Bad Breath: Common Causes and How to Fix It

Almost everyone has bad breath sometimes, especially first thing in the morning or after garlic and coffee. But when it hangs around no matter what you do, it can be embarrassing and frustrating. The encouraging news is that persistent bad breath, called halitosis, usually has a clear cause, and in most cases that cause is in the mouth.

Where bad breath comes from

Bacteria in the mouth break down food particles and proteins and release sulfur compounds with a strong, unpleasant smell. The more bacteria and leftover debris, the stronger the odor. The most common sources are:

• The tongue. The back of the tongue is rough and traps bacteria and debris. It's one of the biggest contributors to bad breath.
• Plaque between teeth. Food and plaque left between teeth, where a toothbrush can't reach, break down and smell.
• Gum disease. Bacteria in pockets below the gumline produce persistent odor. If your gums bleed or look puffy, this may be the cause. Our post on signs of gum disease explains what to look for.
• Dry mouth. Saliva rinses away bacteria. When your mouth is dry, from medications, mouth breathing, dehydration or simply sleep, odor builds up. That's why morning breath is so common.
• Cavities and old dental work. Decay, broken fillings and gaps under crowns or bridges can trap bacteria.
• Food and drinks. Garlic, onions, coffee and alcohol cause temporary odor.
• Tobacco. Smoking and vaping cause their own odor and also dry the mouth and harm the gums.

When the cause is outside the mouth

Less often, bad breath is linked to something elsewhere: sinus infections or postnasal drip, tonsil stones, acid reflux, or certain medical conditions such as uncontrolled diabetes. If your dentist rules out dental causes, it's worth talking with your doctor.

What helps at home

• Brush twice a day for two minutes, including along the gumline.
• Clean your tongue every day with a tongue scraper or your toothbrush, working from back to front.
• Clean between your teeth daily with floss, interdental brushes or a water flosser.
• Stay hydrated. Drink water throughout the day, especially if you drink coffee or alcohol.
• Chew sugar-free gum after meals to boost saliva.
• Clean dental appliances. Dentures, retainers, night guards and aligners collect bacteria too; clean them daily.
• Be careful with mouthwash. Many cover up odor for an hour or two without fixing the cause, and alcohol-based rinses can dry your mouth. If you use one, an alcohol-free rinse is usually a better choice.

When to see your dentist

If bad breath continues for more than a couple of weeks despite good home care, it's time for a visit. Also call us if bad breath comes with:

• Bleeding, swollen or receding gums
• A bad taste that won't go away
• A loose tooth or a tooth that hurts
• A sore in your mouth that doesn't heal

How we find and treat the cause

At your visit, Dr. Kour will look for the source: checking your gums, looking for decay or failing dental work, and asking about medications, dryness and other symptoms. Treatment depends on what we find and may include:

• A professional cleaning to remove plaque and tartar
• Treatment for gum disease, such as a deeper cleaning (periodontal care)
• Repairing cavities or replacing worn fillings and crowns
• Recommendations for dry mouth and a home care routine that targets the problem

Breathe easier

Persistent bad breath is common, treatable and nothing to be embarrassed about. We've seen it all, and we're here to help. Request an appointment online or call Zen Family Dental at (703) 385-2772.