Getting to the Root of Bad Breath

Good dental hygiene should help you clear up a bad case of halitosis. But what's causing your stinky breath in the first place?

By Lynn Yoffee

Medically reviewed by Cynthia Haines, MD

If you're constantly popping mints or chewing gum to cover up bad breath, you're not alone. One in four Americans has halitosis and is cursed with smelly breath.

Why? Most cases of halitosis are caused by improper dental hygiene. If you don't brush and floss your teeth after every meal, bits of food that get stuck in your teeth and gums and on your tongue will begin to decay and emit foul odors.

An unclean mouth also means that bacteria can grow, potentially leading to gum disease, which is also one of the causes of bad breath. In addition, certain foods and drink are more likely to cause bad breath, including:

• Garlic
• Onions
• Cheese
• Orange juice
• Soda, including diet varieties

After these foods or drinks are digested, their oils make their way into your bloodstream and are then carried into your lungs. The odor is then released through your breath.

Other Causes of Bad Breath

Aside from what you eat and drink, bad breath can also be linked to:

• A dry mouth. Saliva is your mouth's natural cleanser, so when your mouth is dry, dead cells can build up, which is what causes morning breath. This is an even bigger problem if you sleep with your mouth open. Smoking and certain medications can also cause dry mouth. In more extreme cases, you could have a problem with your salivary glands that leaves your mouth unusually dry.
• Chronic diseases. Sometimes underlying health conditions can cause bad breath. Lung infections, cancers, kidney or liver failure, diabetes, and gastroesophageal reflux disease (GERD), for example, are all associated with halitosis.
• Respiratory, mouth, throat, and nose conditions. These conditions are also often associated with bad breath. For example, discharge from a sinus infection is known to cause bad breath. If you have an upper respiratory infection such as bronchitis, the sputum coughed up can also cause halitosis.
• Tobacco products, particularly smoking. Tobacco products can dry your mouth and result in bad breath. People who use tobacco are also at greater risk of developing gum disease, poor general oral health, and oral cancers.
• Malnutrition. Starvation or intense dieting can result in bad breath due to ketoacidosis, which is a breakdown of chemicals that occurs during fasting.

Beating Bad Breath

To combat bad breath, try the following:

• Avoid foods and beverages that you know cause bad breath; this may also mean minimizing your intake of alcohol.
• Brush for two to three minutes after every meal and floss your teeth at least once a day.
• Brush your tongue gently to remove dead cells, including the back of your tongue, because that's where bacteria often collect.
• Drink lots of water to keep your mouth moist and clean. And water really is what's best here: Other beverages, particularly caffeinated beverages, don't work as well as water for halitosis treatment and prevention.
• Eat less meat and more vegetables and fruits each day.
• Get dental checkups at least twice a year that include an exam and cleaning.
• If you wear dentures, bridges, or removable braces, clean them thoroughly at least once a day.
• Suck candy or chew gum (preferably sugarless) to stimulate saliva production, which helps wash away food particles and bacteria.

When to See Your Dentist About Bad Breath

If you still feel like you have bad breath after trying these tips, ask someone who is close to you for confirmation. Sometimes, you really are your own worst critic. If it is indeed an issue, make an appointment with your dentist to try to uncover what could be causing your bad breath.

Avoid drinking, eating, chewing gum, or brushing your teeth before your dental appointment. Skip the perfume or other scented products too, so that your dentist can truly assess your halitosis. Your dentist will likely ask you a number of questions, ranging from your dental hygiene habits to your general health.

In some cases, halitosis may be due to a buildup of plaque, which is a layer of bacteria on your teeth. If this is the case, the dentist may have you use a special antimicrobial mouth rinse.

---

---

If your dentist determines that the bad breath is due to gum disease, you'll be treated or referred to a gum disease doctor, called a periodontist. Also called periodontal disease, gum disease causes your gums to recede from the teeth and leaves pockets that gather bacteria and plaque. A periodontal cleaning, or more extensive treatment, may be needed.

If your dentist isn't able to uncover the reason for your bad breath, a trip to your primary care doctor for a physical exam would be the next step to determine the underlying causes of your bad breath.