• Breath odor persists and there is not an obvious cause (such as smoking or eating odor-causing foods).
• You have breath odor and signs of a respiratory infection, such as documented fever, cough, or facial pain with nasal discharge

• Quality
  • Is there a specific odor?
  • Is there a fishy smell?
  • Does the breath smell like ammonia or urine?
  • Does the breath smell like fruit or is there a sweet-chemical smell?
  • Does the breath smell like feces?
  • Does the breath smell like alcohol?
• Aggravating factors
  • Has the person recently eaten a spicy meal, garlic, cabbage, or other "odorous" food?
  • Does the person take vitamin supplements?
  • Does the person smoke?
• Relieving factors
  • Does good oral hygiene improve the odor?
  • What home care measures have been tried? How effective are they?
• Is there a recent sore throat, sinus infection, tooth abscess, or other illness?
• What other symptoms are also present?

The physical examination will include a thorough examination of the mouth and the nose. A throat culture may be taken if the patient has a sore throat or mouth sores.

In rare cases, diagnostic tests that may be performed include:

• Endoscopy (EGD)
• X-ray of the abdomen
• X-ray of the chest
• Blood tests to screen for diabetes or renal failure

Antibiotics may be prescribed for some conditions. For an object in the nose, the doctor will use an instrument to remove it.