What causes a bad smell in the nose?

Source: Medical News Today

By Jennifer Huizen Reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI

Occasionally encountering an unpleasant smell is normal. However, several conditions — including those involving the sinuses, nasal passages, and mouth — can cause a bad smell that seems to come from the inside of the nose.

Conditions that may cause a bad smell in the nose include:

acute and chronic sinusitis

mouth or tooth infections

dry mouth

some foods, drinks, and medications

conditions associated with hallucinations or olfactory damage

Most conditions that cause a bad smell in the nose are not life threatening. However, if the bad smell is severe or chronic, it can negatively impact someone's quality of life and may require medical attention.

This article discusses the causes of a bad smell in the nose, as well as treatments and prevention methods. Several conditions are commonly associated with a bad smell inside the nose, and we cover many of them below.

Acute or chronic sinusitis

📷A person may experience a bad smell in their nose if they have acute or chronic sinusitis.

Sinus infection, called sinusitis, affects around 31 million people in the United States.

Sinusitis causes symptoms such as sinus inflammation and nasal congestion, which can interfere with a person's sense of smell.

The condition can also cause bad breath and a discolored, bad-smelling discharge in the nose and back of the throat, all of which may create a bad smell in the nose.

Acute sinusitis typically lasts for around 3–8 weeks, while chronic cases can last for longer than 8 weeks. A species of bacteria usually causes sinusitis, though viruses, fungi, and molds can also cause it.

Dental issues and poor oral hygiene

Cavities, or holes in the teeth, can trap bacteria that release unpleasant gases such as sulfur when they break down. Cavities usually arise due to tooth decay or gingivitis, which can include inflamed gums or gum disease.

These unpleasant gases, which become foul-smelling odors, can travel through small holes in the back of the mouth that connect to the sinuses and cause a bad smell in the nose.

Poor oral hygiene increases the number of food particles left in the mouth that can decay, increasing the risk of developing a bad taste or smell in the mouth.

Dental issues can also increase the risk of developing plaque, which is a thick film of bacteria that can cause tooth decay and inflame the tissues between the teeth and gums (a condition called periodontitis).

Certain foods, drinks, and medications

Foods and drinks are full of microscopic molecules that stimulate the sense of smell.

Most of our ability to enjoy the taste and smell of food and drink relies on molecules traveling to the sinuses through a passageway near where the roof of the mouth connects to the nose.

All foods release smells as our bodies break them down and digest them. However, certain foods and drinks, as well as some drugs, may linger in the mouth or trigger an unpleasant smell in the nose, especially: garlic and onions, coffee, spicy foods, nitrates and nitrites, amphetaminesphenothiazines. One possible cause of a bad smell in the nose is sinusitis.

Dry mouth

Dry mouth, or xerostomia, can develop when the flow of saliva is not adequate. Most people with dry mouth feel continuously parched and have swollen nasal passages.

Saliva constantly removes unwanted microbes and particles from the mouth. It also neutralizes acids.

So, when there is not enough saliva, a person is more likely to experience conditions that can cause a bad smell or taste in the mouth and nose, such as bad breath and tooth decay.

Dry mouth is also a common side effect of several medications. Causes of dry mouth include: breathing through the mouth, dehydration, pain medications, decongestants, antihistamines, diuretics, salivary gland conditions, such as Sjogren's syndrome

Smoking and tobacco use

Tobacco products contain chemicals that stain and weaken the teeth and gums, thus increasing the risk of tooth and gum disease. Tobacco can also give the breath an unpleasant odor.

Smoking can also reduce someone's ability to taste and smell food properly, which may cause someone to smell odors that they perceive as foul, but which may not actually be bad.

Phantosmia

People with phantosmia smell things that are not there. It occurs when a condition interferes with a person's sense of smell.

Everyone with phantosmia smells a slightly different scent, but most people experience something that smells:

burntmetallicsimilar to chemicalsrottendecayedsimilar to feces

Phantosmia only affects around 10–20% of people with smell disorders. However, a wide range of conditions may cause phantosmia, including:

colds and flu, sinus infections, migraine headaches, nasal polypsepilepsy, head injury or stroke, some conditions that cause hallucinations, such as schizophrenia, Alzheimer's disease, and Parkinson's disease

Digestive conditions and other medical conditions

Some digestive conditions, such as acid reflux, can cause bad breath and a bad taste in the mouth.

Also, although fairly benign conditions are usually behind a bad or unusual smell in the nose, it is rarely linked to more systemic or serious health conditions, which may include:

diabetes, which may cause a sweet smell, liver disease, which may cause a strong musty smell, kidney disease, which may cause an ammonia-like smell

Treatments

The best way to treat a bad smell in the nose depends on the underlying condition.

That said, there are some home remedies that can help reduce a bad smell in the nose:

Try a homemade saltwater rinse

Using a saltwater rinse can help temporarily reduce the intensity of a bad smell in the nose.

