby foods. This process is called ketosis, and ketosis is linked with a fruity smell that people call “Keto breath”. The chemicals created during ketosis (called ketones), can get into your saliva, and that tends to cause the smell. It’s very hard to avoid keto breath, but you can try to mask it if it’s bothering you or your loved ones:
- Carry sugarless mints with you. These will help fresh your breath, without adding more sugar to your intake.
- Drink plenty of water, as this can help ‘dilute’ the smell in your mouth.
- Consider a small intake of complex carbs (not processed carbs). A moderated intake of complex carbohydrates may help you minimise the symptoms of Keto breath while still maintaining your diet.
Paleo Diet
Being quite high in protein, the paleo diet can also contribute to the production of sulphuric compounds in the mouth - those occur when bacteria breaks down protein. Cue the risk of smelly breath. Maintaining good oral health practices and drinking plenty of water will generally help with the risk of smelly breath due to broken-down protein. If ketosis is your objective with paleo, you may also wish to consider carrying sugar-free mints around too.
Fasting
Fasting can cause bad breath in some cases where it reduces saliva production and activates ketosis. With reduced saliva production, you’re at a higher risk of dry mouth. This, in turn, increases your risk of oral health issues, as well as smelly foods and compounds lingering in the mouth for a longer period of time. Even if you’re fasting, it’s still important to maintain good oral health practices. That means brushing and flossing regularly, keeping bacteria down in your mouth. To fight dry mouth, drink water more regularly and avoid things which can dry the mouth out - caffeine and alcohol, for instance, or alcohol-containing mouthwash. If you can’t drink water during your fast, then it’s all the more important to brush your teeth properly and rinse your mouth outside of fasting hours. You might also consider a trip to a dental hygienist prior to the fasting period to ensure your mouth is in good condition.
Juicing and Liquid Diets
Liquid diets may cause bad breath in two ways: activating ketosis due to low carb consumption, and discouraging saliva production. Saliva production typically comes from chewing, so while you might be fairly well hydrated on a liquid diet, the lack of chewing may limit the amount of saliva you produce. To fight bacteria build-up, you’ll need to maintain good oral health habits. That means brushing and flossing regularly, and it’s also a good idea to rinse your mouth with water after you consume anything acidic or sugary (such as fruit). As for “Keto breath”, if it’s a problem for you then consider carrying some sugar-free mints around to mask the smell.
Vegan Diet
Plus, certain vegetables have been known to cause temporary bad breath as they break down in the mouth (such as cabbage or broccoli). The first stop to managing halitosis on a vegan diet is to review what you eat to ensure you’re getting all the nutrients the human body needs on a regular basis. Some common nutrients just aren’t found all that strongly in plant-based foods, meaning alternatives must be sought.
Other Potential Causes of Halitosis
While diet is a significant factor, it's important to consider other potential causes of bad breath:
- Poor oral hygiene: Inadequate brushing and flossing can lead to plaque buildup and gum disease, both of which contribute to bad breath.
- Dry mouth (xerostomia): This condition can be caused by certain medications, medical conditions, or dehydration.
- Infections: Infections in the mouth, nose, sinuses, or throat can cause bad breath.
- Medical conditions: Certain diseases, such as diabetes, kidney disease, and liver disease, can cause distinctive breath odors.
- Tobacco use: Smoking and chewing tobacco cause unpleasant mouth odor and contribute to gum disease.
Professional Evaluation and Treatment
If self-care measures are ineffective, seeking professional help is advisable. Dentists and physicians can identify underlying causes and recommend appropriate treatments. Here are some evaluation and treatment methods:
Assessment Methods
Assessment methods discriminate between pseudo-halitosis and halitophobia. This is by far the commonest method used and the most effective in the clinical scenario. With gas chromatography (GC), a quantitative analysis of VSCs like dimethyl sulfide, methyl mercaptan, and hydrogen sulfide can be carried out even at minuscule concentrations from saliva, tongue debris, or any other oral fluid. It is a highly reliable test; the only drawbacks are expense, it is nontransportable, and requires specialized trained personnel for its usage. This test is only for academic and research purposes. The portable sulfide monitor is a portable device. In this test, a single-use tube is inserted into the patient’s mouth, which is closed for 5 minutes, while the patient breathes through his nose. The device detects sulfur-containing molecules in the breath, and this is reflected in the readings. This user-friendly and quick test detects certain gram-negative proteolytic obligate anaerobes like Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, which form a red complex when treated with BANA, a synthetic trypsin substrate. This technique is user-friendly. This test is more sensitive than the organoleptic test but is more time-consuming. The enzyme beta-galactosidase is directly associated with oral malodor and forms the basis for this test.
Professional Treatments
For effective control of halitosis, antibacterial agents such as chlorhexidine, zinc, triclosan, and cetylpyridinium chloride are recommended for usage. These have different mechanisms of action. Tea tree oil has been used effectively to control malodor caused by the bacterium Solobacterium moorei strain, according to one study. The reduction of VSCs has been noted in certain cases by the usage of photodynamic waves from a photosensitizer. In the absence of intraoral pathology, extraoral causes of halitosis are to be investigated in consultation with the concerned faculty and treated accordingly e.g. antibiotics for respiratory infections, antacids for gastroesophageal reflux disease (GERD), or surgical intervention if adenoids are enlarged and infected.