Halitosis is usually caused by oral bacteria producing odorous compounds on the tongue, teeth and in plaque, often worsened by dry mouth, smoking, certain foods and some medications. Effective first-line steps are twice-daily brushing, daily flossing, tongue cleaning, staying hydrated, using appropriate mouthwashes, and quitting tobacco. Persistent bad breath warrants dental evaluation and possibly medical referral for sinus, tonsil or systemic causes.
What causes bad breath?
Bad breath (halitosis) most often comes from the mouth. Bacteria on the tongue, between teeth and in dental plaque produce volatile sulfur compounds (VSCs) and other odorous chemicals. A dry mouth (xerostomia) - common on waking or caused by some medications - lets these compounds accumulate and makes breath worse. Tobacco, certain foods (garlic, onions), and poor oral hygiene also contribute.
Less commonly, chronic sinus infections, tonsil stones, tooth decay, advanced gum disease (periodontitis) or systemic conditions such as uncontrolled diabetes, liver or kidney disease can produce persistent bad breath. If basic care doesn't help, these causes should be investigated.
Simple, effective steps you can take today
- Brush teeth twice a day and use fluoride toothpaste. Brushing removes plaque and food particles that fuel odor-producing bacteria.
- Floss once daily. Flossing reaches the debris between teeth where a toothbrush can't.
- Clean your tongue every day. The rough back of the tongue (dorsum) often harbors bacteria. Use a tongue scraper or the toothbrush to gently clean the surface.
- Stay hydrated and manage dry mouth. Sip water, avoid excessive alcohol, and consider sugar-free gum or lozenges (xylitol-containing products can stimulate saliva) after meals to increase saliva flow.
- Choose mouthwashes wisely. Antibacterial rinses can lower bacterial load and reduce VSCs. Avoid relying on alcohol-containing rinses if you have chronic dry mouth; your dentist can recommend appropriate products, including prescription rinses when needed.
- Try a warm saltwater gargle for temporary relief from post-nasal drip or throat secretions. Rinse and spit - do not swallow.
- Eat crunchy fruits and vegetables (apple, celery) and herbs (parsley, mint) as short-term breath fresheners; they can help remove debris and stimulate saliva but won't solve an underlying problem.
- Quit tobacco. Smoking both causes and masks bad breath and increases gum disease risk.
When to see a professional
If bad breath persists despite good daily oral care, make an appointment with your dentist. Persistent halitosis can signal gum disease, tooth infections, or other oral health problems that require treatment. If your dentist rules out oral causes, they may refer you to an ENT specialist or your primary care provider to check for sinus disease, tonsil stones or systemic conditions (for example, uncontrolled diabetes).
Addressing halitosis usually starts with simple hygiene changes. If those don't work, timely professional evaluation can identify and treat less common - but important - underlying causes.