To make a saltwater rinse at home:

Boil 460 milliliters of water, then leave to cool.Mix 1 teaspoon (tsp) of salt and 1 tsp of baking soda into the water while it is still quite warm.Wash the hands well with soap and water.Standing over a sink or bowl, pour some of the mixture into the cupped palm of one hand.Lean over the sink and sniff some of the mixture into one nostril at a time, then let it run out of the nose. It may help to keep the other nostril closed with a finger while sniffing.Repeat steps 4 and 5 a few times.Dispose of any unused solution.

People can also use a soft rubber ear bulb syringe or a commercial nasal saline rinse product from a drug store.

Stay hydrated

Many conditions that result in a bad smell in the nose have dehydration as their root cause. How much liquid someone needs each day depends on their age, activity levels, and diet, among other factors.

People whose bodies do not make enough saliva can use artificial saliva or try sugar-free candies or gums to encourage saliva production.

Foods that require a lot of chewing, such as fiber-rich fruits and vegetables, can also promote saliva production.

Practice good dental hygiene

Having good oral hygiene can help treat several conditions that cause a bad smell in the mouth and nose. Some recommendations from the American Dental Association include:

Brush the teeth with a fluoride-based toothpaste for 2 minutes twice daily.Floss daily.Clean the tongue daily with a toothbrush or a tongue scraper.Clean dentures and other dental gear daily.Chew sugarless gum for 5 minutes after meals.Cut back on foods and drinks that contribute to dehydration, such as coffee and alcohol.Quit smoking and tobacco use.Have dental checkups and cleanings frequently.

Use over-the-counter medications

Some over-the-counter (OTC) medications may also help treat conditions that can cause a bad smell in the nose. OTC medications include:

Nasal decongestant spray: This can help shrink inflamed nasal passageways and increase sinus drainage. Most nasal decongestant sprays are useful for 3–4 days.Antihistamines: These block inflammation, which can help open swollen nasal and sinuses pathways.

Some conditions that cause a bad smell in the nose require medical attention. Sinus or nasal infections that last longer than 7–10 days, for example, generally require antibiotic treatment for 3–28 days.

A doctor or allergist may also prescribe certain medications or therapies to help a person manage conditions that cause a bad smell in the nose, including:

Topical nasal corticosteroids sprays: These help reduce nasal and sinus inflammation. Surgery: This can reverse structural problems such as nasal bone defects, nasal polyps, or closed airways.

Prevention

Depending on the condition that causes it, making certain lifestyle changes can help reduce the risk of developing a bad smell in the nose. Lifestyle changes include:

practicing good dental hygienestaying hydratedeating fiber-rich foods, avoiding foods and drinks that cause dehydration, such as caffeine and alcohol, using antihistamines or decongestants to treat nasal or sinus inflammation, avoiding foods and drinks that cause bad smells in the mouth, such as garlic and onions, not smoking or using tobacco products, talking to a doctor about reducing or switching medications that may be linked to dry mouth, having regular dental checkups and treating dental or mouth infections

Summary

Sinusitis, mouth infections, and certain foods, drinks, and lifestyle habits are usually behind bad smells in the nose.

People can usually get rid of bad smells in the nose by using home remedies, trying OTC medications, and making lifestyle changes.

However, a bad smell in the nose can decrease someone's quality of life and cause complications such as malnutrition. It can also be a sign of underlying conditions that require medical treatment.

Talk to an ENT about severe or chronic bad smells in the nose, those that do not respond to home remedies, or those that last longer than a week.

Does Your Tounge Have a Sense of Smell?

Source: By Maria Cohut, Ph.D. https://www.medicalnewstoday.com/articles/325037.php

Many animals taste and smell their environment through the same part of their body, but can the same be true about humans? New research suggests that this might indeed be the case and that we may have smell receptors on our tongues. A new study suggests that the human tongue may be able to do much more than taste.

Unlike humans and other mammals, not all animals have noses with smell receptors, but this does not mean that they have no sense of smell.

For instance, crabs capture smells through the sensory bristles on their antennae, while snakes, although they do have nostrils, actually smell better through their mouths, "fishing" for scents with their forked tongues.

However, smell and taste usually work together in allowing animals to navigate the world. This collaboration is obvious in snails, for instance, whose lower tentacles allow them to smell and taste their environment.

Taste and smell also work as complementary senses in humans. Olfactory (smell) inputs from the nostrils and gustatory (taste) inputs from the tongue interact in the brain to create a complete picture of what, for example, a person is preparing to eat or drink.

Nevertheless, so far, researchers have tended to believe that the senses of taste and smell operate individually in humans and other mammals.

However, a study that Current Biology published earlier this year found that when scientists removed the taste cortex from the brains of rats, this affected not only the animals' ability to perceive taste but also their sense of smell.

Similar research has now led Dr. Mehmet Hakan Ozdener and colleagues from the Monell Center in Philadelphia, PA, to investigate whether mammals — including humans — can also smell with their tongues.

Taste cells could both taste and smell

In the new study, the results of which appear in the journal Chemical Senses, Dr. Ozdener and the team used both genetic and biochemical techniques to determine whether the taste buds of mice, called mouse taste papilla cells, might be able to respond to odor molecules. They then tested laboratory cultures of human fungiform taste papilla cells.

