Bad Breath: Common Causes and What Dentists Can Do

What causes bad breath?

Most bad breath starts in the mouth. MouthHealthy from the ADA says studies show that 50 percent of adults have had bad breath, or halitosis, at some point in their lives. Cleveland Clinic says the main cause is poor oral hygiene. Without brushing, flossing, and routine cleanings, harmful bacteria invade the mouth and cause bad smells.

Many causes are harmless and short-lived. A few point to a health issue that needs care. This post helps you sort them out. It does not diagnose you. A dentist or doctor does that.

What are the common causes?

Cleveland Clinic and MouthHealthy list these. Your own cause may be one or more of them.

How do you know if you have it?

It is tough to tell by cupping a hand over your mouth. Cleveland Clinic says it is better to ask someone you trust. It also offers a rule of thumb. If you have a bad taste in your mouth, you probably have bad breath that others can smell.

Smokers may not notice, since MouthHealthy says smoking affects your sense of smell. Chronic bad breath may smell like fish or rotten eggs, per Cleveland Clinic, and smells can range from sour to unpleasantly sweet. A dentist can tell more from an exam.

What can you do at home?

Cleveland Clinic and MouthHealthy suggest these steps:

1. Brush twice a day and floss once a day.
2. Clean your tongue with a tongue scraper. See tongue scraper in our glossary.
3. Clean retainers and dentures as directed. If you wear removable dentures, take them out at night and clean them well.
4. Rinse with an alcohol-free antibacterial mouthwash. MouthHealthy says over-the-counter mouthwashes can kill bacteria or neutralize and temporarily mask bad breath, so treat a rinse as a short-term aid.
5. Drink water and chew sugar-free gum to help your mouth make more saliva.
6. Skip tobacco, and limit alcohol and caffeine that can dry your mouth.
7. See your dentist regularly for cleanings.

Mints and mouthwashes may cover the smell, says Cleveland Clinic, but it does not go away until the compounds leave your system.

What about dry mouth?

Saliva washes out your mouth. NIDCR explains that saliva moistens food, washes away food particles from the teeth and gums, and contains minerals that help keep teeth strong. When there is too little, bacteria thrive. Hundreds of medicines can cause dry mouth, per NIDCR, including some for high blood pressure, depression, and bladder control. NIDCR also notes that dry mouth is not a normal part of aging.

Do not stop a medicine because of dry mouth. Talk with your doctor and dentist instead. Our post on dry mouth causes and fixes covers the topic in more detail.

Can bad breath come from outside the mouth?

Yes. Cleveland Clinic lists several causes beyond the teeth and gums: tonsil stones, infections in the nose, throat, or lungs, diabetes, acid reflux, head and neck cancers, and kidney or liver disease. MouthHealthy also lists sinus conditions. This is why a dentist who finds a healthy mouth will point you to your doctor for the next step.

What can a dentist do about bad breath?

A dentist can find out whether the cause is in your mouth. Cleveland Clinic says a dentist can diagnose oral issues that cause halitosis by smelling your breath and doing a dental exam. Then the plan depends on what is found.

• A cleaning. If plaque buildup is the cause, a dental cleaning and better home care will likely help, per Cleveland Clinic. Some people build up plaque faster than others and may need more frequent cleanings.
• Gum care. If gum disease is the source, the dentist can talk with you about treatment. Read about teeth cleaning and our gum disease guide.
• A mouth rinse. Cleveland Clinic says dentists may occasionally recommend special rinses, and the kind that kills bacteria is the one that addresses the issue.
• A referral to your doctor. If your dentist finds no oral cause, your primary care physician can look for another one.

When should you call?

Call your dentist if you practice good hygiene and still have bad breath, or if it lasts. Cleveland Clinic says if it does not get better despite changes you make, it is time to see a dentist. Bad breath along with swollen, bleeding gums or loose teeth is a reason to book soon. MouthHealthy says gum disease usually does not hurt, so a bad taste or breath that will not go away can be the first sign you notice.

Next step

Learn about teeth cleaning at Town Center Dental, then call (636) 273-5866 or request an appointment if bad breath will not go away.