Breath odor affects everyone at some point. Bad breath is also known as halitosis or fetor oris. Odor can come from the mouth, teeth, or as a result of an underlying health problem.
Bad breath odor can be a temporary problem or a chronic condition. According to the American Dental Association, at least 50 percent of adults have had halitosis in their lifetime.
In addition to a bad smell, you may also notice a bad taste in your mouth. If the taste is due to an underlying condition and isn’t because of trapped food particles, it may not disappear — even if you brush your teeth and use mouthwash.
Poor dental hygiene
Bacteria breaks down food particles trapped in the teeth or mouth. The combination of the bacteria and decaying food in your mouth produces an unpleasant odor. Brushing and flossing regularly removes trapped food before it decays.
Brushing also removes plaque, a sticky substance that builds up on your teeth and causes odor. Plaque buildup can cause cavities and periodontal disease. Bad breath also can be a problem if you wear dentures and don’t clean them every night.
Strong foods and beverages
When you eat onions, garlic, or other foods with strong odors, your stomach absorbs oils from the foods during digestion. These oils pass into your bloodstream and travel to your lungs.
This produces an odor that others can notice in your breath for up to 72 hours. Drinking beverages with strong odors, such as coffee, can also contribute to bad breath.
Dry mouth can also occur if you don’t create enough saliva. Saliva helps keep your mouth clean and reduces odor.
Dry mouth can be a problem if you have a salivary gland condition, sleep with your mouth open, or take certain medications, including those that treat high blood pressure and urinary conditions.
Periodontal disease, or gum disease, happens when you don’t remove plaque promptly from teeth. Over time, plaque hardens into tartar. You can’t remove tartar by brushing, and trying to do so further irritate your gums.
Tartar may cause pockets, or small openings, to form in the area between the teeth and gums. Food, bacteria, and dental plaque can collect in the pockets, causing a strong odor.
Sinus, mouth, or throat conditions
Bad breath odor may develop if you have:
- a sinus infection
- postnasal drainage
- chronic bronchitis
- an infection in your upper or lower respiratory system
Tonsil stones, which tend to collect bacteria, can also be a source of bad breath.
Unusual breath odor can be a symptom of some diseases. This includes:
- kidney disease or failure
- liver disease or failure
- sleep apnea
- gastroesophageal reflux disorder (GERD), which is a relatively common cause of halitosis
Tell by the smell
If you have kidney or liver failure or diabetes, your breath may smell fishy. When your diabetes isn’t under control, your breath may smell fruity.
Your dentist will smell your breath and ask you questions about your problem. They may recommend you schedule an appointment for the morning, before you brush your teeth.
You can expect to answer questions regarding how often you brush and floss, the kinds of food you eat, and any allergies or diseases you may have. Tell your doctor how often you snore, what medications you take, and when the problem started.
To diagnose what’s causing your bad breath, your doctor will smell your mouth, nose, and tongue to try to determine the source of the odor.
If the odor doesn’t seem to be coming from your teeth or mouth, your dentist will recommend that you visit your family doctor to rule out an underlying disease or condition.
If breath odor is due to a plaque buildup, a dental cleaning may solve the problem. A deep dental cleaning may be necessary if you have periodontal disease.
Treating underlying medical problems, such as a sinus infection or kidney disease, can also help improve breath odor. Your dentist may recommend that you use an artificial saliva product and drink plenty of water if dry mouth causes your odor problem.
You should brush your teeth twice a day (while taking care not to overbrush).
Floss daily, making sure to get in between all of your teeth. Use antimicrobial mouthwash daily to kill bacteria. Brushing your tongue with a toothbrush or tongue scraper can also help remove bacteria.
Staying hydrated can often help to eliminate or prevent breath odor. Drink water to wash away food particles and keep your mouth moist. If you smoke, quitting can also help keep your mouth moist and free of odor.
There are several routines that can help prevent breath odor:
- Clean your dentures, mouth guards, and retainers daily.
- Replace your old toothbrush with a new one every 3 months.
- Schedule a dental cleaning and examination every 6 months.
- American Academy of Family Physicians. (2019). Halitosis. familydoctor.org/familydoctor/en/diseases-conditions/halitosis.html
- American Dental Association. (n.d.). Halitosis. http://www.mouthhealthy.org/en/az-topics/h/halitosis
- American Dental Association. (n.d.). Bad breath: 6 causes (and 6 solutions). https://www.mouthhealthy.org/en/az-topics/b/bad-breath
- Kapoor U, et al. (2016). Halitosis: Current concepts on etiology, diagnosis and management. https://doi.org/10.4103/1305-7456.178294
- Krishnan ST, et al. (2016). Recent analytical approaches to detect exhaled breath ammonia with special reference to renal patients. https://doi.org/10.1007/s00216-016-9903-3
- Ontario Dental Association. (2020). Tips for fresh breath. https://www.youroralhealth.ca/personal-oral-care/tips-for-fresh-breath
- Torsten M, et al. (2017). Drug-related oral malodour (halitosis): a literature review. http://www.europeanreview.org/wp/wp-content/uploads/4930-4934-Drug-related-oral-malodour-halitosis-a-literature-review.pdf
- Villa A, et al. (2014). Diagnosis and management of xerostomia and hyposalivation. https://doi.org/10.2147/TCRM.S76282