First, the researchers found that mouse taste papilla cells actually contained olfactory receptors and that the same was true of the cultured human taste cells.

Following this, the team used a scientific technique called calcium imaging to assess how the cultured taste cells responded to odor molecules, which revealed that the taste cells interacted with them in a very similar way to regular smell receptor cells.

How the smell of disease can affect healthy people Can we smell disease, and, if so, what does this mean for our interactions with other humans?

Further experiments then also showed, for the first time, that one taste cell can contain receptors for both smell and taste. This discovery could help shed new light on just how closely taste and smell work together to alert us to the desirability of a particular food, for instance.

"The presence of olfactory receptors and taste receptors in the same cell will provide us with exciting opportunities to study interactions between odor and taste stimuli on the tongue." Dr. Mehmet Hakan Ozdener

"Our research may help explain how odor molecules modulate taste perception," Dr. Ozdener also notes, adding that it "may lead to the development of odor-based taste modifiers that can help combat the excess salt, sugar, and fat intake associated with diet-related diseases, such as obesity and diabetes."

In the future, the research team hopes to find out whether only certain taste cells contain smell receptors and to what extent the odor molecules that taste cells capture can change how an individual perceives specific tastes.

Source: By Maria Cohut, Ph.D. https://www.medicalnewstoday.com/articles/325037.php

Balloon Dilation Flops in Sleep Apnea without Sinus Disease-

Randomized study supports recent AAO-HNSF consensus statement

by Wayne Kuznar, Contributing Writer

Primary Source

American Academy of Otolaryngology-Head and Neck Surgery Foundation

Source Reference: Ortiz AS, et al “Effects of balloon catheter dilation of sinus ostia on obstructive sleep apnea and snoring” AAO-HNSF 2018.

Balloon catheter dilation yielded no improvement for obstructive sleep apnea patients with sinus pressure headache, a small prospective single-blind study found.

The group randomized to dilation of the sinus ostia had a mean decrease of 2.11 in apnea-hypopnea index from pre- to post-treatment, which was not significantly different than the decrease of 2.04 in the control arm of placebo nasal dilation (P=0.89), Alexandra S. Ortiz, MD, of the San Antonio Uniformed Services Health Education Consortium, reported.

Similarly, the mean change in lowest oxygen saturation was similar between the two groups: a 1% increase in the active-treatment group compared with a 0.5% decline in the nasal dilation group (P=0.89), according to the findings presented here at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) meeting.

The results are consistent with a recent AAO-HNSF consensus statement that balloon catheter dilation of sinus ostia is not an effective treatment for sleep apnea in patients without sinus disease.

The typical first-line management of obstructive sleep apnea in adults is continuous positive airway pressure (CPAP), but up to 50% of patients cannot tolerate or are not adherent to CPAP therapy, Ortiz said.

Balloon catheter dilation received FDA approval in 2005 for the treatment of chronic rhinosinusitis. Since then, it has been marketed for other indications such as snoring, obstructive sleep apnea, and headaches, despite lacking evidence of efficacy for these indications, said Ortiz.

"You can find on multiple practice's websites that it's being done for those indications ... and the Department of Defense's database showed that a significant number of clinicians were using balloon dilation for indications other than chronic rhinosinusitis," she told MedPage Today.

The AAO-HNSF consensus statement, issued in February 2018, indicates that balloon catheter dilation is not appropriate for patients without both sinonasal symptoms and positive findings on computed tomography (CT), nor for the management of headache or sleep apnea in patients who do not otherwise meet the criteria for chronic sinusitis or recurrent acute sinusitis.

Further, CT scanning of the sinuses is required before balloon dilation can be performed; patients with sinonasal symptoms and a CT that does not show evidence of sinonasal disease should not undergo balloon catheter dilation, according to the AAO-HNSF recommendation.

For the current study, Ortiz's group randomized 18 patients who were part of a larger study evaluating maxillary balloon catheter dilation on patients with symptoms of sinus pressure headache, but no evidence of sinus mucosal thickening on CT. All 18 patients had home polysomnography performed before and after balloon catheter dilation.

Subjective measures of sleep quality were also performed. On the Berlin questionnaire, there was no significant difference in the change from baseline in the total, category 1, or category 2 scores in either group. Snoring visual analog scale (VAS) scores were not different compared with baseline at 2 weeks (P=0.38), 3 months (P=0.19), and 6 months (P=0.47) after the procedure.

"These results show that sinus balloon catheter dilation does not improve important metrics of obstructive sleep apnea severity when compared to placebo," said Ortiz. "Berlin questionnaire and VAS results show that sleep quality and snoring are also unaffected by maxillary balloon catheter dilation."

Ortiz reported no disclosures.

LAST UPDATED 10.09.18

Primary Source

American Academy of Otolaryngology-Head and Neck Surgery Foundation

Source Reference: Ortiz AS, et al “Effects of balloon catheter dilation of sinus ostia on obstructive sleep apnea and snoring” AAO-HNSF 2018.