Bad breath: what causes it and what helps

What causes bad breath?

Morning breath is normal. Saliva slows down while you sleep, bacteria build up overnight, and brushing and breakfast clear it. Breath that stays bad through the day is different.

Most lasting bad breath starts in the mouth, where bacteria break down bits of food and dead cells and give off smelly gases. Where those bacteria gather is usually where the problem is:

• The tongue, especially toward the back, where a coating builds up.
• Gum disease, where bacteria collect in pockets below the gum line.
• A dry mouth. Saliva rinses the mouth, so anything that dries it out, from some medications to breathing through your mouth, lets odor build.
• Garlic, onions and other strong foods, whose smell lingers whatever you do.
• Tobacco, which has its own smell, dries the mouth and worsens gum disease.
• Food trapped in a cavity, at the edge of an old filling or crown, or under a denture.

What helps at home

Mouthwash covers bad breath for a while but does not fix what is causing it. These habits deal with most of the common causes:

• Clean your tongue every day with a scraper or your toothbrush, back to front.
• Floss or use small brushes between the teeth once a day.
• Brush twice a day, along the gum line as well as the teeth.
• Drink water through the day, especially if your mouth feels dry.
• If you wear a denture, clean it every day and take it out at night unless we have told you otherwise.

When should you see a dentist?

If it has been a while since your last cleaning, that alone is a good reason to come in, and nobody here is going to make you feel bad about it. Come in sooner if:

• Your breath stays bad despite good cleaning at home.
• Your gums bleed, look swollen or are receding. Our guide to bleeding gums explains why that matters.
• There is a bad taste that keeps coming back.
• A tooth hurts, or food keeps catching in the same place.
• Your mouth feels dry most of the time.

What we check

At a visit to the office in Pearisburg, we look for the causes that live in the mouth. We measure the gums for pockets, look for decay, and check old fillings and crowns for gaps or rough edges that trap food. If you wear a denture, we check its fit and condition and the gums underneath. We look at your tongue and throat too, and ask about your medications, since many of them cause a dry mouth.

Whatever we find, we explain it and show you on the screen, along with what fixing it involves. Sometimes a thorough cleaning is all it takes.

When the cause is not in your mouth

Sometimes the teeth and gums are healthy and the breath still does not improve. Then the cause may be the sinuses, the tonsils (including small stones that can form in them), or a medical condition. When that seems likely, we will say so and suggest you see your physician, rather than keep treating a mouth that is not the problem.

It is worth telling your physician too if bad breath comes with other symptoms, such as a blocked nose, a sore throat that will not clear, or heartburn.

Questions patients ask