girl with bad breath

I know what you’re thinking. “Breath smells like urine?!” It’s actually not that uncommon for your breath to give off an ammonia-like scent, depending on some pretty unique underlying factors. In fact, if you or your child’s breath smells like urine, it could be a serious red-flag for underlying diseases or undiagnosed medical conditions. Being able to differentiate whether it’s just something you ate or a requires a trip to the doctor can help you manage an embarrassing situation and take better care of your overall health!

What Could It Be? Common Causes

1) Diet 

Your diet is the first place you want to start if you have problems with your breath smelling like pee. Since certain foods can alter your body’s natural ammonia levels, changing the way you eat can help regulate the causes of different odors (including other types of B.O.) In this case, one of the biggest offenders is going on a ketogenic / “keto” diet that’s high in protein. If your ketone levels get thrown off or you’ve been on the keto diet for a while, your breath may eventually start to give off a urine-like ammonia scent.

Symptoms

People who are experiencing ketosis or high ketone levels (usually from a high protein diet) may start to notice their breath smelling like ammonia.

Treatment

Coming off of a ketogenic diet can help to eliminate bad breath or ammonia smells. However, if it doesn’t, you need to talk to your doctor about possible liver/kidney problems.

2) Nasal Congestion Or Sinusitis 

Any time there are issues like allergies or sinus infections, it creates a “postnasal drip” where drainage goes down the back of your throat. When it does, it can give you bad breath or halitosis even if you’re brushing and flossing routinely.

Symptoms

Runny nose, nasal congestion, sneezing, watery eyes, stuffy nose, coughing, sore throat, and bad breath.

Treatment

Over the counter decongestants, antihistamines, corticosteroid sprays, or allergy meds. If severe, prescription medication or antibiotics from your doctor. You can also gargle/rinse with an alcohol-free mouthwash to help remove phlegm or mucous from the back of your mouth.

3) Helicobacter Pylori Infection 

“H. pylori” is a totally normal bacteria that’s found inside of about half of people’s bodies.[1] It lives inside of the stomach and typically doesn’t cause problems. The key word is “typically.” Unfortunately, these bacteria are also linked with stomach infections and cancer.

Symptoms

If you have an H. pylori infection, you might experience stomach bloating, nausea/vomiting, general stomach aches, or a lack of appetite. Some people even see dark stools or have an ammonia-scent to their breath, which can make your breath smell like urine.

Treatment

Most doctors will treat H. pylori infections with prescription medications like “proton pump inhibitors” and/or a round of antibiotics. If there are stomach ulcers or signs of cancer, those will require separate treatment protocols.

4) Chronic Kidney Disease (CKD)  

In serious conditions, a medical condition known as Chronic Kidney Disease/CKD can damage your body’s ability to filter out waste.[2] When that happens, toxins build up inside of it. For some people, their breath smells like urine or parents notice that their child’s breath smells like urine. In children, it’s usually due to some type of kidney dysfunction. CKD can also happen in adults over years of alcohol use or abuse. However, it can also be impacted by things like blood pressure or cholesterol problems.[3]

Symptoms

Typical symptoms of kidney failure include ammonia breath, dizziness, swelling in the extremities, nausea, pain in your side or back, and shortness of breath.

Treatment

Kidney disease treatments are based around what’s specifically causing the problem. This could be an alcohol dependency. Additionally, a low-protein diet is recommended. Your physician will prescribe medication to help regulate things like swelling and blood pressure to reduce the strain on your kidneys.

5) Uremia 

Along the lines of kidney disease is uremia, which is the final stage of kidney failure. If someone has uremia, their kidneys are no longer functioning properly and are not filtering out waste. As a result, that waste builds up inside of the body instead of normally being excreted in the urine. When that happens, your body can give off nitrous compounds that smell like ammonia and urine.

Symptoms

People who have uremia tend to see symptoms like nausea, itchy sensations, food aversions and loss of appetite, fatigue, weight loss, difficulty concentrating, and nerve damage that causes pain, numbness, or cramps.[4]

Treatment

Usually the treatment for uremia is what’s causing it, such as diabetes or high blood pressure. However, most people experiencing advanced stages of kidney failure will also need dialysis (which is where your blood is filtered to remove all of the toxins, then put back into your bloodstream.)

