[30F] With chronic halitosis and altered taste post-COVID-19

Patient Description

A 30-year-old female has been experiencing severe and persistent halitosis for approximately 20 years. Despite maintaining excellent oral hygiene and regular dental check-ups, the issue persists. The halitosis is exacerbated by the consumption of dairy, meats, high sulfur foods, caffeine, and sugary items, and it tends to be worse after waking up. Alongside the bad breath, the patient reports a constant bad taste in her mouth. Since contracting COVID-19 about two years ago, she feels her sense of taste has been affected and has not fully recovered. She has not found any remedies that alleviate her symptoms and has not been evaluated for any metabolic or systemic conditions that might contribute to her halitosis. The patient has no known pre-existing conditions or chronic illnesses, except for seasonal allergies, and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your persistent halitosis:

  • Metabolic or Systemic Conditions: Conditions such as diabetes, liver disease, or kidney disease can sometimes cause persistent bad breath. These conditions can lead to the production of certain chemicals in the body that may be exhaled in the breath.

    • Testing for these conditions typically involves blood tests and other diagnostic evaluations by a healthcare provider.
  • Post-COVID-19 Effects: Since you mentioned a change in your sense of taste following a COVID-19 infection, it's possible that the virus has had a lingering effect on your oral or nasal health, which could contribute to halitosis.

    • There is ongoing research into the long-term effects of COVID-19, and management often involves supportive care and symptom management.
  • Sinus or Nasal Issues: Chronic sinus infections or nasal issues can sometimes lead to bad breath due to the presence of bacteria or mucus.

    • Treatment may involve addressing any underlying sinus or nasal conditions, possibly with medications or other interventions.
  • Dietary Factors: Certain foods, as you mentioned, can exacerbate bad breath. Foods high in sulfur, such as garlic and onions, can contribute to this issue.

    • Identifying and avoiding trigger foods can be helpful in managing symptoms.

What you can do

While it's important to consult with a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Hydration: Ensure you are drinking plenty of water throughout the day to help keep your mouth moist and reduce bad breath.
  2. Dietary Adjustments: Continue to monitor your diet and try to identify any additional foods that may be contributing to your symptoms. Consider keeping a food diary using MDandMe to track your symptoms and share this information with your healthcare provider.
  3. Oral Hygiene: Maintain your excellent oral hygiene practices, including regular brushing, flossing, and dental check-ups.
  4. Nasal Care: Consider using a saline nasal rinse to help clear any potential nasal or sinus issues that could be contributing to your symptoms.
  5. Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and gain insights that you can share with your healthcare provider.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • New or worsening symptoms, such as changes in your sense of taste or smell, or any other unusual symptoms.
  • Signs of a systemic condition, such as unexplained weight loss, fatigue, or changes in urination.
  • If your symptoms significantly impact your quality of life or if you have concerns about your health.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a comprehensive evaluation and personalized treatment plan.

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1 mo ago


People Also Ask


Can metabolic or systemic conditions cause persistent bad breath?

Yes, metabolic or systemic conditions such as diabetes, liver disease, or kidney disease can cause persistent bad breath. These conditions may lead to the production of certain chemicals that are exhaled in the breath, contributing to halitosis.


How might COVID-19 affect my sense of taste and contribute to halitosis?

COVID-19 can have lingering effects on oral or nasal health, potentially affecting the sense of taste and contributing to halitosis. The virus may alter the normal function of taste and smell, and ongoing research is exploring these long-term effects.


What role do sinus or nasal issues play in causing bad breath?

Chronic sinus infections or nasal issues can lead to bad breath due to the presence of bacteria or mucus. Addressing underlying sinus or nasal conditions with appropriate treatments can help alleviate this type of halitosis.


How can dietary factors influence halitosis?

Dietary factors can significantly influence halitosis. Foods high in sulfur, such as garlic and onions, can exacerbate bad breath. Identifying and avoiding trigger foods can help manage symptoms effectively.


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