Where bad breath comes from
Most bad breath starts in your mouth. Cleveland Clinic and Mayo Clinic both say poor oral hygiene is the main cause. When food bits, plaque and bacteria stay on your teeth, gums and tongue, the bacteria give off smelly gases. Doctors call this halitosis.
That is good news, because it means the fix is often in your hands. Cleaning the right places, every day, takes care of most cases. A simple test: lick the inside of your wrist, let it dry a few seconds and smell it. Or floss and smell the floss. It is hard to judge your own breath, so these checks help. A mint or a stick of gum only hides it for a short time.
Bad breath is not a sign of poor character. Nearly everyone has it at times. Morning breath happens because your saliva slows down overnight. That is normal and goes away after you brush and drink water.
The most common causes
Bad breath has a few usual suspects:
Plaque and food stuck between teeth.
Bacteria on the back of the tongue. The tongue has a rough surface where bacteria hide.
Gum disease. Pockets under the gums trap bacteria that smell. Persistent bad breath is a common sign of gingivitis and periodontitis.
Dry mouth. Saliva washes your mouth clean. When there is less of it, odor builds up. Mouth breathing, some medicines and morning hours all dry the mouth.
Strong foods, such as garlic and onions. Their smell reaches your lungs and comes out with each breath until the food is gone.
Smoking and tobacco, which leave their own odor and raise the risk of gum disease.
Tooth decay, abscesses and dentures that do not fit well.
Tonsil stones, small white lumps that can form in the back of the throat.
Less often, bad breath comes from outside the mouth. Sinus or throat infections, acid reflux, and conditions such as diabetes, liver disease or kidney disease can play a role. These are far less common than mouth causes.
Fasting, crash diets and very low-carb diets can cause a fruity or metallic breath odor. Drinking enough water and eating regular meals helps. If you notice a fruity smell and you have diabetes, tell your doctor right away, because it can be a sign of a blood sugar emergency.
What to do every day
Give your routine a few weeks. Bacteria on the tongue and between the teeth take time to settle down. Stick with brushing, flossing and tongue cleaning, and you should notice a difference. A hygienist can show you where you are missing spots.
These habits fix most bad breath:
- Brush twice a day for two minutes, including along the gum line
- Floss or use interdental brushes once a day. Bacteria between teeth cause much of the smell.
- Clean your tongue. Brush it gently or use a tongue scraper, going from back to front. Do not go so far back that you gag.
- Drink water through the day, especially if your mouth is dry
- Chew sugar-free gum, which boosts saliva
- Clean dentures, retainers and night guards as directed. Take dentures out at night.
- Skip tobacco
- Replace your toothbrush every three to four months
What about mouthwash?
A mouthwash can help in the short term, but it is not a fix on its own. Mayo Clinic says rinses that only mask odor do not treat the cause. Some rinses contain antibacterial ingredients that cut down on odor-causing bacteria. Your dentist can suggest one that suits you.
Be careful with rinses that contain alcohol. They can dry out your mouth, which can make the problem worse over time. If your mouth feels dry, ask about an alcohol-free option.
Never use mouthwash to cover up a problem that keeps coming back. If your breath stays bad after good cleaning, something else is going on.
Zinc and cetylpyridinium chloride are ingredients you may see on labels of rinses made to fight odor. They may help some people. Always check that a product carries the American Dental Association Seal of Acceptance, and ask your dentist if you are not sure.
Gum disease and bad breath
If you brush and floss well and your breath still smells, gum disease is a likely reason. Bacteria that live in deep pockets around the teeth give off a strong odor, and you cannot reach them with a brush. Signs to watch for: bleeding when you brush or floss; red, swollen or tender gums; gums that look like they are pulling away from the teeth; a bad taste that does not go away; loose teeth.
A professional cleaning removes the tartar and bacteria that home care misses. For gum disease that has moved deeper, a deep cleaning called scaling and root planing treats the roots and pockets. Some people simply build plaque faster than others and need cleanings more often than twice a year.
When to see a dentist, and when to see a doctor
See a dentist if your breath is bad for more than a couple of weeks even after you improve your cleaning habits. Your dentist can check for gum disease, cavities, abscesses and dry mouth, and can tell you what they find.
If your dentist finds nothing in your mouth, talk to your primary care doctor. They can look for causes elsewhere in the body, such as sinus issues, reflux or other conditions. Mayo Clinic says to see a doctor if the dentist does not find the cause.
See someone sooner if bad breath comes with a fever, swelling, trouble swallowing or sudden weight loss. Those can mean a more serious problem.
Bring a list of your medicines. Many common ones, including some for allergies, blood pressure and depression, cause dry mouth. If a medicine is the cause, your doctor may be able to adjust it. Do not stop a prescription on your own.
Help for bad breath at KDA
At Kendall Dental Associates, a routine cleaning is an hour with one of our hygienists. That is time enough to clean carefully, look at your gums and tongue and talk with you about what you notice. If bad breath is why you came, tell us. We will check for the causes that dentists can treat and explain what we find in plain words.
You do not have to be embarrassed. Bad breath is common, and it is very treatable. Call 305-271-1421 to book a visit. We are at 8833 SW 107th Ave in Miami, in the Kendall Mall, open Monday to Friday, 8:00 AM to 5:00 PM. We accept most dental insurances and most Medicare supplemental plans, and financing is available.
Common questions
Why does my breath smell even after I brush?
Bacteria on your tongue and between your teeth may not be getting cleaned. Gum disease, dry mouth and tonsil stones are other common reasons. A dentist can find the cause.
Does bad breath come from the stomach?
Sometimes, but it is not common. Most bad breath starts in the mouth. Acid reflux can contribute in some people.
Is bad breath a sign of gum disease?
It can be. Persistent bad breath, with bleeding or red gums, is a common sign of gum disease.
How do I check my own breath?
Lick your wrist, let it dry a few seconds and smell it. You can also floss and smell the floss. A trusted friend can also tell you honestly.
How long does it take to get rid of bad breath?
If plaque and the tongue are the cause, good daily cleaning can help within days. If gum disease is the cause, it takes professional treatment first.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: my.clevelandclinic.org, mayoclinic.org, mayoclinic.org.