Persistent bad breath (halitosis) is far more common than people admit, and in nine cases out of ten it starts in the mouth. That is good news, because a dental cause is a fixable cause. Mints and mouthwash cover the smell for an hour or two; finding what is producing it makes it go away.
Where bad breath comes from
The smell is produced by bacteria breaking down proteins, releasing sulphur compounds. Those bacteria thrive in places that are hard to clean and short of oxygen:
- Beneath the gum line, in the pockets that form with gum disease. This is the most common cause of persistent bad breath in adults.
- On the back of the tongue, where a coating of bacteria and food debris builds up and is rarely brushed.
- Around decayed teeth, broken fillings and infected gums, which trap food and bacteria.
- Under poorly fitting dentures or around crowded teeth.
A dry mouth makes everything worse, because saliva normally washes bacteria away. Mouth breathing, some medications, dehydration and alcohol-based mouthwashes all reduce saliva. Diet plays a part too: garlic, onions, coffee and very low-carbohydrate diets each have a recognisable effect.
Genuinely non-dental causes, such as sinus infections, tonsil stones, acid reflux or other medical conditions, are the exception rather than the rule. If we cannot find a cause in your mouth we will say so and point you towards your GP.
How we assess it
At an Oral Health Assessment we look for the usual suspects in order: the health of your gums and the depth of any pockets, tongue coating, decay, failing fillings, dry mouth and anything that traps food. It takes a few minutes and we will tell you plainly what we think is causing it.
Treatment
Treatment follows the cause. Where gum disease is behind it, a professional clean or Gum Disease Treatment removes the bacteria that produce the smell, and the difference is usually noticeable within days. Decay and broken fillings are repaired. If the tongue is the main source, a tongue scraper used each morning makes a surprising difference. For dry mouth we look at the likely cause and suggest ways to keep saliva flowing.
Whatever the cause, cleaning between your teeth every day matters more than any mouthwash, because the bacteria that cause bad breath live in the places a toothbrush cannot reach.
Home habits that help
- Clean between your teeth daily with interdental brushes or floss
- Gently scrape or brush the back of your tongue each morning
- Drink water through the day and avoid letting your mouth dry out
- Choose an alcohol-free mouthwash if you use one; alcohol dries the mouth
- Keep up with hygiene appointments so tartar never builds up
