Bad Breath: The Real Causes and How to Fix It

Bad breath is the problem nobody asks a friend about, which is why so many people manage it with mints for years without ever finding out what is causing it. Almost always the answer is in the mouth, and almost always it is fixable.

The short answer

The large majority of persistent bad breath, or halitosis, comes from bacteria in the mouth breaking down proteins and releasing sulphur compounds. The commonest single source is the back of the tongue, not the teeth. Gum disease and dry mouth are the next most likely causes. Mints and mouthwash mask the smell for twenty minutes; cleaning the source deals with it.

Where it actually comes from

• The back of your tongue. The rough surface traps bacteria and debris, and this is the origin of most cases. It is also the bit almost nobody cleans. A tongue scraper or the back of your toothbrush, used gently as far back as you can comfortably reach, makes more difference than any mouthwash.
• Gum disease. Inflamed gums and the pockets that form around teeth harbour exactly the bacteria that produce the worst odours. If your gums also bleed when you brush, that is very likely your answer.
• Dry mouth. Saliva is your natural rinse. Anything that reduces it makes breath worse, which is why it is worst first thing in the morning. Common culprits are many prescription medications, alcohol, mouth breathing, snoring and simply not drinking enough water.
• Food trapped between teeth or under a bridge. A single stagnant spot can be the whole problem, and it is often somewhere you have stopped cleaning because it is awkward.
• Decay, a failing filling or an infection. A cavity or a dying nerve gives a distinctive smell and a bad taste, and needs treating rather than managing.
• Smoking. Directly, and also by drying the mouth and accelerating gum disease.
• Things that are not the mouth. Tonsil stones, sinus and throat infections, acid reflux and, uncommonly, diabetes, liver or kidney problems. Worth raising with your GP if your mouth is genuinely healthy and the problem persists.

What genuinely helps

• Clean your tongue daily. If you do one new thing, do this one.
• Clean between all your teeth once a day with interdental brushes or floss. Brushing alone leaves the surfaces where odour-producing bacteria concentrate.
• Drink more water, and keep sipping through the day if you take medication that dries your mouth.
• Chew sugar-free gum after meals. It stimulates saliva, which is doing the real work.
• Choose an alcohol-free mouthwash if you use one at all. Alcohol dries the mouth, which can make things worse over time. Use it between brushings, never straight after, as it washes away the concentrated fluoride.
• Get any gum inflammation properly treated. A hygiene appointment removes the hardened deposits you cannot shift at home.

How to tell whether you actually have it

You cannot smell your own breath reliably, because you are acclimatised to it, and cupping your hand tells you almost nothing. A better test is to lick the back of your wrist, let it dry for ten seconds and smell it, or to scrape the back of your tongue and smell the scraper. Failing that, ask someone you trust to be honest.

Equally worth knowing: some people are convinced they have bad breath when they do not. If you have had it checked and been told your mouth is healthy, that is worth believing.

What it costs to get to the bottom of it

A new patient examination is £89 including X-rays, which finds decay, failing fillings and gum pockets, the three dental causes worth ruling out first. Hygiene appointments are £60 for twenty minutes or £89 for thirty, with Airflow as a £20 add-on. Full prices are on our fees page.

Frequently asked questions

Why is my breath worse in the morning?

Saliva production drops while you sleep, so bacteria multiply undisturbed for seven or eight hours. Morning breath is normal and it clears once you brush, clean your tongue and have a drink. Persistent bad breath through the day is the kind worth investigating.

Does mouthwash cure bad breath?

No. It masks it, usually for less than an hour, and an alcohol-based one can leave your mouth drier and the problem slightly worse. Mouthwash is a useful extra alongside brushing and interdental cleaning, never a substitute for them.

Can bad breath come from my stomach?

Far less often than people assume. Acid reflux can contribute, but the digestive system is normally closed off from the mouth, so the stomach is rarely the source. Look in the mouth first.

My teeth are fine but my breath is not. What now?

Then the likely candidates are the tongue, dry mouth, or something outside the mouth such as tonsil stones or sinus trouble. Come and let us confirm the mouth is genuinely healthy, because that narrows it down considerably, and then it becomes a conversation with your GP.

If what you notice is a persistent taste rather than a smell, that narrows things down differently, and our guide to a bad taste in the mouth covers what each flavour tends to point to.

It is a more common reason for booking than you would think, and nobody here will make it awkward. Call us on 01625 574609.

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