6) Urinary Tract Infections 

UTIs are also tied to your kidney health. If you’re prone to getting urinary tract infections, it may also cause bad breath. Because remember, if ammonia levels get too high, it can cause your breath to smell like pee.

Symptoms

If you have a UTI, the way your breath smells is probably the last thing on your mind. Urinary tract infections can cause severe pain and burning when you urinate, a fever, and constantly feeling like you need to use the restroom. It can also lead to concentrated, strong-smelling urine.

Treatment

Some people treat their UTIs with things like cranberry juice or cranberry capsules. The best thing to do is drink tons of water to stay hydrated and flush everything out. If your UTI is severe, your doctor may need to prescribe antibiotics.

When To See A Dentist

Based on the common causes we just covered, if you’re fairly certain that your breath smells like urine and dietary changes or oral hygiene doesn’t help, then it’s time to see a doctor about it. Especially if it’s something that’s a fairly significant change or extremely noticeable, like when your child’s breath smells like urine and you know it didn’t used to.

Chances are that your doctor will want to run some bloodwork or other types of tests to check your kidneys and GI tract. They might even refer you to a specialist such as a hematologist, endocrinologist, or gastroenterologist based on what their findings are.

On the other hand, if your breath improves with better oral hygiene and dietary changes, there’s probably nothing to panic about. But it never hurts to talk to your primary care physician, and you should be having annual well-checks anyway (just like you’re supposed to have checkups with the dentist and hygienist!) so be sure to mention it during your next appointment.

How To Treat Bad Breath At Home

Let’s say that the reason your breath smells like urine is because of what’s inside of your mouth, rather than a serious medical condition. If that’s the case, here are some super-effective ways to help manage halitosis and keep your breath fresh on an everyday basis:

  • brush twice a day for at least two minutes
  • floss daily to clean under the gums and between teeth, where plaque likes to hide
  • consider using a water flosser to reach deep gum pockets or areas where flossing can’t get to
  • use a tongue scraper to clean hidden bacteria out from between the tiny papillae all over your tongue’s surface (FYI: that’s where about 90% of “bad breath bacteria” hideout inside of your mouth)
  • use alcohol-free mouthwash, since alcohol can dry out your mouth and make breath worse
  • avoid mints or gums that contain sugar, since sugar feeds bacteria
  • schedule regular dental cleanings to prevent tartar buildup and gum disease

Remember, you can also combat issues like nasal drainage or congestion with an over-the-counter decongestant to help prevent bad breath. But decongestants can dry you out – just like mouth breathing or drinking alcohol – which alter your normal oral flora, so keep your mouth lubricated by drinking plenty of water. If you suffer from tonsillitis, make sure to gargle with warm salt water to help manage tonsil stones

Overcoming Breath That Smells Like Urine

If you’re freaking out because your breath smells like urine, or your child’s breath smells like urine, your dentist and doctor can help you figure out why. The good news is that it could be an easy fix like changing your oral hygiene routine or snacking habits.

The bad news is that it could be something serious like kidney disease. Then there’s all those “in-betweens” like nasal congestion, keto diets, and other causes. A process of elimination can help you figure out your most likely causes before you schedule embarrassing medical appointments or tests. Just don’t ignore the warning signs! Your health could depend on it.

Related Articles


Scalloped Tongue

7 Reasons For A Scalloped Tongue & Treatments

fluoride treatment at the dentist young woman

How Long After Fluoride Treatment Can I Eat?

dying dead tooth

5 Signs Your Tooth Is Dead & What To Do About It 

toothpaste tube and toothbrush

Sodium Fluoride vs. Stannous Fluoride | Which Is Best?

woman drink with a straw

Is Drinking Through A Straw Good Or Bad For Your Teeth?

woman mouth with bleeding gums during teeth brushing

9 Ways To Stop Bleeding Gums From Brushing Teeth

young woman with toothache with purple background

15 Reasons Why Your Teeth Hurt & What To Do About It

dental curing light on patient

Teeth Bonding: What To Expect & Dental Bonding Cost

gum graft procedure

Gum Graft Explained & What to Expect

watermelon gummy candies

7 Reasons Why Your Teeth Hurt When Eating Sweets Or Sugar

baby with teething fever Close-up mother's hand holding thermometer

Parents Guide for Teething Fever: How Long Does It Last & Treatments

white tongue with bumps

11 Reasons For A White Tongue & Treatments