A relationship between weight loss and halitosis

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  Posted by: Dental Design      6th June 2024

Weight loss can be a taboo topic for many individuals, with people taking drastic action to address health issues, change their appearance, or achieve other targets. It can also be an entirely unintentional product of changing lifestyle habits or illness, with causes ranging from depression to diarrhoea, viral infections such as a common cold, or extreme illness like cancer.[i]

Losing weight, especially in a short span of time, can affect a person’s oral health and hygiene in a number of ways. Dental professionals are in a unique position to help manage unfortunate side effects of weight loss, which include the development of halitosis.

Choosing the right foods

A change in diet can be an effective method of losing weight. Patients may choose to cut calories from their daily intake either by taking in smaller meals or adjusting the types of food they eat. When taken to the extreme, it is sometimes called a crash diet.[ii]

The food that individuals replace their everyday meals with makes an enormous impact on both their general and oral health. For example, the ketogenic diet, sometimes just called the keto diet, sees people adopt a high-fat, moderate-protein, low-carb intake to achieve ketosis.[iii] In short, this is the body’s natural adaption to a lack of carbohydrates as an energy source. It overproduces acetyl coenzyme A to serve as the replacement, but the process also sees increased levels of ketone bodies – acetoacetate, ß-hydroxybutryric acid and acetone – which will eventually be used for energy too.[iv]

The acetone is our main focus. Its presence can alter an individual’s breath in an unfortunate manner, previously described as the odour of decaying apples,[v] which can be both noticeable and repugnant. Patients may attribute the malodour to an issue with the dentition, or perhaps even an infection, but it is the duty of the dental practitioner to recognise that the source may actually lie in their diet or general weight loss.

Weight loss in-demand

When the matter of weight loss takes up headlines now, it is often linked with the use of semaglutide, better known by the brand name Ozempic. The type 2 diabetes medication is a weekly injection that, aside from its benefits for diabetic patients, causes a reduction of appetite and slows down the movement of food in the gut.[vi] In turn, users eat less and feel full for longer, making it an effective weight loss aid – though current guidelines emphasise that it must not be prescribed solely for weight loss purposes.[vii]

Semaglutide and its effect on oral health is still being explored, and may see further studies established given the interest around its weight loss abilities. At this moment, there are some things we can assess. A small-scale 2023 report saw three female patients taking the drug for weight loss purposes, each stated that they had dry mouth, or xerostomia, which has links to caries, oral fungal infections, and halitosis.[viii]

Whilst patients may experience this as a result of limited water intake because of their suppressed appetite, there are other potential causes related to semaglutide. The drug has known body water loss properties, and one of its common side effects, chronic diarrhoea, could lead to total body dehydration.viii This could bring on xerostomia, and the resultant bad breath that sometimes accompanies it.

The effect of semaglutide on the gut has also been considered a potential causation of halitosis. Theories suggest that the drug could contribute to gut dysbiosis. One animal study found that a GLP-1 receptor agonist (liraglutide) that shares qualities with semaglutide decreased microbial diversity and led to gut imbalance. Because this drug, like semaglutide, slows digestion, it could lead to a proliferation of gut bacteria known to produce volatile sulphur compounds,[ix] which are heavily linked to halitosis.[x]

Effective support

Dental professionals might be able to identify the cause of halitosis as a change in diet or the use of weight loss aids, but patients may be unwilling or unable to alter from their current health practices. In the case of semaglutide use, this may be because the patient is also type 2 diabetic, for example.

In such a case, clinicians must be able to provide an effective solution that combats halitosis directly. Consider the Fresh Breath Oral Rinse from The Breath Co., a powerful and alcohol-free mouthwash that fights bad breath for up to 12 hours. Available in mild mint and icy mint flavours, they each use sodium chlorite to activate the power of oxygen to tackle bacteria, and negate halitosis. The unique formula is pH-balanced, unlike other acid-based mouthwashes.

Understanding the potential links between weight loss, the medications used to help it, and the effects on oral health is essential for every clinician. Providing support when a patient encounters a side effect like halitosis can ensure they maintain confidence in everyday life, no matter the associated cause.



For more information about The Breath Co.,

please visit http://www.thebreathco.com/

Andrea Bio:

 Andrea Hammond is a Dental Hygienist and Waterpik Professional Educator. Andrea has worked in dentistry since 1996, first qualifying as a dental nurse in 1998 – the same year in which she secured a place on the very first dental therapy cohort at the Eastman Dental Hospital. Following this, she was awarded diplomas in both dental hygiene and dental therapy in the year 2000, and became an active member of the GDC fitness to practice panel since 2015. Today, she continues to share knowledge as a Professional Educator for Waterpik and be deeply involved in the industry as a Regional Group Representative for the British Society of Dental Hygiene and Therapy (BSDHT).

[i] Kahn, A., Pletcher, P., (2023). Unintentional Weight Loss. Healthline. (Online) Available at: https://www.healthline.com/health/weight-loss-unintentional [Accessed February 2024]

[ii] Oxford English Dictionary, (2023). Crash diet. Oxford English Dictionary. (Online) Available at: https://www.oed.com/dictionary/crash-diet_n?tl=true [Accessed February 2024]

[iii] Higuera, V., Olsen, N., (2018). Everything You Need to Know About Keto Breath. Healthline (Online) Available at: https://www.healthline.com/health/keto-breath [Accessed February 2024]

[iv] Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition67(8), 789-796.

[v] Ruzsányi, V., & Kalapos, M. P. (2017). Breath acetone as a potential marker in clinical practice. Journal of breath research11(2), 024002.

[vi] Diabetes UK., (2024). Ozempic and weight loss: the facts behind the headlines. (Online) Available at: https://www.diabetes.org.uk/about-us/news-and-views/ozempic-and-weight-loss-facts-behind-headlines [Accessed February 2024]

[vii] DHSC Media Team, (2023). Accessing Wegovy for weight loss: Everything you need to know. GOV.UK. (Online) Available at: https://healthmedia.blog.gov.uk/2023/09/04/accessing-wegovy-for-weight-loss-everything-you-need-to-know/ [Accessed February 2024]

[viii] Mawardi, H. H., Almazrooa, S. A., Dakhil, S. A., Aboalola, A. A., Al-Ghalib, T. A., Eshky, R. T., … & Mawardi, M. H. (2023). Semaglutide-associated hyposalivation: A report of case series. Medicine102(52), e36730.


[ix] Froum, S., (2023). How Ozempic has the potential to cause halitosis. Perio-Implant Advisory. (Online). Available at: https://www.perioimplantadvisory.com/clinical-tips/article/14298799/how-ozempic-has-the-potential-to-cause-halitosis [Accessed March 2024]

[x] Aylıkcı, B. U., & Çolak, H. (2013). Halitosis: From diagnosis to management. Journal of natural science, biology, and medicine4(1), 14.

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